Prepared Citizens

Do unto others as you would have them do unto you.

  • Previous Posts

  • Michael Osterholm Quotes:

    “What we need to be doing now is the basic planning of how we get our communities through 12 to 18 months of a pandemic.”

    “Ninety-five out of 100 will live. But with the nation in crisis, will we have food and water? Are we going to have police and security? Will people come to work at all?”

    “It's the perfect setup. Then you put air travel in and it could be around the world overnight.”

    “We can predict now 12 to 18 months of stress of watching loved ones die, of wondering if you are going to have food on the table the next day. Those are all things that are going to mean that we are going to have to plan -- unlike any other crisis that we have had in literally the last 80-some years in this country.”

  • US Health and Human Services

    Secretary Michael Leavitt

    "If there is one message on pandemic preparedness that I could leave today that you would remember, it would be this:

    Any community that fails to prepare with the expectation that the federal government or for that matter the state government will be able to step forward and come to their rescue at the final hour will be tragically wrong,

    not because government will lack a will, not because we lack a collective wallet, but because there is no way that you can respond to every hometown in America at the same time."
  • Joseph C. Napoli, MD of Resiliency LLC

    "I think a new meaning is evolving for resiliency and resilience.

    In some contexts the words are being used to mean the strength to resist being impacted by an adverse event rather than either the “capacity to rebound” or “act of rebounding” from adversity.

    Therefore, resiliency and resilience appear to be assuming the meaning of fortitude, that is, “the strength or firmness of mind that enables a person to encounter danger with coolness and courage or to bear pain or adversity without despondency” as defined in the Webster’s Third New International Dictionary.

    If so, we are coming full circle with science accepting a religious moral virtue – fortitude – as written in the Bible’s Book of Wisdom"




  • Faith Based Resources

    John Piper
    Jonathan Edwards
    Reformation
    Pink-Saving Faith
    Pink-Christian Ethics

    "Examine yourselves, whether ye be in the faith; prove your own selves"
    (2 Corinthians 13:5).

    Why Faith Groups Must Care

    When the Darkness Will Not Lift by John Piper

    Stand

    Be Not Afraid
    Overcoming the fear of Death
    by Johann Christoph Arnold







    While I am not a professional journalist, I do embrace the code of ethics put forth by the Society of Professional Journalists and the statement of purpose by the Association of Health Care Journalists and above all else I strive to "do no harm".


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  • Definitions

    from Wikipedia



    Pandemic Influenza


    An influenza pandemic is an epidemic of the influenza virus that spreads on a worldwide scale and infects a large proportion of the human population.

    In contrast to the regular seasonal epidemics of influenza, these pandemics occur irregularly, with the 1918 Spanish flu the most serious pandemic in recent history.

    Pandemics can cause high levels of mortality, with the Spanish influenza being responsible for the deaths of over 50 million people.

    There have been about 3 influenza pandemics in each century for the last 300 years. The most recent ones were the Asian Flu in 1957 and the Hong Kong Flu in 1968.



    Seasonal Influenza


    Flu season is the portion of the year in which there is a regular outbreak in flu cases.

    It occurs during the cold half of the year in each hemisphere.

    Flu activity can sometimes be predicted and even tracked geographically. While the beginning of major flu activity in each season varies by location, in any specific location these minor epidemics usually take about 3 weeks to peak and another 3 weeks to significantly diminish.

    Individual cases of the flu however, usually only last a few days. In some countries such as Japan and China, infected persons sometimes wear a surgical mask out of respect for others.



    Avian (Bird) Flu
    Avian influenza,

    sometimes Avian flu, and commonly Bird flu refers to "influenza caused by viruses adapted to birds."


    "Bird flu" is a phrase similar to "Swine flu", "Dog flu", "Horse flu", or "Human flu" in that it refers to an illness caused by any of many different strains of influenza viruses that have adapted to a specific host.

    All known viruses that cause influenza in birds belong to the species: Influenza A virus.

    All subtypes (but not all strains of all subtypes) of Influenza A virus are adapted to birds, which is why for many purposes avian flu virus is the Influenza A virus (note that the "A" does not stand for "avian").
    Adaptation is non-exclusive.

    Being adapted towards a particular species does not preclude adaptations, or partial adaptations, towards infecting different species.

    In this way strains of influenza viruses are adapted to multiple species, though may be preferential towards a particular host.

    For example, viruses responsible for influenza pandemics are adapted to both humans and birds.

    Recent influenza research into the genes of the Spanish Flu virus shows it to have genes adapted to both birds and humans; with more of its genes from birds than less deadly later pandemic strains.

    H5N1 Strain


    Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species.

    A bird-adapted strain of H5N1, called HPAI A(H5N1) for "highly pathogenic avian influenza virus of type A of subtype H5N1", is the causative agent of H5N1 flu, commonly known as "avian influenza" or "bird flu".

    It is enzootic in many bird populations, especially in Southeast Asia. One strain of HPAI A(H5N1) is spreading globally after first appearing in Asia.

    It is epizootic (an epidemic in nonhumans) and panzootic (affecting animals of many species, especially over a wide area), killing tens of millions of birds and spurring the culling of hundreds of millions of others to stem its spread.

    Most references to "bird flu" and H5N1 in the popular media refer to this strain.



    As of the July 25, 2008 FAO Avian Influenza Disease Emergency Situation Update, H5N1 pathogenicity is continuing to gradually rise in wild birds in endemic areas but the avian influenza disease situation in farmed birds is being held in check by vaccination.

    Eleven outbreaks of H5N1 were reported worldwide in June 2008 in five countries (China, Egypt, Indonesia, Pakistan and Vietnam) compared to 65 outbreaks in June 2006 and 55 in June 2007.

    The "global HPAI situation can be said to have improved markedly in the first half of 2008 [but] cases of HPAI are still underestimated and underreported in many countries because of limitations in country disease surveillance systems".





    Pandemic Severity Index


    The Pandemic Severity Index (PSI) is a proposed classification scale for reporting the severity of influenza pandemics in the United States.

    The PSI was accompanied by a set of guidelines intended to help communicate appropriate actions for communities to follow in potential pandemic situations. [1]

    Released by the United States Department of Health and Human Services (HHS) on February 1, 2007, the PSI was designed to resemble the Saffir-Simpson Hurricane Scale





    From the Massachusetts Health and Human Services



    Isolation


    refers to separating people who are ill from other people to prevent the spread of a communicable disease.



    Quarantine


    refers to separating and restricting the movement of people who have been exposed to a communicable disease and are not yet ill.
  • Additional Information

    Creative Commons License
    Prepared Citizens by Catherine "Jackie" Mitchell is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 United States License.
    Based on a work at http://www.preparedcitizens.org.




    The posts on this site are subject to change. Mostly due to errors in spelling or grammar. I never said I am a professional journalist. I have new appreciation for the job that they do. Also, not all comments made by others will make it onto this site. Comments that advertise a commercial product do not get posted most of the time.


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  • standingfirm

Vaccines: What Are People Really Saying?

Posted by preparedcitizens on December 24, 2008

Countless reports have been published this flu season alone of how much vaccine is going unused.

What comes to mind when you read these reports?

  • Do you automatically assume that those who do not vaccinate are ignorant?
  • Do you automatically assume that their behavior is unnecessarily placing others at risk?

If you do, you are making dangerous assumptions and also elevating your own standards at the expense of others. I believe that we must put others first. This works for vaccinating and the flip side is that it works for not vaccinating. (oh the moderation of it all — simply beautiful wisdom.)

There are plenty of very intelligent people in this country who have concerns about what we are injecting into our bodies, drinking in our water, eating in our food, and breathing in our air. It isn’t God’s creation that we are finding fault with, it is man’s intervention into that creation. And plenty of people have concerns about a growing trend, the reliance on technology in our lives. As I sit here on a wireless laptop listening to my own radio station speaking to hundreds perhaps thousands of people it is hard to see the downside to this…but there is always a flip side…always.

As I have said, I am a vaccinator. I have also appreciated and recognize the advances that are being made in medicine but I also see some danger.

The point of this post is not to harp on what I see as ethical and moral considerations of the use of science and technology in medicine or other areas of our lives, my focus is on what people are saying by their actions. They do not trust, nor do they see the benefit, of some of what is being offered as a benefit to their health and to the health of others in their immediate environment who their lives and decisions have an impact on. How their decisions drive our thinking, that is the thrust here. And that is where I feel a stone burdening my heart.

In the face of extreme pressure will we always respect others freedom to refuse medical treatment or vaccination? I look to some extremes…the forced sterilization and reproduction laws in China are, in my humble opinion, a human rights abuse. And this is dissimilar to the fight to abolish abortion and infanticide the world over. In the first case does a government have a right over the womb when what issues from it, a beautiful child made in God’s image, is a burden on a government? In the second case, the rights of the unborn, who have no voice, are the focus. The choice was made at and leading up to conception, after that point the child must be afforded all the rights under our constitution.

So the question remains and it must be asked now, before a pandemic, before a bioterrorism attack, this is “pre”paredness.

Will the right to opt-out of vaccination, the right to refuse medical treatment, always be respected even when that refusal will have an impact on our neighbor, other family members, our communities. And will the rights of those who refuse be further infringed upon by other measures under our current isolation and quarantine laws?

The heart walks a fine line and history does repeat itself. Different issues, similar responses because as human beings, right or wrong, we generally have the same fears.

So even though, up to THIS point I have been a vaccinator and an encourager of vaccination in it’s current state, this may not be true in the future. Advances in techniques are increasingly ethically precarious and I want the right to refuse without fearing the strong arm of the law by, for instance, being interned over my decision. The internment of the Japanese was not that long ago and I do not think that we adequately addressed this as a country.

It is time to revisit what we have done in the past before we walk so boldly into the future.

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6 Responses to “Vaccines: What Are People Really Saying?”

  1. Jim Wilson said

    Catherine,

    If the regular average Joe/Jane had access to a continuous flow of near-real time situational awareness for all potentially disruptive biological events effecting animals or humans… regardless of whether laboratory confirmation and diagnostic certainty has been achieved… would this help?

    Vaccination is a necessary baseline to maintain herd immunity, and it requires a given percentage (80%, if I recall correctly…) of the population to be vaccinated for full protective effect. Unfortunately, the US continues to fall beyond this threshold.

    And an estimated 36k Americans die every year due to influenza.

    I strongly disagree with the notion of placing the full bore of blame upon local, state, national, and international public health authorities- it takes partnership with the public to make it work.

    There are those of us who believe the full effect of a pandemic may be blunted by residual immunity provided by current vaccination… we hope there is some protective effect offered in the N1 component in particular, recognizing it is a minor effect.

    So here is what I’m getting at:

    1. The average US citizen does not typically vaccinate. Here were the midseason stats, courtesy of the recent RAND report:

    “Survey results suggest that by mid-November 2008:

    * 30 percent of all U.S. adults had been vaccinated against influenza
    * 37 percent of U.S. adults with a health or occupational indication had been vaccinated
    * 17 percent of adults and adults with indications intended to receive the vaccine by the end of the vaccination season”

    http://www.rand.org/health/projects/flu_survey/

    2. The baby boomer population continues to balloon- hence, we now have a substantial component of our population at risk for the most severe clinical outcomes of influenza (i.e., death).

    3. Should a pandemic be declared, you are nearly guaranteed to trigger a panic-buy of influenza vaccine- of both the seasonal and whatever “pandemic vaccine” that may or may not (more likely not) will be available on the market. Local supplies will be depleted quickly, and then you may see social unrest.

    So, again I ask- how might we marry graded awareness with a more gentle, graded social response?

  2. preparedcitizens said

    forewarning: semi rant follows – (not at you Jim…just the situation in general)

    “So, again I ask- how might we marry graded awareness with a more gentle, graded social response?”

    First let me start with….
    The average Joe/Jane who is interested in a continuous flow of near-real time situational awareness is a bit hard to find. I would be interested in that information but I am a bit of an odd duck. Truly, I know of very few people who really care about infectious diseases and what is happening in that realm right now.

    My short answer (and the one that makes me weep)…If a tree falls in the forest and there is no one there to hear it fall does it make a sound?

    I am realizing more and more that people may not be interested in any of this until it is too late. It will take a crisis of some magnitude to awaken the masses I fear and that is the last thing that we want or need. And then they will be loaded for bear and ready to blame any and all who knew and (they believe) did not tell them – and that is the real tragedy here – we have tried to tell them.

    It isn’t that we cannot prepare as a society, there is no public will to prepare (with vaccinations and also non-pharmaceutical interventions) and there won’t be as long as so many other every day things keep stealing the focus away from this issue – (unless a major announcement from a trusted public figure is made. But who will the majority of people trust, we are now a deeply divided nation and seem to be becoming more so instead of less so – and then what if they announce too early doing more damage).

    It isn’t because the public is stupid, it is because the public is busy living their lives with the concerns that they already have day in and day out and unfortunately they leave the medical stuff to the medical people – that is what they pay them for, or so they think.

    Basically people just do not care about influenza, it is not viewed as a threat. To most folks it is just something they get every year (not realizing that the vomitting bug isn’t influenza) and that is a problem. More education needs to be done. But who is going to do it? We can tell them about bad flu seasons in the U.K. and Australia and point to the real world deaths that are occuring and still they will think *that’s over there, what does it have to do with us here*?

    Many people figure that their physician will tell them what they need. When a patient only sees their physician once or twice a year a flu shot falls way down on the priority list. I am 48 and only see my physician when absolutely necessary and even then I put it off. I cannot afford the co-pays. When I go the waiting rooms are typically filled with the elderly who have wonderful insurance policies. I wonder what the statistics are for elderly compliance with flu vaccination? I am sure I saw those statistics somewhere.

    “So, again I ask- how might we marry graded awareness with a more gentle, graded social response?”

    Back in the day of *housecalls* – and I am old enough to remember them – a family physician brought care to the door. I have often wondered if that would not work now. Instead of waiting for the crisis send out medical teams of medics and physicians door to door in order to build up trust, answer questions, belay fears, destroy myths, and get to know their patients right in their environment.

    Do I know the answer to your question? If I had a nickel for every hour that I have thought about this question over the last 5 years I would be a very wealthy woman.

    How I approach this:
    “…how might we marry graded awareness with a more gentle, graded social response?”

    I do the brunt of my work one on one, face to face, and through online communication. When I do what I do in person I typically have a total of two sentences to make my impact statement and that is it. I am just another member of the public, albeit a very medically informed one (I must have earned an unofficial masters in public health by now…lol). I have to make very quick empathetic judgments about the audience that I have based on environment, what is being understood, and the psychological impact of what I am presenting before I even mention what I need to say. If the subject is intense I may only get one opportunity and one sentence before the eyes glaze over and the fear level increases to the point that the mind closes.

    How? The answer has become one person at a time.
    We can do better….but how?

    Someone who is recognized as a subject authority and is known to the community will be able to do so much more.

    One problem is that some in the medical field promote reasons to not be vaccinated.

    Can we educate the educators? They are the hardest folks to convince because they think they know and will not budge.

    A theory that crops up time and time again is that people would rather get the flu and have their own immunity built up rather than develop antibodies from a vaccine that may not be available or well matched the following season. Vaccines are not as reliable as we want them to be and there is some merit to the argument that if you are young and healthy and do not desire to vaccinate every single year then it is better to forgo the vaccine until you are 65. Once that mindset is there it is almost impossible to overcome it.

    No, we don’t want to play the blame game, and it is unwise to do so, but there is a major problem here in the US especially in rural areas with boards of health not being manned by people who *can* educate. Without education myths remain firmly entrenched. I hear the myths parroted from BOH members themselves.

    I am in a rural area and my local board of health is not manned by medical professionals who specialize in infectious diseases. (I could say quite a bit more but it probably isn’t wise to do so). They are unpaid volunteers who fight off apathy by getting involved in town activities and they should be applauded for doing so, but they aren’t able to solve this either….it takes many, many, hands.

    Years ago I handed my BOH a complete package of information for the public. I even offered to them the opportunity to have a well known “flubie” physician/speaker do a small or large town hall type meeting in order to increase situational awareness. I demonstrated that going door to door with educational materials neither caused an uproar, a panic, and neither did it generate any complaints to anyone. Without follow-up by someone else I am sure those seeds that were planted got washed away.

    Frankly, people just do not believe *me* that a pandemic (or any other health disaster) is likely (I was told that they thought it was Bush Administration scare tactics) so now even my own BOH seems to be more interested in outdoor wood boilers and licensing the local chiropractors massage therapists. And they don’t listen to *me* that an influenza shot could save their life or the life of their immunocompromised family member or friend.

    When the local board of health is not behind the issue who can we look to locally – certainly not some resident of the town who has no credentials (me). So will it help if I have near real time situational awareness? Probably not and that is why my focus is becoming gearing up for the questions (and panic) when the crisis becomes unavoidable and quite real (and when vaccines will not be available) and I know that information will be sought by ready minds.

    People with children fear vaccination and the vocal minority has planted enough seeds of doubt that fence sitters lean away especially regarding influenza vaccination which is largely seen as unnecessary for children who are already seen as being over vaccinated. Childhood illnesses and their severity and adverse consequences is gone from our memories. It is easier to leave the responsibility of vaccination to other parents. Influenza is far too common an illness to care about. And people just do not understand the difference between seasonal influenza and pandemic influenza – which, as you know, can be like night and day. Nevermind the adverse neuro complications – we can’t even begin to go there yet.

    For seasonal influenza too many do not understand that the vaccine does not give you the flu, that it can’t give you the flu. Too many are afraid of the adjuvants because *mercury* in an injection is scary (not thinking of the myriad of highly toxic things we encounter every day – someone will stand there complaining to me about mercury in a flu shot while sucking down the smoke of a cigarette with child in tow).

    “…how might we marry graded awareness with a more gentle, graded social response?”

    Currently, I use this blog and the social networking sites in order to spread the word and as I said, I do my best to give accurate information one on one to overcome the bad information that is out there. I keep trying and I have not and will not give up. This is just too important.

    Well, now I have run on too long and it’s time for bed and I am all fired up. I guess I will go punch my pillow.

    Thank you for reading my blog and asking this thoughtful question. It is good to know that there are people (probably many people) thinking about this very important topic.

  3. Jim Wilson said

    Catherine,

    Well, I’ve got to say I completely agree with your response! I’m not sure how you would feel if I told you this, but if you look at the local social reporting on a daily basis during the 1889, 1918, 1957, and 1968 pandemics you see the same concerns you’ve expressed above over and over again.

    History repeats itself for those who refuse to remember it. And in every prior pandemic, mankind relearned the same lessons over and over again. Pre-crisis apathy led to blame after the disaster struck.

    What I can say is there are people out there watching the world and trying to find a way to get appropriate warning information to both the public and the officials entrusted by the public to do their jobs.

    Cheers,
    Jim

  4. preparedcitizens said

    ….and I am going to be one of those folks that will get blamed because people know that I know (it is much easier for them to think I am bonkers) and they will think that I have not done enough in my town. I know this, I am willing to accept this and it does push me on. Just this morning, I haven’t even had my coffee, I spoke with one more person and told him (he has asthma) of the need. To me the telling is like doing CPR, it is that important.

    Jim, one other thing. For some of us who have had to learn this infectious disease stuff on their own hearing all this near real time news from our own flubie news aggregators can trigger a first year medical school response – i.e. chikungunya becomes a clear and present danger (which it is not). This was all part of my learning process. The fact of the matter is becoming saturated in this information didn’t cause panic. I had a little agita but the information itself should never be viewed by the public as hidden from them. That results in outrage toward the authorities who hold it and probably will be a cause for more blame. But if the information does start flowing more and more there must be people who are willing to step forward and explain the information that is coming out. The MSM, by and large, is not ready to do that alone (another reason for this blog and my Facebook page). Will I always get it right? I know that I will not but I will keep trying.

    Let the information flow. But it must be from reliable sources. I truly believe that we are still in a war. Just because we disengage our enemies may not. Information can and will be used against us. Terror, and the spreading of it, relies a lot on the spreading of misinformation. I will never forget the words that President Bush said (paraphrasing) “this will be a different sort of war”. I never knew exactly what he meant but I remembered his words.

    Madame Supari, the health minister from Indonesia, has whipped up anti U.S. sentiment the world over with her false accusations. Telling the truth to the American people circumvents any lies that can be told. We just must be empathetic and compassionate in how we educate otherwise we end up doing harm.

    I know that there are people further up doing their jobs. I know that people are absolutely dedicated and approach this with great care. Allowing “flubie” news aggregators and those who ARE listening for the sound the tree makes to have complete access allows for the many hands that are needed to get sound information out. Treyfish and Commonground at at Pandemic Information News do a very good job at posting the news. Mike Coston at Avian Flu Diary, Crawford Kilian at H5N1, and Debi Brandon at A Pandemic Chronicle all are quite gifted at posting the news. I rely on them because the news, well, I just don’t have the talent. Fluwiki also is a trusted source. Allowing these folks access to the near real time information is both appropriate and to my mind, absolutely necessary in order to add that level of transparency that we need in order to stop the blame game later on. (“I had access, so did you”).

    Just because I cannot do the news doesn’t mean others in the flubie community cannot or won’t. Please consider their many talents.

    Onward and Upwards,
    Catherine

  5. Jim Wilson said

    Catherine,

    Indeed your words are wise.

    I understand the need for news aggregators to assist in public awareness. The main problem I have with them is lack of analysis.

    For example, suspect human clusters of A/H5N1 are certainly a concern. We have been involved in detecting and tracking dozens of them across the world. But they are in of themselves, no reason for panic- but ground investigation is required. One needs to understand the signs to watch for once a suspect cluster appears… it is rigorous analysis that is needed to bound the uncertainty and calm fears.

    Cheers,
    J

  6. preparedcitizens said

    I understand exactly what you are saying. At first ProMed made me quiver like Jello. It wasn’t until I understood that there are semantic differences in the words used that I was able to temper these alerts with a rational approach.

    Certain words like cluster, epidemic, outbreak, hysteria, panic, fear, spreading, uncontrollable, failure, these are all evocative words that must be used very carefully. They may have their place in risk communication but there is a time and place. But then, saying that, makes me sound like I am attempting to manipulate the flow of information. It isn’t that so much as I know that certain words at certain times during our understanding of these things as members of the public at large can really do more harm than good. Adjustment reactions are hard things sometimes and there are times when people really have trouble making it through them. I just do not want to be one who adds to anyone’s burden unnecessarily.

    I can explain how a pandemic balls starts rolling across the globe with increasing sizes and numbers of clusters but I got to the point in my communication where I did not see the point of doing so. When I look someone in the eye and tell them why pandemic influenza needs to be mitigated and how a flu vaccination may help them they get the point without me having to tell them of an imminence that may not be there yet.

    To me, this is so much like spreading the Gospel message. The importance isn’t in the imminent return of our Lord (although I long for and look forward to His return). The importance of the Gospel message is in Jesus Christ’s atonement for our sins on the cross. If you understand and accept *that* His imminent return, while not unimportant, is in proper perspective. We want a deep abiding faith and not a foxhole faith (although a foxhole faith works).

    What I want is for people to understand that we are in a normal cycle of ebb and flo which is made a bit worse because of how we have structured our modern world (JIT delivery etc.). The problem is not insurmountable but we have to work at it. Failure to work at it will result in more death than the disease itself would have caused.

    Rigorous analysis of these news stories is accomplished on some of the forums like Plan for Pandemic and Pandemic Flu Information Forum, Zonegrippeaviare, La Grippe Aviaire, and Flutrackers. Over the years we were able to discuss these news items, their importance, and their deeper meaning. Greater flublogia has done some amazing work and these are mostly just citizens like me in their own countries working on this common issue of understanding a terrible problem and how to safeguard themselves and their families. A few of us have taken this work a bit further into our communities.

    Without the news and information I doubt that all that has been done would have even been carried this far. I know that it doesn’t seem like much but Readymom’s Alliance and GetPandemicReady has reached thousands of people already with solid pandemic preparedness information.

    Knowing what is happening in these far flung places around the globe does help us to know how to temper our words.

    When I hear of larger clusters anywhere in the world (and know for sure that it is H5N1, or another novel strain of influenza and not a local outbreak of Dengue, Malaria, Chikungunya, yellow fever or ebola etc.), I will probably turn up the heat of my words. Not because I am panicking but because time to “pre”pare will be over and it will be time to put action and response in its place. I do have to keep an eye on the horizon and the news aggregators help.

    Do I think that we in the public will receive timely information? Unfortunately my state has every intention of informing the public after it is too late to prepare. Once a state of emergency is declared much too little can be accomplished. I have read the response “triggers” and I do not understand how they can think a family of 4 making under $35,000 per year would be able to stock up for an extended period of time in their home. If we are expecting a category 1 or 2 pandemic, fine, that would work. If we are expecting anything beyond a category 3, um, that is way less than fine. There are no guarantees that H5N1 (or any virus that becomes H2H) will attenuate. There are many variables at play here. Because there is no guarantee “first, do no harm” tells me that informing the public in enough time for them to prepare is crucial.

    So we have gone full circle here…”how might we marry graded awareness with a more gentle, graded social response?”

    Sometimes “gentle” just does not work. Sometimes the brutal, honest, straightforward truth is what is needed. A brimstone and fire sermon had it’s place (and probably should be preached today). As for me, I would rather deal with a little panic now, before the pandemic, than during the initial stages where congregating to prepare will just spread the virus further faster.

    So just because few are watching these news reports doesn’t mean that they are without worth. They are worthy. How we who blog discuss them and bring them to peoples attention….with great care, at least for me. I pray about the words that are laid on my heart every single time I sit down to post.

    Thanks Jim. You have made me think. That is always good. :-)

    I pray that you have, that we all have, a healthy New Year!

    Catherine

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