WHO Declares Phase 6 - Full Pandemic Due to Novel H1N1 Spread

[theforeigner]

Re: WHO getting close to declaring H1N1 pandemic

UPDATE 1-WHO getting close to declaring H1N1 pandemic

Tue Jun 9, 2009 12:17pm EDT

* WHO "very close" to declaring full pandemic
* Important to avoid panic, says Fukuda

(Combines stories, adds quotes and background)

GENEVA, June 9 (Reuters) - The World Health Organisation is getting close to declaring a full H1N1 influenza pandemic but wants to make sure countries are well prepared for such a move to prevent a panic, its top flu expert said on Tuesday.

Keiji Fukuda, acting WHO assistant director-general, voiced concern at the sustained spread of the new strain in countries including more than 1,000 cases in Australia following major outbreaks in North America where it was first detected.

The disease, widely known as swine flu, which has infected over 26,500 people in 73 countries, with 140 deaths, has also spread widely in Britain, Spain and Japan.

Confirmed community spread in a second region beyond North America would trigger moving to phase 6 from the current phase 5 on the WHO's 6-level pandemic alert scale.

Asked whether there was any doubt that a pandemic was under way, Fukuda told a weekly teleconference: "We are really getting very close to that."

Fukuda said a decision to declare a pandemic involved more than simply making an announcement. The United Nations agency had to ensure that countries were able to deal with the new situation and also handle any public reaction.

"One of the critical issues is that we do not want people to 'over-panic' if they hear that we are in a pandemic situation," Fukuda said.

A very real danger was that hospitals could be overwhelmed by people seeking help when they did not really need it.

Since the new flu strain first appeared, many people have stopped eating pork, pigs have been culled in some countries, trade bans on meat imposed, travellers quarantined and some countries have discussed closing borders.

"These are the kinds of potential adverse effects that you can have if you go out without making sure people understand the situation as well as possible," Fukuda said. (For a WHO note on its pandemic alert scale go to: here ) (Reporting by Jonathan Lynn and Stephanie Nebehay; Editing by Richard Balmforth)

[Gert van der Hoek]

Re: WHO getting close to declaring H1N1 pandemic

WHO Needs to Prepare Before Declaring Flu Pandemic, Fukuda Says


By Phil Serafino

June 9 (Bloomberg) -- The World Health Organization is holding off on declaring a flu pandemic while it prepares governments and the public for the announcement, said Keiji Fukuda, the agency?s assistant director-general of health security and environment.

The Geneva-based United Nations health agency wants to educate countries further about the meaning of a pandemic to prevent overreaction, Fukuda said on a conference call with journalists today. Raising the WHO?s six-step pandemic scale to its highest level might cause people who are healthy to flock to hospitals, preventing the sick from getting care, he said.

?We are really working pretty hard to get these messages out to people,? said Fukuda. ?We know that we are getting closer probably to a pandemic situation.?

The swine flu virus, also known as H1N1, is spreading in Australia, Chile and the U.K. The number of confirmed swine flu cases in Australia reached 1,211, the government said today, the highest number outside North America. The southeastern state of Victoria has 1,011 confirmed cases, the federal health department said on its Web site.

The WHO also is continuing to lay the groundwork for development of a vaccine, ensuring a supply of antiviral medicines and providing clinical guidelines on the flu, Fukuda said.

?We very clearly see what is going on in Australia, but what we?re doing is working very hard to make sure that everyone is in the best position as we get closer to a phase six declaration,? Fukuda said.

The agency has noticed a disproportionate number of serious cases among Canada?s Inuit population, and it?s not clear why, he said.

The WHO says 26,563 cases, including 140 deaths, have been reported in 73 countries. In most cases, the illness causes symptoms no more serious than seasonal flu.

http://www.bloomberg.com/apps/news?pid=20601081&sid=aA4ZtujVg7E4

[sharon sanders]

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

hat tip FT Resident Revere -


Swine flu: are we there, yet?



Category: Infectious disease ? Influenza treatment ? Pandemic preparedness ? Swine flu ? WHO

Posted on: June 10, 2009 6:56 AM, by revere


Listening to yesterday's press briefing with WHO's Dr. Keiji Fukuda (audio file here), several things seemed clear to me. The first is that everyone, WHO included, thinks a pandemic is well underway. Second, WHO's efforts to explain why they are not making it "official" by going to phase 6 are becoming increasingly awkward and the explanations manifestly tortured. Essentially what Fukuda said was that WHO was waiting for its member nations to signal they knew it was a pandemic and then WHO would say it was a pandemic. It was reminiscent of the cries of one of the principals of the revolution of 1848 as he chased the mob into Paris's Jardin du Luxembourg: "I'm their leader! I must follow them!" Third, despite Fukuda's calm and measured tone, there was an undercurrent of worry. The severity of the not-yet-called-a-pandemic pandemic is now being termed "moderate" (which seems accurate to me). Fukuda explicitly declined to characterize it as "mild." He also called attention to reports of "disproportionate numbers of serious cases occurring? in Canada's First Nation (indigenous) community. From the Winnipeg Free Press:

There has been a "surge" in the number of people requiring intensive care in Manitoba hospitals with flu-like illnesses, the province said Monday. As of Sunday night, there were 26 such people in hospital -- more than half of them aboriginal. All were or had been on ventilators due to influenza or of an influenza-like illness. Eight persons with severe cases required hospitalization in the past week alone.
Joel Kettner, chief provincial public health officer, said Monday "most if not all" of the cases are expected to be confirmed as the new H1N1 influenza.
[snip]
Kettner said the 26 people on ventilators in hospital are "very ill."
"Some of them have been on ventilators for several weeks... The pattern has been so far that many of these patients have required several weeks of intensive care before they have recovered."
He said that in the first week of June, the rate at which people became severely ill with what is suspected as H1N1 was far higher than it was in April or May.
More than half of those in intensive care are First Nations people -- status or non-status as well as Inuit.
[snip]
Jan Currie, vice-president of the Winnipeg Regional Health Authority, said there are normally 30 to 35 people on ventilators in Winnipeg hospitals at any one time for a variety of reasons.
The 26 listed by Kettner are in addition to that, she said. The WRHA has acquired 15 extra ventilators and may defer non-urgent procedures that would normally require ICU care. It is also taking steps to provide enough support in intensive-care units and prioritizing patients for personal care home beds.(Larry Kusch, Winnipeg Free Press)

As Fukuda points out, influenza took a heavy toll in isolated and disadvantaged communities in earlier pandemics. This is part of a picture of a well transmitted novel influenza virus, circulating out of season and hitting younger age groups differentially, just what one expects from a pandemic strain based on past experience.


The on-again-now-off-again inclusion of severity as a criterion for a pandemic is currently being spun as a descriptor to give member nation's the best information on the nature of the pandemic they are dealing with. I think that's a sensible attitude, and I don't fault WHO. The politics of any intergovernmental agency, especially in the UN system, produce a difficult and treacherous landscape to negotiate. If you've never seen it close up, it's hard to appreciate the labyrinthine and counter-to-common sense ways of the international community. This is not the UN's fault and certainly not WHO's. It is the system they (and we) are forced to work within, as mandated by the nations of the world. If the space program becomes robust enough, someday you may be able to opt out for another planet. Until then, it's no use complaining.


Meanwhile we now have the long predicted influenza pandemic. It's neither so scary nor so benign that we can afford to either hide under the bed or ignore it. What we must do is roll up our sleeves and manage the consequences.

[sharon sanders]

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

"..The on-again-now-off-again inclusion of severity as a criterion for a pandemic is currently being spun as a descriptor to give member nation's the best information on the nature of the pandemic they are dealing with. I think that's a sensible attitude,.."


I agree.

[The Mountains Voice]

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

Meanwhile we now have the long predicted influenza pandemic. It's neither so scary nor so benign that we can afford to either hide under the bed or ignore it. What we must do is roll up our sleeves and manage the consequences.

And that's the $100 Question..... How are officials going to manage the information rollout?

I just got off the phone with a client. Yesterday I was speaking with an architect friend on the phone. These are both very educated people. Yet BOTH of them found hilarity / disgust with the Media & Officials OVERBLOWING A MADE-UP Crisis. Therein lies the rub..... in a vacuum of real facts, a large percentage of the people will assume there is NO threat, NO reason to prepare. Yet in an announcement - a large percentage of the people will act stupidly with over concern.

What is needed is calm fact, reasonable expectations & timelines for changes that may occur - and very clear, calm guidance as to what steps people should be taking.

There will ALWAYS be people that over-react & under-react. We need to quit worrying that a percentage of the population will misinterpret what the situation is / will be......... BECAUSE THEY ALWAYS WILL. But for those that can think rationally - those are the people that need the facts, and REAL & HELPFUL GUIDANCE.

[tropical]

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

And that's the $100 Question..... How are officials going to manage the information rollout?

I just got off the phone with a client. Yesterday I was speaking with an architect friend on the phone. These are both very educated people. Yet BOTH of them found hilarity / disgust with the Media & Officials OVERBLOWING A MADE-UP Crisis. Therein lies the rub..... in a vacuum of real facts, a large percentage of the people will assume there is NO threat, NO reason to prepare. Yet in an announcement - a large percentage of the people will act stupidly with over concern.

What is needed is calm fact, reasonable expectations & timelines for changes that may occur - and very clear, calm guidance as to what steps people should be taking.

There will ALWAYS be people that over-react & under-react. We need to quit worrying that a percentage of the population will misinterpret what the situation is / will be......... BECAUSE THEY ALWAYS WILL. But for those that can think rationally - those are the people that need the facts, and REAL & HELPFUL GUIDANCE.

I agree.

And such guidance from the health sectors to the ordinary citizens are mainly unexistant in many countries.

Additionaly, the factual storidges and public/business preparedness items/facts, are in many regions not proportionated to the possible pandemic waves entity.

If we omited the web awareness, for the majority of world citizens, this pandemic exists only in sporadic news, and is depicted many times as TMVoice said, and as I heard daily/weekly: as hilarius inventions made by the vaccine producers pushers or mediatic alarmistic frantic web groups ...

[Siegfried X]

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

How are officials going to manage the information rollout?

I think it will be almost totally ignored in the United States. The CDC has already said it won't make a difference since we already have widespread infection.

It will be a one day news blip, then people will realize that nothing has changed.

[Legadillo]

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

Sadly, this may very well be the case. Since that magic (and fictional) number of 36,000 annual flu cases a year is nowhere near the numbers of swine flu (I had it two weeks ago) cases being officially reported, few are concerned. I work at a residential treatment facility where several staff have the flu and some have been to the emergency room. However, little to nothing is done here! No pandemic prepardness plan---nothing!!!! I inform others but no one wants to listen!!!

[The Mountains Voice]

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

I think it will be almost totally ignored in the United States. The CDC has already said it won't make a difference since we already have widespread infection.

It will be a one day news blip, then people will realize that nothing has changed.

Perhaps. But I do think some things have changed. My gut thought is that this will be a very coordinated event. I think a few things will happen...

1st - it will get an attention blip in the media.

2nd - They will ATTEMPT to control it / put out consistent & central spin

2nd - However, it's coinciding timewise with the leading edge of the curve as the exponential growth continues, and the deaths begin to be more noticeable. We're approaching a point on the curve that exponential growth start moving VERY fast.

3rd - I think that because this time the media will actually have some specific death stories to grab hold of - it'll get some traction.

That's probably what WHO & Official are most afraid of - that an uncontrollable, and undisciplined news media will behave irresponsibly. Can't say I blame them actually.

[The Mountains Voice]

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

...it's coinciding timewise with the leading edge of the curve as the exponential growth continues, and the deaths begin to be more noticeable. We're approaching a point on the curve that exponential growth start moving VERY fast.

Here's something I just thought of...
We here at Flutrackers know what is going on. That is because as a group we scour the news stories for information. But even we rely on the overall news media to report those stories - so that we can then find & categorize them.

We really don't have any idea what the numbers could be. If the entire eye of the news media turns towards this subject - albeit even for a day or two..... I'm thinking there might be a small shock at what the hoards of media uncover. There might be a lot more hospitalizations & deaths out there than we even realize.

News Media can be incredibly irresponsible at times - but they are also a very powerful information gathering force. My guess is that we're going to be busy keeping up with the explosion of case counts.

[Diane Morin]

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

Perhaps. But I do think some things have changed. My gut thought is that this will be a very coordinated event. I think a few things will happen...

1st - it will get an attention blip in the media.

2nd - They will ATTEMPT to control it / put out consistent & central spin

2nd - However, it's coinciding timewise with the leading edge of the curve as the exponential growth continues, and the deaths begin to be more noticeable. We're approaching a point on the curve that exponential growth start moving VERY fast.

3rd - I think that because this time the media will actually have some specific death stories to grab hold of - it'll get some traction.

That's probably what WHO & Official are most afraid of - that an uncontrollable, and undisciplined news media will behave irresponsibly. Can't say I blame them actually.

I agree with you. The touched WHO and countries have a good hundred deaths to announce. I saw an article yesterday which spoke about 100 dead for the United States I did not post it by I did not find it reliable.

Today I read this:

It is, at June 9, 73 countries which are touched by the virus, 26.563 proven cases in deferred laboratories and 249 deaths. (Fukuda)


http://www.santelog.com/modules/connaissances/actualite-sante-oms--grippe-a-le-dr.-fukuda-vient-de-confirmer-une-%C3%A9volution-du-type-pand%C3%A9mique_1270.htm


<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p>Influenza A(H1N1) - update 45</o:p>
<o:p><o:p></o:p>
8 June 2009 -- As of 06:00 GMT, 8 June 2009, 73 countries have officially reported 25,288 cases of influenza A(H1N1) infection, including 139 deaths.
<o:p></o:p>
<o:p></o:p>
http://www.who.int/csr/don/2009_06_08/en/index.html
<o:p></o:p>
The United States has not made of update for last Friday. Manitoba has not made any for last Thursday. Etc The cases of Quebec, for example, doubled in one week (June 2: 307, June 9: 593) but that did not highlight yet. Australia and Chile know fast rises. Etc The journalists will have matter to show that a pandemia and indeed arrived. I noticed that other spokesman credible currently take over like the doctors who to launch an alarm yesterday to Canada. The citizens skeptics will believe them probably more than the experts. I excuse myself near the experts it is not malicious what I say.
</o:p>

[HenryN]

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

Here's something I just thought of...
We here at Flutrackers know what is going on. That is because as a group we scour the news stories for information. But even we rely on the overall news media to report those stories - so that we can then find & categorize them.

We really don't have any idea what the numbers could be. If the entire eye of the news media turns towards this subject - albeit even for a day or two..... I'm thinking there might be a small shock at what the hoards of media uncover. There might be a lot more hospitalizations & deaths out there than we even realize.

News Media can be incredibly irresponsible at times - but they are also a very powerful information gathering force. My guess is that we're going to be busy keeping up with the explosion of case counts.

Yes, the media is confused, and the spread of H1N1 is VERY significant and HEAVILY underplayed.

Each region has its own set of rules. In the US, mild cases are essentially ignored (and NOT tested) and severe cases are largely undiscoved.

In Mexico, confirmations lag, so although the probables are significant, they are not reported.

Outside of North America, most detection efforts are at airports, while community spread accelerates.

A pandemic 6 may create more analysis of the psuedo surveillance, and the media may be VERY surpised by what they find if they do a little digging.

[Science Teacher]

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

I, too, think that the media will be shocked when and if they really investigate the numbers. I hope they will help get the word out that this is not a cotton candy flu we are getting exposed to.
If they want to act responsibly, the media must also focus on getting out the preparation message as this critical factor has not been addressed for the most part.

[tropical]

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

Here's something I just thought of...
We here at Flutrackers know what is going on. That is because as a group we scour the news stories for information. But even we rely on the overall news media to report those stories - so that we can then find & categorize them.
...

I posed this problem last year here at FT, pointing that the official individual health releases could be closed (job pending if make public releases), and the individual health professionals will have a deny of publications other than the officialy decided from the under-censor.

The recent developments with lowering infected numbers, new emergency procedures for official web site publishing, confirm such problem is already present.

But I don't think they will so fast publish the real numbers after settling up the phase 6.

At the contrary, than could enact all the various countries pandemic guidance laws based on WHO guideliness, which in fact support an country centralized and censored infection news publication.


If that would be the case, I suggest that FT will must rely more on individual tips about local based rumors or evidently present surge in flu illnessed.

Than, the FT policy of a needed provided cited web link for numbers/events could became tricky to achieve ...

[Giuseppe]

Re: WHO Moving to Phase 6 Due to Novel H1N1 Spread

I agree with you. The touched WHO and countries have a good hundred deaths to announce. I saw an article yesterday which spoke about 100 dead for the United States I did not post it by I did not find it reliable.

Today I read this:

It is, at June 9, 73 countries which are touched by the virus, 26.563 proven cases in deferred laboratories and 249 deaths. (Fukuda)


http://www.santelog.com/modules/conn...mique_1270.htm


<o:p>Influenza A(H1N1) - update 45</o:p>
<o:p><o:p></o:p>
8 June 2009 -- As of 06:00 GMT, 8 June 2009, 73 countries have officially reported 25,288 cases of influenza A(H1N1) infection, including 139 deaths.
<o:p></o:p>
<o:p></o:p>
http://www.who.int/csr/don/2009_06_08/en/index.html
<o:p></o:p>
The United States has not made of update for last Friday. Manitoba has not made any for last Thursday. Etc The cases of Quebec, for example, doubled in one week (June 2: 307, June 9: 593) but that did not highlight yet. Australia and Chile know fast rises. Etc The journalists will have matter to show that a pandemia and indeed arrived. I noticed that other spokesman credible currently take over like the doctors who to launch an alarm yesterday to Canada. The citizens skeptics will believe them probably more than the experts. I excuse myself near the experts it is not malicious what I say.
</o:p>

From Transcript: (http://www.who.int/mediacentre/influ...t_20090609.pdf )

Jonathan Lynn, Reuters, Geneva:
Dr Fukuda, I just wanted to check what you said at the very outset where you referred to 249 deaths and the figures of yesterday was only 139, that seems a very big jump, and I wanted to know if I had heard that correctly, and if so, what is the explanation for that. I had a second question as well but would you like to take that one first.

Dr Fukuda:
Jonathan, let me actually ask for a verification on that and let me come back to you. Can you give me your second question.
(...)

Dr Fukuda:
First let me clarify the number that came up earlier. The number I gave you on the number of deaths was erroneous. The number of deaths is 140 so rather than the 249 ? if you can make that correction ? that is the number of reported deaths from this virus to WHO is 140.

In terms of examples of adverse reaction that we would like to either see not occur or have them be reduced. When we first announced about this virus and the situation, there were certain actions that were taken such as questioning the safety of pork, there was culling of pigs that went on, there were trade embargoes which were issued, there were concerns about travellers coming from certain areas, and there was concern over border closures or travel restrictions... a lot of those kinds of questions came up. (...)

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