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by revere, cross-posted from Effect Measure

We are now almost through the period considered to be the traditional flu season (to the end of March in the temperate northern hemisphere) and so far the amount of documented influenza infection is at a relatively low normal level and pneumonia and influenza deaths are about usual for this time of year. Said another way, there so far has been no big “third wave” of pandemic swine flu. Most flu experts didn’t know what would happen but if they had to bet, probably would have bet on a resurgence. I suppose it could still happen, since the original transmission in the community occurred “out of season” (April to June of last year). But now the odds look to be against it. So what lesson do we draw from this? I hope it’s not the wrong one:

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by revere, cross-posted from Effect Measure

It really gives me heartburn to see an otherwise sensible article in AOLNews by Katie Drummond with a headline: “Hyping H1N1: Did It Create a Dangerous Flu Fatigue?” I don’t know if that was her title or not. Newspapers have headline writers who often seem never to have read the piece they are headlining, but online authors often title their own pieces. In any event, the word in the headline I object to is “Hyping.” It implies deliberate exaggeration for ulterior motives.

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by revere, cross-posted from Effect Measure

The finger pointing and the told-you-so-ers are out in force these days and WHO seems to be one of their targets. In the face of wealthy European countries cutting their swine flu vaccine orders because of limited demand, critics are claiming that WHO exaggerated the threat in league with or under the influence of Big Pharma vaccine makers out to make a killing. This is really two issues. One, did WHO appropriately appraise the risk; and two, were they unduly influenced by greedy drug makers. I think the answer to these questions are “Yes” and “No.”

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by revere, cross-posted from Effect Measure

I’m an epidemiologist and I train epidemiologists so you expect me to think epidemiology is important to public health. Epidemiology describes the pattern of diseases in the community and tries to figure out why some patterns exist and not others. It is used for both applied health research (causes of disease and disease outbreaks), disease control and for administrative purposes (how many hospital beds will we need, for example). When I was in medical school most epidemiology, such as there was, was done by medical doctors or employees of federal, state and local health departments. Starting in the sixties, academic programs in epidemiology started to take off, and now there are many masters and doctoral level training programs in epidemiology. But still not enough epidemiologists to meet the need, apparently. And we aren’t moving forward. We’re sliding backward.

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by Ken Ward, Jr., cross-posted from Sustained Outrage: A Gazette Watchdog blog

Last August, Kanawha Valley residents lived through the spectacle of their public safety officials practically begging the folks who run the Bayer CropScience chemical plant to tell them what was on fire, and what toxic chemicals residents nearby were being exposed to.

Remember the exchange between Metro 911 officials and the plant?

“Well, I can’t give out any information, like I say, we’ll contact you with the, with the proper information,” a plant gate worker who identified himself only as Steve told a 911 dispatcher.

Kanawha County officials and local firefighters said the situation led to “chaos” in their efforts to protect the public.  Political leaders demanded improvements, and we are promised they’ve been made.

But have reforms been made? Will the public be better served the next time there’s a big plant accident?

Well, let’s consider last evening’s apparent spill from Dow Chemical’s South Charleston plant. We had a small item today in the print edition, and online, about this incident:

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by revere, cross-posted from Effect Measure

There is an attitude toward the prospects of an influenza pandemic and what, or what not, to do about it that I have little patience with. We saw examples a couple of years ago with the writings of Wendy Orent and Marc Siegel and now it is surfacing again from Philip Alcabes, in an op ed in the Washington Post over the weekend. All three are smart and well informed — but that doesn’t prevent them from being wrong headed. The Alcabes piece, ironically entitled “5 Myths About Pandemic Panic” is either built on myths or strawmen, take your pick. Here is my commentary on the “5 Myths”:

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by revere, cross-posted from Effect Measure

There is a good summary by Robert Roos at CIDRAP News about the $420 billion spending bill signed by President Obama this week to cover the next six months. The good news edges out the bad news, so the net is positive, a welcome change from the kind of deeply depressing budget news to which we became accustomed during the Bush years. Bush took a teetering public health system whose decline started with Reagan and continued through Clinton and put it on life support. Now a couple of items in the spending bill have upped the oxygen slightly but don’t increase the circulation in all the critical organ systems. In particular, it didn’t restore any of the $900 million in aid to state and local public health that was zeroed out of the stimulus bill. The new spending bill includes no pandemic money for them, either, an incredible omission. It will be the state and local public sector people that will bear the brunt of a pandemic. Much better to fund local public health than $40 million for countermeasures for HHS staff and contractors or $700 million for pandemic planning at HHS. Too much of that planning is wheel spinning at this point. Better to give more money to state and local health departments to implement plans and build badly depleted capacity. But there is also some badly needed money for important purposes.

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Last August 28, Bill Oxley and Barry Withrow, 45 were working at the Bayer CropScience’s plant  in Institute, WV when a massive fireball erupted in an area where methomyl for the carbamate insecticide thiodicarb (Larvin) is produced.  Mr. Withrow was killed immediately in the blast, and Mr. Oxley died after 43 days in a Pittsburgh burn center.   When I first wrote about this disaster, in “911 operator: “I’m only allowed to tell you we have an emergency,” I focused on reporting by the Charleston-Gazette’s Ken Ward, who used excerpts from the 911 emergency call transcripts to demonstrate Bayer’s dangerous tight lips about the explosion.  They refused to give adequate details to the 911 dispatcher, complicating the situation for local officials responsible for citizen’s safety.  For a time, a “shelter-in-place” order was made for local residents.

BayerCrop Science’s secrecy continues, at the expense of the public’s right-to-know.  The U.S. Chemical Safety Hazard Investigation Board (CSB) is investigating the incident and had scheduled a public meeting on March 19 to brief residents openly about the Board’s work.  Ken Ward reported yesterday that the company’s lawyers warned the CSB that information about the blast should not be discussed in a public forum. 

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