Analysis of H1N1 flu response shows progress, problems

first_imgJun 4, 2009 (CIDRAP News) – A coalition of health policy groups today offered a “good news, bad news” evaluation of the US response to the novel H1N1 influenza epidemic so far.The good news: The experience has shown that years of pandemic preparation have paid dividends, particularly with regard to coordination, communication, antiviral drugs, and vaccine development.The bad news: The outbreak has pointed up the serious limitations of the financially strapped public health sector, suggesting that it would be overwhelmed in a more severe and widespread epidemic.The report was produced by Trust for America’s Health (TFAH), a nonprofit, nonpartisan advocacy group in Washington, DC, in collaboration with the Center for Biosecurity at the University of Pittsburgh Medical Center and the Robert Wood Johnson Foundation.”It was clear in our report that all the pandemic planning and preparedness efforts over the past several years have improved our ability to respond to an outbreak, but it was also clear that the situation didn’t test the limits of our response,” said Jeff Levi, PhD, executive director of TFAH, at a press briefing this morning.Positives and negatives are sprinkled through the 10 lessons presented in the report, titled “Pandemic Flu Preparedness: Lessons from the Frontlines.” Many of them repeat familiar TFAH messages about the need to restore and strengthen the nation’s public health infrastructure.Investments prove wiseThe first finding was that federal, state, and local planning efforts of recent years “enabled public health officials to react to the outbreak effectively and keep the public informed. Investments in antiviral stockpiles and enhanced vaccine manufacturing capacity also proved to be prudent.”At the press briefing, David Fleming, MD, director of Seattle and King County Public Health, strongly endorsed that conclusion. He said Seattle officials had thought through many of the issues and stockpiled medications.In particular, “Telling citizens we had sufficient supplies of Tamiflu [oseltamivir] went a long way” to help the situation, said Fleming, a peer reviewer for the report.He said that by the time the outbreak began, private antiviral supplies were “essentially zero,” because it was the end of the regular flu season. “We dipped into our local reserve [of antivirals] and made those available to people through our public health clinics,” which resulted in moderate but not overwhelming use, he added.Nationally, only modest amounts of stockpiled antivirals have been used, since relatively few people have been infected, said Thomas V. Inglesby, MD, deputy director of the Center for Biosecurity and a co-author of the report. But he said the stockpiles gave people confidence in their ability to help the sickest patients, adding, “I think the investment is widely seen to have been wise.”Lack of resources exposedThe second lesson cited in the report is that public health departments didn’t have enough resources to carry out their carefully made plans.”Capacity to track, investigate and contain cases of H1N1 has been hampered due to lack of resources,” the document states. “For instance, CDC [Centers for Disease Control and Prevention] and state laboratory testing was days to more than a week behind the on-the-ground reality.”Fleming said the national surveillance picture was 1 to 2 weeks behind what was happening on the ground. In Seattle, some schools that had possible cases were closed and then reopened before the CDC confirmed and reported a single local case of the novel flu, he said.Largely because of the economic recession, Fleming said, “It’s getting really tough on the front lines of public health in this country now.” For example, he said Seattle has had to reduce its public sector immunization efforts by 80%.He also said a key part of Seattle’s response to the novel flu was using public health nurses to educate school and daycare authorities about the outbreak. Ironically, many of the nurses were due to receive layoff notices 2 weeks after the start of the flu outbreak.A third finding was that, though the outbreak was mild, healthcare systems in some areas were “overwhelmed.” In many hospitals, emergency departments were flooded by the “worried well,” and some outpatient clinics had inadequate personal protective equipment and “a limited understanding of infection control measures.”The report, however, doesn’t offer an estimate of how widespread these problems were.Need for flexibility, good communicationAnother lesson was that the outbreak underlined that pandemic plans must be adaptable, according to the report. It notes that pandemic planning has focused on the threat of the virulent H5N1 avian influenza and often has assumed that the United States would have 6 weeks of lead time before an emerging pandemic strain overseas reached US shores. Instead, the novel H1N1 outbreak featured a generally mild virus emerging in North America.On the public communication front, the report gives US leaders good grades, saying the president and other authorities conveyed consistent, accurate information about hand hygiene, respiratory etiquette, and the need to stay home when sick. Leaders also helped dispel rumors, such as concerns about the safety of imported Mexican foodstuffs.Other lessonsOther early lessons from the epidemic, the report says, include the following:Where schools were closed because of the outbreak, parents had to scramble to find alternative child care arrangements.The lack of sick leave caused problems. There were reports of people with flu-like symptoms going to work because they had no sick leave, which is true for 48% of American workers, said Levi. Also, some parents sent sick children to school because they couldn’t stay home to care for them.Communication between the public health system and medical providers fell short, as many private practitioners complained that they did not receive CDC guidance documents in a timely fashion.The World Health Organization’s (WHO’s) pandemic alert system was not well-matched with the realities of the H1N1 outbreak. (The WHO’s alert phases are based strictly on the geographic spread of the virus, not the severity of disease. The agency said this week it would come up with a severity scale in an effort to reduce confusion.)International coordination posed some problems: Against WHO advice, some countries closed their borders to Mexican citizens or banned pork from the United States and Mexico.’Biggest single vaccination program’Several questions at the press briefing had to do with how the novel virus might behave when the next flu season hits in the fall and the prospect of a nationwide vaccination campaign.Inglesby predicted that the vaccination drive will be “the biggest single vaccination program for influenza and probably for any virus in a short period of time that’s been performed in the United States.” Five or six years ago, there would have been no possibility of starting mass vaccinations in the fall, because the necessary infrastructure investments had not been made, he added.He and the other officials asserted that vaccination planning should forge ahead despite the unpredictability of public demand for the vaccine.”If it turns out that for whatever reason there’s not an interest in taking the vaccine, there’d be the ability to slow down or turn off production,” he said. “But my sense is there’ll be an unusual level of interest in the vaccine.”Fleming said school children will be a critical target group for vaccination against the new virus. Asserting that the virus is capable of causing “explosive” school outbreaks, he said, “We absolutely need to prioritize our kids and especially kids who are susceptible to complications from influenza.”It’s not possible to predict whether the new virus will elbow out seasonal viruses and become the predominant strain next fall and winter, said Inglesby. That’s why the government is proceeding with plans to offer vaccination against seasonal flu and the new virus.”I’m agnostic, and health authorities seem to be agnostic in general about which one will out-compete the other,” he said.See also: TFAH press releasehttp://healthyamericans.org/newsroom/releases/?releaseid=178Full text of reporthttp://healthyamericans.org/assets/files/pandemic-flu-lesson.pdflast_img read more

John wins Victor Macedo 75-mile cycle road race

first_imgTEAM Coco’s Jamal John rode a well-calculated race to win the 15th edition of the Victor Macedo Memorial cycle road race yesterday, in a time of three hours, five minutes 11 seconds. The winning time was six minutes faster than last year’s, which was three hours 11 minutes six seconds.After rolling off from Macedo’s residence on Peter Rose Street, Queenstown, Georgetown, and getting the green flag on Homestretch Avenue, John along with Jaikarran Sukhai, Paul Cho-Wee-Nam, Alonzo Ambrose, Michael Anthony, Akeem Wilkinson and Raul Leal broke from the pack and led all the way to Long Creek, Linden/Soesdyke Highway, via the East Bank Demerara carriageway and were never caught again until after turning for home from Long Creek, Linden/Soesdyke Highway.They were eventually caught by Team Evolution’s Orville Hinds near the Umbrella Resort on the Linden Highway.Together, the leading bunch worked in tandem until they reached the final turn at the National Cultural Centre into Homestretch Avenue when Cho-Wee-Nam staged an attack with approximately 500 metres remaining to the finish line, but John was quick to respond followed by Ambrose with the other five cyclists struggling to keep up with the pace.In the end, the inform John won ahead of Ambrose, Hinds, Cho-Wee-Nam, Wilkinson, Leal, Anthony and De Nobrega respectively.Anthony won three of the 10 prime prizes that were up for grabs, while John and Leal won two each. Ambrose, Cho-Wee-Nam and Hinds won one each.In the Junior category, Christopher Cornelius returned three hours 16 minutes 17 seconds in winning his category ahead of Nigel Dugid and Adealie Hodge, respectively.Eon `Dumb Boy’ Jackson won the Veterans’ over 40 years of age category ahead of Amrit sankar, while in the Veterans’ under 45 years category, Jaikarran Sukhai was first. Second place went to Junior Niles, while Warren McKay placed third.Ozia McAullay won the Mountain Bike category ahead of Julio Melville and Jude Bentley in that order.The event was sponsored by Macedo Transportation Services and was organised by the Flying Stars Cycle Club.last_img

Dino Babers on ACC coaches teleconference: ‘Lamar’s going to get his’

first_img Published on November 15, 2017 at 12:27 pm Contact Matthew: mguti100@syr.edu | @MatthewGut21 Babers said Jackson does “everything” better than WFU QB John Wolford, who racked up 502 total yards last week in SU’s 64-43 loss. Syracuse allowed a season-worst 64 points and 734 yards against. Wake Forest’s spread, no-huddle offense clicked via run-pass options, which Jackson has practically mastered at the college level. And Wednesday morning, Babers said that he thinks Jackson is having a better season than he did last year.“That’s not good for us,” Babers said. “We need to find a way to play team defense.”Louisville head coach Bobby Petrino said Wednesday that Jackson may not be able to exploit the SU defense the same way Wolford did. Petrino said most teams UofL has played this season draft up different defenses specifically for Jackson, who is averaging 418 total yards per game (393 in 2016). He is 11th in the country in passing yards, 25th in passing efficiency and fourth in points responsible for.“All year long people have come in with a different game plan for Lamar,” Petrino said. “Lamar’s been very good at adjusting, understanding the fronts, coverages, who they’re trying to get to … we’ll need to be aggressive early.”Other notes from Babers’ teleconference:Babers said he believes junior quarterback Eric Dungey is getting better and is hopeful he can play at Louisville. Dungey did not play against Wake Forest. On Monday, Babers said: “If he’s capable, I expect him to go.”On the WFU loss, during which Syracuse blew a 17-point lead: “I think they’re a little embarrassed. I think they’ve got a bad taste in their mouth.”On backup QB Zack Mahoney, who threw for nearly 300 yards in the first half against WFU but was picked off twice in the second: “When he’s on, we’re capable of scoring a lot of points with him. Hopefully we get first-half Zack and not second-half Zack.”Babers on personnel: “We have to play more people. We’ve got to get more people in there especially when you don’t have the depth that we have. With the amount of snaps offensively and defensively we have, you have to rotate those guys in there so they’re fresh at the end of the game.” Facebook Twitter Google+ Led by Heisman Trophy winner Lamar Jackson, Louisville scored three touchdowns last year against Syracuse — on its first five plays from scrimmage. Head coach Dino Babers addressed the performance on the Atlantic Coast Conference teleconference on Wednesday morning.Jackson, then a sophomore, was effective with his zone reads against SU’s Tampa-2 defense, racking up 199 yards on 21 carries for four touchdowns. That was just on the ground. He threw for another 411 yards and one TD, which came on the first play of the game.Against the Orange inside the Carrier Dome, Jackson became the second player in FBS history to record 400 passing yards and 150 rush yards in a game. He was one rushing yard short of becoming the first player in FBS history to run for 400 yards and pass for 200 yards in a single game. On Saturday at 3:30 p.m., Syracuse (4-6, 2-4 Atlantic Coast) will be tested again as Jackson plays what’s likely the final home game of his college career for Louisville (6-4, 3-4).“I don’t even know if you can control the guy,” Babers said. “It’s like the (Michael) Jordan Rules: Lamar’s going to get his … you try to stop everything else if you’re going to win against those guys. That guy is so dynamic, he’s so hard to stop by himself.“Last year he ran all over us and he threw all over us. He got both parts in last year … people were taking pictures (with him) out of the stadium after the game.”AdvertisementThis is placeholder text Commentslast_img read more