HHS releases plan for coping with pandemic flu

first_imgAug 26, 2004 (CIDRAP News) – Federal health officials today released a lengthy plan for dealing with the potentially overwhelming threat of an influenza pandemic like those that occurred three times in the last century.A flu pandemic today would find the nation unprepared to respond immediately with an effective vaccine or adequate supplies of antiviral drugs, says the plan released by the Department of Health and Human Services (HHS). Such an event could put a crushing burden on the healthcare system and disrupt transportation, business, and public safety, the document states.The draft plan describes numerous steps to take before and during a pandemic. “This plan will serve as our roadmap on how we as a nation, and as a member of the global health community, respond to the next pandemic influenza outbreak,” HHS Secretary Tommy Thompson said in a news release. “Our proposed strategy draws upon the wealth of experience and knowledge we have gained in responding to a number of recent public health threats, including SARS and avian influenza.”Flu pandemics struck three times in the 20th century, the release notes. In 1968 the Hong Kong flu caused close to 34,000 deaths in the United States, and in 1957 the Asian flu killed about 70,000. The most deadly pandemic, the Spanish flu in 1918 and 1919, sickened 20% to 40% of the world’s population and killed about 675,000 people in the United States alone, according to HHS.Flu viruses change slightly each year, requiring annual modifications in the vaccines used against them. In contrast, HHS says, “A pandemic influenza virus is one that represents a major, sudden shift in the virus’ structure that increases its ability to cause illness in a large proportion of the population.” Disease experts fear that such a shift could occur if the H5N1 avian influenza virus currently circulating in East Asia combined with a human flu virus, spawning a new variety that could spread easily from person to person.The Pandemic Influenza Preparedness and Response Plan, as it is called, includes a 55-page main document and 12 “annexes,” which provide guidance for state and local health departments and private healthcare organizations as well as technical information on various preparedness topics. HHS is inviting the public to comment on the plan within the next 60 days.The nation’s first pandemic preparedness plan was developed in 1978, not long after the swine flu cases and vaccination campaign in 1976, according to the document. The plan was last updated in 1993. HHS calls the new plan an “evergreen” document—one that will be constantly modified as new developments warrant.The report cites five grim characteristics of a flu pandemic that guided the planning: simultaneous outbreaks in communities nationwide; an overwhelming burden of ill persons requiring hospitalization or outpatient medical care; likely shortages and delays in the availability of vaccines and antiviral drugs; disruption of national and community infrastructures including transportation, commerce, utilities and public safety; and global outbreaks.The plan says it’s impossible to predict the overall impact of a pandemic on the nation. But it cites estimates published in 1999 of 89,000 to 207,000 deaths, 314,000 to 733,000 hospitalizations, and 18 million to 42 million outpatient medical visits.Vaccination is the primary tool for fighting a flu pandemic, but it takes 6 to 8 months to produce a vaccine for a newly identified flu virus, the document says. Thus it’s not likely that a vaccine will be ready when a pandemic first emerges. In the early stages, the nation will have to rely on antiviral drugs, “quality medical care,” and infection control measures to keep the virus from spreading.Antiviral drugs such as amantadine and oseltamivir can reduce the severity of flu when used preventively or given within 48 hours of illness onset. But, the plan says, the supply of these is limited and cannot be rapidly expanded because there are few manufacturers and the production process is slow. Oseltamivir was added to the Strategic National Stockpile of drugs last year, and HHS is continuing to study how best to use antivirals in a pandemic, according to the plan.Once a vaccine does become available in a pandemic setting, the demand is likely to far exceed the supply at first, the document states. Consequently, the vaccine initially will have to be reserved for certain groups, such as healthcare workers, people providing essential public services, and those with certain medical conditions. Other decisions about who should have priority for vaccine will depend on the pattern of the pandemic and may not necessarily be the same as for annual flu vaccination.HHS expects that in a pandemic, vaccine shortages could spawn a “gray market” with high prices for some vaccine doses, as has happened in some recent years. The agency is considering several options for buying and distributing vaccine. The government could buy all the available vaccine and then distribute it to state and local health departments, or the country could rely on a mixed public-private system or on the present, primarily private system of vaccine purchasing and distribution.The plan says disease-control measures other than vaccines and antivirals could also be used to fight a flu pandemic. For example, usual infection control measures would be helpful in hospitals. However, because people can carry flu viruses without being sick, efforts to keep the viruses out of the country or limit spread in the community are not very effective. On the other hand, if a new virus strain didn’t spread quite as readily, measures such as screening travelers, closing schools, and quarantining exposed people could help, the report states.The plan says that HHS must help state and local governments and the healthcare system plan for a pandemic in view of the likelihood of illness among healthcare workers and shortages of hospital beds and medical equipment and supplies. “Health care facilities may need to be established in nontraditional sites to help address temporary surge needs,” the plan states.The document recommends taking numerous preparedness steps during “inter-pandemic” periods. For example, in the vaccine arena, the plan calls for developing libraries of novel influenza strains that could cause a pandemic and preparing reagents to diagnose infection. The plan also calls for efforts to develop a vaccine targeting an unchanging portion of the flu virus, which would sidestep the need to modify the vaccine every year and possibly permit the establishment of a vaccine stockpile.Some of the other recommended measures include:Strengthening global human and veterinary surveillance of influenzaIncreasing US influenza surveillance to a year-round effortDeveloping investigational vaccines for selected novel influenza strains and evaluating them in clinical studiesDisease expert Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of this Web site, said he hopes the new plan will spur state and local officials and the healthcare system to recognize the serious threat of a flu pandemic. He said he has contributed to federal preparedness efforts for pandemic flu over the years but was not directly involved in producing the latest plan.”The important message is that this plan lays out in substantial detail what needs to be done at the federal, state, and local level to better prepare us for a potential pandemic of influenza,” Osterholm said. “It really calls upon state and local officials, together with healthcare providers and the healthcare system, to come together and take this seriously—that in fact a pandemic is going to occur.”We’re talking about the possibility of 3% to 5% of the population getting ill and dying. Even with this plan, will we be able to get the kinds of hard-to-conduct planning activities moving in state and local areas? It would be unfortunate if state and local officials say, ‘Here’s a federal plan, we don’t have to do any more.’ This is just a start.”See also:Aug 26 HHS news releasehttp://archive.hhs.gov/news/press/2004pres/20040826.htmlMain body of preparedness planhttp://www.flu.gov/planning-preparedness/federal/hhspandemicinfluenzaplan.pdflast_img read more

Wenger: Chelsea are still serene

first_img The Gunners’ sixth successive league win left them just four points behind leaders Chelsea, who have two games in hand, but Wenger is adopting a one-game-at-a-time approach to the closing stages of the campaign. He said: “Look, Chelsea have a good security and at the moment, I feel they have enough cushion to be quite serene. “But we had an outstanding first half going forward and a very fluent game by creating chance after chance, and in the second half, we had just to show different qualities and hang on.” But Newcastle head coach John Carver, who had only one fit central defender for the game, was also able to take positives from a spirited fightback which he felt demonstrated the fact that his players have not started their summer holiday just yet. Carver said: “There certainly wasn’t anyone on the beach with their flip-flops on, that’s for sure. “After the comments last week, which were ridiculous, from ex-players – I’m surprised at that – every single one of them, and I include the lads who came on the pitch as second-half substitutes, gave everything for this football club. “It showed that they are not on their holidays yet.” That barb was aimed in the direction of Match of the Day pundit Phil Neville after his comments last Sunday night, although the former Manchester United and Everton man tweeted during the second half: “Newcastle been brilliant 2nd half so far!”. When informed, Carver said: “That’s nice, I didn’t realise that had happened.” Defeat, coupled with Crystal Palace’s 2-1 victory at Stoke, saw Alan Pardew’s Eagles leapfrog the Magpies into 11th place, although the former Magpies manager’s progress was of little concern to Carver. He said: “I’ve got to be honest, it is because of the situation we are in. Congratulations to Alan, but I am not worried about Crystal Palace. “The only thing that’s on my mind and the only thing I’m worried about is this football club and making sure everything I do is 100 per cent, everything the players do and give is 100 per cent, and that’s all I can ask for.” “We have Manchester City in front of us and behind us, it is tight as well – the only thing we can do is to win our games. “I think Chelsea have too much security. I just think at the moment we are not concluding, we are in a fight. You have seen the game today – in every game, we need to turn up and fight until the last minute to get the points. “That’s what we have to do, just go for the next game and win it. Look, the players want to do as well as they can. We know we have a fight first to be in the top four. We will go step by step, game by game.” Arsenal looked to be heading for a comfortable victory at St James’ Park when Olivier Giroud struck twice inside four first-half minutes to give them a commanding 2-0 lead at the break. But the Magpies, who were booed off at half-time, returned in determined mood and Moussa Sissoko reduced the deficit within three minutes of the restart. They then laid siege to the Gunners’ goal and but for fine reaction saves by David Ospina from Mike Williamson and Ayoze Perez, they might have emerged with something to show for their efforts. Wenger said: “We have played four games in two weeks and three away games at Manchester, in Monaco and here today and we have won all the three. “The last 40 minutes were difficult because our legs had gone a little bit and Newcastle played very well in the second half. Arsene Wenger refused to be drawn into a discussion of Arsenal’s Barclays Premier League title chances after seeing them hold out to claim a hard-fought victory at Newcastle. Press Associationlast_img read more

Report: Arsenal 5 Everton 1

first_imgArsenal 5 Everton 1: Aubameyang, Mkhitaryan sparkle as Ramsey hits treble Dom Farrell Last updated 1 year ago 03:22 2/4/18 AaronRamsey - cropped Getty Images Aaron Ramsey helped himself to a hat-trick and Pierre-Emerick Aubameyang made a goalscoring start to his Arsenal career against Everton. Pierre-Emerick Aubameyang and Henrikh Mkhitaryan dazzled on their Emirates Stadium debuts as Aaron Ramsey’s hat-trick led Arsenal’s unceremonious 5-1 thumping of Everton.By the time £56million recruit Aubameyang displayed his midas touch in front of goal, Arsene Wenger’s side were already three goals to the good and cruising on account of Aaron Ramsey’s first two strikes, which came either side of a Laurent Koscielny header.Mkhitaryan set up the Wales international’s opener and also laid on Aubameyang, his old partner in crime at Borussia Dortmund, for a goal on his maiden Premier League appearance, although the offside flag should have ruled that one out. 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A Liverpool legend in the making: Behind Virgil van Dijk’s remarkable rise to world’s best player Arguably, a defensive showing as abject as the ramshackle interpretation offered by Everton in the first half deserved such ill fortune.On-loan Manchester City centre-back Eliaquim Mangala suffered a debut ordeal and deflected Ramsey’s second past Jordan Pickford, while Sam Allardyce’s pre-match assertion that Arsenal were defensively weak came back to bite him brutally and repeatedly.Everton improved after the break – it would have surely been impossible to do otherwise – and substitute Dominic Calvert-Lewin reduced the arrears before Ramsey claimed the match ball from Mkhitaryan’s third assist.#BIG17 lays it off to @aaronramsey on the edge of the box, and Rambo lashes an unstoppable strike into the roof of the net #AFCvEFC  3-0  (22) pic.twitter.com/em03QHuvcB — Arsenal FC (@Arsenal) February 3, 2018 Arsenal’s new-look forward line slotted effortlessly into gear as the two one-time Dortmund allies combined to create a sixth-minute opener.Aubameyang found Mkhitaryan with a clever reverse pass down the right channel and the Armenia playmaker cut an excellent ball across the Everton six-yard box to leave Ramsey with a simple finish.The record signing had a shot deflected behind by Ashley Williams that led to another corner, at which point Arsenal made it 2-0 – Shkodran Mustafi flicking on a delivery from the newly contracted Mesut Ozil for fellow centre-back Koscielny to stoop and convert.It was proving to be a somewhat contrasting debut for Mangala as he turned his back to deflect Ramsey’s 19th-minute drive beyond Pickford’s best efforts.Mustafi celebrated as if he was the latest man to get on the scoresheet when his flying challenge denied Theo Walcott a breakaway goal on his return to Emirates Stadium.In the 32nd minute it was time for Aubameyang’s counter-attacking pace to come to the fore, with Ozil’s ball over the top releasing him, but England goalkeeper Pickford stood firm.Having gone for power on that occasion, the Gabon striker delighted with sumptuous finesse to chip home his maiden Premier League goal – his link-up with Mkhitaryan proving fruitful once more.You’ve heard from us all day, so we want to hear from you…How would you sum up our #AFCvEFC performance in 5️ emojis? pic.twitter.com/lMEA6wl9P1— Arsenal FC (@Arsenal) February 3, 2018Arsenal left-back Nacho Monreal almost prolonged his recent goalscoring form by heading against the post before a disorientated Everton made hastily for the dressing room.Walcott had a shot blocked before curling in a delightful cross for Oumar Niasse to hit the upright, meaning the visitors’ rally early in the second half was as impressive as it was futile.Allardyce decided Walcott had given enough on his old stomping ground after the hour and replacement Calvert-Lewin outjumped fellow substitute Sead Kolasinac to plant a header past Petr Cech.The veteran goalkeeper soon made way for David Ospina, having failed to shake off a knock from when Niasse tested his post.And the new shot stopper was given even more insurance 16 minutes from time when the on-rushing Ramsey slammed home Mkhitaryan’s cutback.Sixth-placed Arsenal are now within three points of Tottenham in fifth, while Everton being 14 back from the Gunners in 10th seems an inadequate demonstration of the gulf between the sides.Hat-trick for @aaronramseyHat-trick of assists for @HenrikhMkhDebut goal for @Aubameyang7Four first-half goals help Arsenal to a resounding win at the Emirates #ARSEVE pic.twitter.com/CX3IaZ5daK— Premier League (@premierleague) February 3, 2018 Key Opta stats: – Arsenal are only the second team to lead by 4+ goals in half-time in consecutive Premier League home games, after Manchester United in November 1997 (vs Barnsley and Sheffield Wednesday).- Arsenal vs Everton is the highest scoring fixture in Premier League history (151 goals), with Arsenal’s 105 against the Toffees a record for one team against another in the competition.- Pierre-Emerick Aubameyang became the eighth player to score on his first ever Premier League appearance for Arsenal, after Steve Bould, Kevin Campbell, Freddie Ljungberg, Emmanuel Adebayor, Samir Nasri, Thomas Vermaelen and Alexandre Lacazette. read morelast_img read more