WHO Moves to Phase 5: Pandemic

[ghostship]

04/29/2009 16:07 *DJ WHO Chan: Pandemic Level Now 5

[medstudent55]

It is official. We are at phase 5.

[Jeremy]

Being reported on TV

[hawkeye]

mpoppel All countries should immediately pandemic preparedness plan

[pablomorgan]

Who site still says 4. i bet it changes and makes a liar of me by the time you look.
http://www.who.int/csr/disease/swineflu/en/index.html

[Tea]

Current WHO phase of pandemic alert

Still shows level 4. Although the site just went down for me. Everyone must be checking.

[hawkeye]

mpoppel WHO's Chan: Higher alert is signal to governments, pharma industry and usiness community to take action

[AlaskaDenise]

MSNBC put up the biggest red banner at the page top - you cannot miss it.

.

[sharon sanders]

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

[hawkeye]

mpoppelChan: Current WHO antiviral stocks are not enough, need more donations from companies and government donor support.

[Tea]

I had it handy from posting in another forum with friends.

WHO raises swine flu alert to 'pandemic level 5'

msnbc.com staff and news service reports
updated less than 1 minute ago

The World Health Organization has raised its pandemic alert for swine flu to the second highest level, meaning that it believes a global outbreak of the disease is imminent.

WHO says the phase 5 alert means there is sustained human-to-human spread in at least two countries. It also signals that efforts to produce a vaccine will be ramped up.

WHO has confirmed human cases of swine flu in Mexico, the United States, Canada, Britain, Israel, New Zealand and Spain. Mexico and the U.S. have reported deaths.

WHO Director-General Margaret Chan made the decision Wednesday to raise the alert level from phase 4 — signifying transmission in only one country — after reviewing the latest scientific evidence on the outbreak.

"It is important to take this very seriously," Chan told a press conference watched around the globe on Wednesday.

As fear and uncertainty about the disease ricocheted around the globe, nations took all sorts of precautions, some more useful than others.

Britain closed a school after a 12-year-old girl was found to have the disease. Egypt slaughtered all its pigs and the central African nation of Gabon became the latest nation to ban pork imports, despite assurances that swine flu was not related to eating pork.

Cuba eased its flight ban, deciding just to block flights coming in from Mexico. And Asian nations greeted returning airport travelers with teams of medical workers and carts of disinfectants, eager to keep swine flu from infecting their continent.

In Mexico City, the epicenter of the epidemic, the mayor said Wednesday the outbreak seemed to be stabilizing and he was considering easing the citywide shutdown that closed schools, restaurants, concert halls and sports arenas.

Swine flu is suspected of killing more than 150 people in Mexico and sickening over 2,400 there.

Nearly 100 cases have now been confirmed in the U.S. across 11 states, and health officials reported Wednesday that a 23-month-old Mexican boy had died in Texas.

Across Europe, Germany confirmed three swine flu cases and Austria one, while the number of confirmed cases rose to five in Britain and ten in Spain.

WHO conducted a scientific review Wednesday to determine exactly what is known about how the disease spreads, how it affects human health and how it can be treated.

Dr. Nikki Shindo, a WHO flu expert, said the review would focus on the large trove of data coming from Mexico and from a school in New York City that has been hard-hit by the outbreak.

Germany’s national disease control center, the Robert Koch Institute, said the country’s three cases include a 22-year-old woman hospitalized in Hamburg, a man in his late 30s at a hospital in Regensburg, north of Munich, and a 37-year-old woman from another Bavarian town. All three had recently returned from Mexico.

Austria’s health ministry said a 28-year-old woman who recently returned from a monthlong trip to Guatemala via Mexico City and Miami has the virus but is recovering.

British Prime Minister Gordon Brown said health officials were ordering extra medicine and “several million more” face masks to deal with the virus.

British media reports, citing an unidentified European surgical mask manufacturer, said the U.K. was seeking 32 million masks to protect its health workers from a possible pandemic.

“We’ve decided to build stocks of anti-virals, from 35 million to 50 million,” Brown said, adding that the government had put in enhanced airport checks and was going to mail swine flu information leaflets to every household in Britain.

In addition to a couple in Scotland who got swine flu on their Mexican honeymoon, new British cases included a 12-year-old girl in the southwest English town of Torbay. Brown said her school had been closed as a precaution.

He said the other two cases were adults in London and in Birmingham. All three had visited Mexico, were receiving anti-viral drugs and were responding well to treatment, Brown said.

French President Nicolas Sarkozy met with Cabinet ministers to discuss swine flu and his health minister said France will ask the European Union to suspend flights to Mexico.

The U.S., the European Union and other countries have discouraged nonessential travel to Mexico. Cuba suspended all regular and charter flights from Mexico to the island but was still allowing airlines to return travelers to Mexico.

New Zealand’s number of swine flu cases rose to 14, 13 of them among a school group that recently returned from Mexico. Officials say the swine flu strain infecting the students is the same as that in Mexico. All were responding well to antiviral drugs and in voluntary quarantine at home.

New Zealand has 44 other possible cases, with tests under way.

Mexico was taking drastic measures to fight the outbreak. It closed all archaeological sites and allowed restaurants in the capital to only serve takeout food in an aggressive bid to stop gatherings where the virus can spread. Schools remained closed until at least May 6.

A regional beach soccer championship in Mexico was postponed and all Mexican first-division soccer games this weekend will be played with no audiences. Cruise lines were avoiding Mexican ports and holiday tour groups are canceling holiday charter flights there.

The Philippine health chief appealed to dozens of Filipino legislators to abandon plans to visit Las Vegas to cheer for boxing idol Manny Pacquiao — even though Las Vegas is more than 300 miles (480 kilometers) from the Mexican border.

Egypt’s government ordered the slaughter of all pigs in the country as a precaution, though no swine flu cases have been reported there. Egypt’s overwhelmingly Muslim population does not eat pork, but farmers raise up to 350,000 pigs for its Christian minority.

In Australia, officials were testing more than 100 people with flu symptoms for the virus and the government gave health authorities wide powers to contain contagious diseases.

“(We can make) sure that people are isolated and perhaps detained if they don’t cooperate and are showing symptoms,” said Health Minister Nicola Roxon.

[Lurker]

GENEVA – The World Health Organization has raised its pandemic alert for swine flu to the second highest level, meaning that it believes a global outbreak of the disease is imminent.

WHO says the phase 5 alert means there is sustained human to human spread in at least two countries. It also signals that efforts to produce a vaccine will be ramped up.

WHO has confirmed human cases of swine flu in Mexico, the United States, Canada, Britain, Israel, New Zealand and Spain. Mexico and the U.S. have reported deaths.

WHO Director-General Margaret Chan made the decision Wednesday to raise the alert level from phase 4 — signifying transmission in only one country — after reviewing the latest scientific evidence on the outbreak.

THIS IS A BREAKING NEWS UPDATE. Check back soon for further information. AP's earlier story is below.

BERLIN (AP) — The World Health Organization warned Wednesday that the swine flu outbreak is moving closer to becoming a pandemic, as the United States reported the first swine flu death outside of Mexico, and Germany and Austria became latest European nations hit by the disease.

In Geneva, WHO flu chief Dr. Keiji Fukuda told reporters that there was no evidence the virus was slowing down, moving the agency closer to raising its pandemic alert to phase 5, indicating widespread human-to-human transmission.

But he said the health body not yet ready to move the pandemic alert level up from its current level of 4, which means the virus is being passed among people. Phase 6 — the highest in the scale — is for a full-scale pandemic.

As fear and uncertainty about the disease ricocheted around the globe, nations took all sorts of precautions, some more useful than others.

Britain closed a school after a 12-year-old girl was found to have the disease. Egypt slaughtered all its pigs and the central African nation of Gabon became the latest nation to ban pork imports, despite assurances that swine flu was not related to eating pork.

Cuba eased its flight ban, deciding just to block flights coming in from Mexico. And Asian nations greeted returning airport travelers with teams of medical workers and carts of disinfectants, eager to keep swine flu from infecting their continent.

In Mexico City, the epicenter of the epidemic, the mayor said Wednesday the outbreak seemed to be stabilizing and he was considering easing the citywide shutdown that closed schools, restaurants, concert halls and sports arenas.

Swine flu is suspected of killing more than 150 people in Mexico and sickening over 2,400 there.

Dr. Richard Besser, the acting chief of the U.S. Centers for Disease Control and Prevention, said 91 cases have now been confirmed in 10 states, and health officials there reported Wednesday that a 23-month-old Mexican boy had died in Texas from the disease.

Across Europe, Germany confirmed three swine flu cases and Austria one, while the number of confirmed cases rose to five in Britain and ten in Spain.

WHO conducted a scientific review Wednesday to determine exactly what is known about how the disease spreads, how it affects human health and how it can be treated.

Dr. Nikki Shindo, a WHO flu expert, said the review would focus on the large trove of data coming from Mexico and from a school in New York City that has been hard-hit by the outbreak.

Germany's national disease control center, the Robert Koch Institute, said the country's three cases include a 22-year-old woman hospitalized in Hamburg, a man in his late 30s at a hospital in Regensburg, north of Munich, and a 37-year-old woman from another Bavarian town. All three had recently returned from Mexico.

Austria's health ministry said a 28-year-old woman who recently returned from a monthlong trip to Guatemala via Mexico City and Miami has the virus but is recovering.

British Prime Minister Gordon Brown said health officials were ordering extra medicine and "several million more" face masks to deal with the virus.

British media reports, citing an unidentified European surgical mask manufacturer, said the U.K. was seeking 32 million masks to protect its health workers from a possible pandemic.

"We've decided to build stocks of anti-virals, from 35 million to 50 million," Brown said, adding that the government had put in enhanced airport checks and was going to mail swine flu information leaflets to every household in Britain.

In addition to a couple in Scotland who got swine flu on their Mexican honeymoon, new British cases included a 12-year-old girl in the southwest English town of Torbay. Brown said her school had been closed as a precaution.

He said the other two cases were adults in London and in Birmingham. All three had visited Mexico, were receiving anti-viral drugs and were responding well to treatment, Brown said.

French President Nicolas Sarkozy met with Cabinet ministers to discuss swine flu and his health minister said France will ask the European Union to suspend flights to Mexico.

The U.S., the European Union and other countries have discouraged nonessential travel to Mexico. Cuba suspended all regular and charter flights from Mexico to the island but was still allowing airlines to return travelers to Mexico.

New Zealand's number of swine flu cases rose to 14, 13 of them among a school group that recently returned from Mexico. Officials say the swine flu strain infecting the students is the same as that in Mexico. All were responding well to antiviral drugs and in voluntary quarantine at home.

New Zealand has 44 other possible cases, with tests under way.

Mexico was taking drastic measures to fight the outbreak. It closed all archaeological sites and allowed restaurants in the capital to only serve takeout food in an aggressive bid to stop gatherings where the virus can spread. Schools remained closed until at least May 6.

A regional beach soccer championship in Mexico was postponed and all Mexican first-division soccer games this weekend will be played with no audiences. Cruise lines were avoiding Mexican ports and holiday tour groups are canceling holiday charter flights there.

The Philippine health chief appealed to dozens of Filipino legislators to abandon plans to visit Las Vegas to cheer for boxing idol Manny Pacquiao — even though Las Vegas is more than 300 miles (480 kilometers) from the Mexican border.

Egypt's government ordered the slaughter of all pigs in the country as a precaution, though no swine flu cases have been reported there. Egypt's overwhelmingly Muslim population does not eat pork, but farmers raise up to 350,000 pigs for its Christian minority.

In Australia, officials were testing more than 100 people with flu symptoms for the virus and the government gave health authorities wide powers to contain contagious diseases.

"(We can make) sure that people are isolated and perhaps detained if they don't cooperate and are showing symptoms," said Health Minister Nicola Roxon.

___

Associated Press Writers around the world contributed to this report.


http://news.yahoo.com/s/ap/swine_flu_world

[AlaskaDenise]

I think Margaret Chan's comments were very good.

Nice to have someone with her experience with H5N1 in HK on deck at WHO.

.

[Shannon]

She didn't pull any punches. The message is a pandemic is imminent. We do not know what the severity will be, and we have contacted world leaders, and pharmaceuticals to get on board with preparing.

I give her an A+.

[BeauD]

Originally Posted by wotan

I don't believe the definition of pandemic actually speaks to the potential deadliness of the disease, just that is is (or in this case is likely to be) widespread and transmits easily between people. Compare the Spanish Flu to the much "milder" Hong Kong and Asian flus of the last century. All three were pandemics but you really can't compare the latter two with the first.

Exactly. It has nothing to do with how many people will die. It has to do with how many people are likely to get sick.

IMPORTANT to remember.

[Rocky]

so in Austrailia, at this level, the government has the rights to pick up and isolate whether someone is willing or not...

How many other countries are the same at 5 versus 6?

[HenryN]

The is the new may of counting WHO initiated, which was 1,2,3 6. The new definitions left little doubt that when3 went to 4, 5 and 6 were right behind. Should be 6 within the next several days (but it was six a few weeks ago).

[HenryN]

Sequences have been released from Mexico, California, Texas, Kansas, New York, and Australia and they are all VERY closely related.

[Jeremy]

Originally Posted by niman

Sequences have been released from Mexico, California, Texas, Kansas, New York, and Australia and they are all VERY closely related.

Henry,

Is there anything in the sequences that would rule in or out a justification for higher/lower mortality in different countries?

[Rocky]

National Emergency Centers Establishment Act (Introduced in House)

HR 645 IH

111th CONGRESS

1st Session

H. R. 645
To direct the Secretary of Homeland Security to establish national emergency centers on military installations.

IN THE HOUSE OF REPRESENTATIVES

January 22, 2009

Mr. HASTINGS of Florida introduced the following bill; which was referred to the Committee on Transportation and Infrastructure, and in addition to the Committee on Armed Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

——————————————————————————–

A BILL
To direct the Secretary of Homeland Security to establish national emergency centers on military installations.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `National Emergency Centers Establishment Act’.

SEC. 2. ESTABLISHMENT OF NATIONAL EMERGENCY CENTERS.

(a) In General- In accordance with the requirements of this Act, the Secretary of Homeland Security shall establish not fewer than 6 national emergency centers on military installations.

(b) Purpose of National Emergency Centers- The purpose of a national emergency center shall be to use existing infrastructure–

(1) to provide temporary housing, medical, and humanitarian assistance to individuals and families dislocated due to an emergency or major disaster;

(2) to provide centralized locations for the purposes of training and ensuring the coordination of Federal, State, and local first responders;

(3) to provide centralized locations to improve the coordination of preparedness, response, and recovery efforts of government, private, and not-for-profit entities and faith-based organizations; and

(4) to meet other appropriate needs, as determined by the Secretary of Homeland Security.

SEC. 3. DESIGNATION OF MILITARY INSTALLATIONS AS NATIONAL EMERGENCY CENTERS.

(a) In General- Not later than 60 days after the date of the enactment of this Act, the Secretary of Homeland Security, in consultation with the Secretary of Defense, shall designate not fewer than 6 military installations as sites for the establishment of national emergency centers.

(b) Minimum Requirements- A site designated as a national emergency center shall be–

(1) capable of meeting for an extended period of time the housing, health, transportation, education, public works, humanitarian and other transition needs of a large number of individuals affected by an emergency or major disaster;

(2) environmentally safe and shall not pose a health risk to individuals who may use the center;

(3) capable of being scaled up or down to accommodate major disaster preparedness and response drills, operations, and procedures;

(4) capable of housing existing permanent structures necessary to meet training and first responders coordination requirements during nondisaster periods;

(5) capable of hosting the infrastructure necessary to rapidly adjust to temporary housing, medical, and humanitarian assistance needs;

(6) required to consist of a complete operations command center, including 2 state-of-the art command and control centers that will comprise a 24/7 operations watch center as follows:

(A) one of the command and control centers shall be in full ready mode; and

(B) the other shall be used daily for training; and

(7) easily accessible at all times and be able to facilitate handicapped and medical facilities, including during an emergency or major disaster.

(c) Location of National Emergency Centers- There shall be established not fewer than one national emergency center in each of the following areas:

(1) The area consisting of Federal Emergency Management Agency Regions I, II, and III.

(2) The area consisting of Federal Emergency Management Agency Region IV.

(3) The area consisting of Federal Emergency Management Agency Regions V and VII.

(4) The area consisting of Federal Emergency Management Agency Region VI.

(5) The area consisting of Federal Emergency Management Agency Regions VIII and X.

(6) The area consisting of Federal Emergency Management Agency Region IX.

(d) Preference for Designation of Closed Military Installations- Wherever possible, the Secretary of Homeland Security, in consultation with the Secretary of Defense, shall designate a closed military installation as a site for a national emergency center. If the Secretaries of Homeland Security and Defense jointly determine that there is not a sufficient number of closed military installations that meet the requirements of subsections (b) and (c), the Secretaries shall jointly designate portions of existing military installations other than closed military installations as national emergency centers.

(e) Transfer of Control of Closed Military Installations- If a closed military installation is designated as a national emergency center, not later than 180 days after the date of designation, the Secretary of Defense shall transfer to the Secretary of Homeland Security administrative jurisdiction over such closed military installation.

(f) Cooperative Agreement for Joint Use of Existing Military Installations- If an existing military installation other than a closed military installation is designated as a national emergency center, not later than 180 days after the date of designation, the Secretary of Homeland Security and the Secretary of Defense shall enter into a cooperative agreement to provide for the establishment of the national emergency center.

(g) Reports-

(1) PRELIMINARY REPORT- Not later than 90 days after the date of the enactment of this Act, the Secretary of Homeland Security, acting jointly with the Secretary of Defense, shall submit to Congress a report that contains for each designated site–

(A) an outline of the reasons why the site was selected;

(B) an outline of the need to construct, repair, or update any existing infrastructure at the site;

(C) an outline of the need to conduct any necessary environmental clean-up at the site;

(D) an outline of preliminary plans for the transfer of control of the site from the Secretary of Defense to the Secretary of Homeland Security, if necessary under subsection (e); and

(E) an outline of preliminary plans for entering into a cooperative agreement for the establishment of a national emergency center at the site, if necessary under subsection (f).

(2) UPDATE REPORT- Not later than 120 days after the date of the enactment of this Act, the Secretary of Homeland Security, acting jointly with the Secretary of Defense, shall submit to Congress a report that contains for each designated site–

(A) an update on the information contained in the report as required by paragraph (1);

(B) an outline of the progress made toward the transfer of control of the site, if necessary under subsection (e);

(C) an outline of the progress made toward entering a cooperative agreement for the establishment of a national emergency center at the site, if necessary under subsection (f); and

(D) recommendations regarding any authorizations and appropriations that may be necessary to provide for the establishment of a national emergency center at the site.

(3) FINAL REPORT- Not later than 1 year after the date of the enactment of this Act, the Secretary of Homeland Security, acting jointly with the Secretary of Defense, shall submit to Congress a report that contains for each designated site–

(A) finalized information detailing the transfer of control of the site, if necessary under subsection (e);

(B) the finalized cooperative agreement for the establishment of a national emergency center at the site, if necessary under subsection (f); and

(C) any additional information pertinent to the establishment of a national emergency center at the site.

(4) ADDITIONAL REPORTS- The Secretary of Homeland Security, acting jointly with the Secretary of Defense, may submit to Congress additional reports as necessary to provide updates on steps being taken to meet the requirements of this Act.

SEC. 4. LIMITATIONS ON STATUTORY CONSTRUCTION.

This Act does not affect–

(1) the authority of the Federal Government to provide emergency or major disaster assistance or to implement any disaster mitigation and response program, including any program authorized by the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.); or

(2) the authority of a State or local government to respond to an emergency.

SEC. 5. AUTHORIZATION OF APPROPRIATIONS.

There is authorized to be appropriated $180,000,000 for each of fiscal years 2009 and 2010 to carry out this Act. Such funds shall remain available until expended.

SEC. 6. DEFINITIONS.

In this Act, the following definitions apply:

(1) CLOSED MILITARY INSTALLATION- The term `closed military installation’ means a military installation, or portion thereof, approved for closure or realignment under the Defense Base Closure and Realignment Act of 1990 (part A of title XXIX of Public Law 101-510; 10 U.S.C. 2687 note) that meet all, or 2 out of the 3 following requirements:

(A) Is located in close proximity to a transportation corridor.

(B) Is located in a State with a high level or threat of disaster related activities.

(C) Is located near a major metropolitan center.

(2) EMERGENCY- The term `emergency’ has the meaning given such term in section 102 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5122).

(3) MAJOR DISASTER- The term `major disaster’ has the meaning given such term in section 102 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5122).

(4) MILITARY INSTALLATION- The term `military installation’ has the meaning given such term in section 2910 of the Defense Base Closure and Realignment Act of 1990 (part A of title XXIX of Public Law 101-510; 10 U.S.C. 2687 note).

"<<

http://www.govtrack.us/congress/bill...?bill=h111-645

[HenryN]

Commentary

[AlaskaDenise]

Originally Posted by niman

Commentary

Commentary

WHO Confirms Sustained Swine H1N1 Transmission in Humans

Recombinomics Commentary 23:53
April 29, 2009


Apr 27, 2009 (CIDRAP News) – The World Health Organization (WHO) today raised its official pandemic alert level from the current phase 3 to phase 4 on its 6-phase scale, saying the newly identified swine influenza virus has made a pandemic more likely but not inevitable.

The above comments describe the phase increase from 3 to 4, which left little doubt that the phase would be raised to 6 within a few days because of the spread of H1N1 swine flu out of Mexico. The earlier definitions used sustained transmission as the definition of phase 6. This change was due in part to limited human to human transmission of H5N1. The repeated reports of smaller clusters dictated a change from 3 to 4, but such a change was linked to significant increases in pandemic preparedness.

The new definition, that required sustained transmission, made it clear that the progress of phases from 4 to 6 would just be a matter of days as noted in yesterday’s lengthy interview.

The pandemic is quite predictable, as detailed in the video above, has much in common with the 1918 outbreak, including the start in the late spring as a mild infection, the targeting of previously healthy adults, and the origin as swine H1N1. Over the summer the swine H1N1 will proliferate in the southern hemisphere and recombine with H1N1 seasonal flu, leading to a much more virulent H1N1 in the fall.

Active surveillance and the developing a vaccine that targets the predicted product is critical. Tamiflu resistance will almost certainly develop in swine H1N1, leading to a heavy reliance on a well matched vaccine.

The CDC has quickly released sequences for swine H1N1 in humans. Similar release of seasonal flu H1N1 in the southern hemisphere, as well as the private swine sequence database maintained by WHO consultants should also be made public immediately.

Phase 6 should be announced within the next few days.

It is time for serious vaccine targeting of emerging sequences.

.

[wotan]

Without seeing the actual report(s) on that, I can read it in two ways. One is that we are pretty sure these cases are really all the same strain of the virus rather than increased vigilance allowing us to catch more Influenza A infections.

The other is that we are seeing it still evolving and it already has noticeable differences in these different cases.