Both Overreacting And Underreacting

While the WHO raised their pandemic alert to Level 5, the second-highest level, they also significantly lowered the confirmed number of deaths in Mexico from the H1N1 (swine flu) virus.

30 April 2009 -- The situation continues to evolve rapidly. As of 17:00 GMT, 30 April 2009, 11 countries have officially reported 257 cases of influenza A (H1N1) infection.

The United States Government has reported 109 laboratory confirmed human cases, including one death. Mexico has reported 97 confirmed human cases of infection, including seven deaths.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (19), Germany (3), Israel (2), Netherlands (1), New Zealand (3), Spain (13), Switzerland (1) and the United Kingdom (8).

Further information on the situation will be available on the WHO website on a regular basis.

In that context, Joe Biden's comments about not allowing his own children to fly on planes or ride on subways seem hyperbolic. But Ezra Klein makes a compelling case that we SHOULD overreact to this possible pandemic.

It's true that the flu is, as of now, not especially deadly. Survival rates are quite high. That's a very good thing. And there's some evidence that this flu will prove mild. Possibly even more mild than a bad flu season. But it's not the end of the story. Influenzas mutate. The question is whether it mutates out of existence or towards lethality. "Towards lethality" becomes more likely if more people catch the flu and thus more mutations emerge. So being aggressive in stopping the spread of the largely non-lethal variant is important if we want to avert the development of a more lethal strain. It's not about stopping this flu. It's about stopping what this flu can become.

But if the flu isn't currently very lethal, it does appear to be extremely infectious. The reason is simple enough: It's a new strain of flu that human beings don't have resistance against. Not only can it spread very quickly, it is spreading very quickly. We've hit five on the World Health Organization's flu threat level. It only goes up to six. Six denotes a pandemic: The flu has spread to two or more WHO regions. And most experts expect we'll be there in days.

It's true that people shouldn't panic in the sense of stockpiling ammunition and duct taping windows. But this is a situation in which a short-term overreaction might be the best strategy. That would mean that people really curtail the sort of activities that abet the spread of infection: They cancel non-essential travel, bike rather than take the subway, wash their hands obsessively, etc. It's not crazy stuff. And unlike in financial crises or recessions, where cutting spending worsens the downturn, the sensible actions for fearful individuals will actually improve the probable outcomes.

I think the media has a responsibility to deliver realistic information, not conservative scaremongering that over-hype the threat and unjustifiably blame illegal immigrants and not what appears to be the central cause, factory farms. And I think there is a responsibility to keep this virus in perspective. At the same time, Klein's warning seems eminently reasonable. We don't have enough information to blow this off completely.

Steele's Got Them Right Where He Wants Them

Michael Steele, last seen arguing that nobody could have anticipated the swine flu, so it's OK for Republicans to have cut flu preparedness money out of the stimulus (because the duty of government is to not anticipate anything), now may get a leash put on him by the party officials who elected him, to their eternal regret:

A battle over control of the party's purse strings has erupted at the troubled Republican National Committee, with defenders of Chairman Michael S. Steele accusing dissident RNC members of trying to "embarrass and neuter" the party's new leader.

Randy Pullen, the RNC's elected treasurer, former RNC General Counsel David Norcross and three other former top RNC officers have presented Mr. Steele with a resolution, calling for a new set of checks and balances on the chairman's power to dole out money.

The powers include new controls on awarding contracts and spending money on outside legal and other services.

If I were a member of the party, I'd want this, actually. Here in California, we saw a grassroots candidate, Hillary Crosby, win the race for Democratic Party Controller over just this issue, the ability to provide meaningful checks to the party over where money should be allocated. To see it in the national Republican Party, which has always been top-down, is striking, and a symbol of just how little control Steele has. His first 100 days have been atrocious, and the party appears to be slinking quietly away from him.

The Answer Is We Don't Know

The first US victim of swine flu is a 23 month-old child who died in Texas. However, he was infected in Mexico. The danger of this strain of flu will probably not be apparent until the fall, when we see if it mutates. Right now, it's harmful, but not more so than other flu viruses, which kill thousands annually, usually those who are vulnerable like children and the elderly. If it mutates into something more dangerous, we won't be able to mitigate the effects as well. Whether or not that will happen remains to be seen.

...Meanwhile, the Organic Consumers Association has demanded that Smithfield close its factory farms that may have contributed to the virus.

Factory farms, such as Smithfield, dose pigs with massive amounts of antibiotics and vaccines, resulting in swine incubating and spreading antibiotic-resistant pathogens and mutated viruses. This is considered a major human health hazard by the United Nations Food and Agriculture Organization. Given these serious public health concerns, a number of health and safety organizations have called for limits or bans on the use of antibiotics in livestock farming including the American Public Health Association, American Medical Association, Infectious Diseases Society of America, the American Academy of Pediatrics, and the Union of Concerned Scientists. .

Organic Consumers Association and Via Organica are calling on their hundreds of thousands of members in the US and Mexico to contact Mexican President Calderon and his Agriculture Secretary Alberto Cardenas and US President Obama and his Agriculture Secretary Tom Vilsack and urge them to:

• Immediately ban Confined Animal Feeding Operations (hog, beef, and chicken factory farms) across the United States and end the dangerous practice of feeding antibiotics to farm animals.

• Initiate a criminal investigation of Smithfield Foods and other major factory farms that could be a source of disease outbreaks.

It's "Interesting" That I'm A Complete Loon

Michelle Bachmann fails to grasp the difficult concept of the timing of Inauguration Day.

BACHMANN: I find it interesting that it was back in the 1970s that the swine flu broke out then under Democrat President Jimmy Carter. And I'm not blaming this on President Obama, I just think it is an interesting coincidence.

Last US outbreak of swine flu: February 1976.

President of the United States at the time: Gerald R. Ford.

Michelle Bachmann: out of her gourd.

I'm not blaming her lack of a brain on Bachmann herself, I just think it is an interesting coincidence.

As The Swine Flu Turns

Let's move from Specter, donkeys and elephants, over to swine flu. We're up to 68 cases in the United States and 98 cases outside of Mexico in the rest of the world. We've seen hospitalization here but not as virulent a sickness as in Mexico, where reports show up to 150 dead. The expert at the WHO said yesterday that the spread of the virus cannot be contained, and now we need to work on mitigating its worst effects. And considering that we're starting to see new cases in new countries, that seems correct.

While the WHO has raised the global pandemic alert, they're also keying in on the source of the outbreak.

In Mexico, where the only related deaths have been reported, state health authorities looking for the initial source of the outbreak toured a million-pig hog farm in Perote, in Veracruz State. The plant is half-owned by Smithfield Foods, an American company and the world’s largest pork producer.

Mexico’s first known swine flu case, which was later confirmed, was from Perote, according to Health Minister José Ángel Córdova. The case involved a 5-year-old boy who recovered.

But a spokesman for the plant said the boy was not related to a plant worker, that none of its workers were sick and that its hogs were vaccinated against flu.

Tom Philpott has been all over this since Friday. The Smithfield farms in Perote are thought to have infected the water supply and the atmosphere. Drinking pig shit will tend to do that. Can we finally have this debate about factory farming?

The latest news is that the LA County Coroner is investigating two deaths that may have resulted from swine flu. Obviously this is concerning, but at the same time, the large majority of strains here have been less virulent, and we have no confirmation on this case in LA.

...It's amusing to hear media types talking about how people should stay home from work if they're sick when nearly half of private-sector workers don't have paid sick days. I'm one of them. As a freelancer, I only get paid if I come to work. So if you want to keep America prepared in the event of an outbreak, you have to set up ways for Americans to be able to stay home from work without threatening their financial livelihood. Not to mention the 47 million without health insurance. This highlights the need for a bigger public health safety net.

...John Barry, author of a great book about the deadly 1918 influenza that killed 670,000 in the United States, has a good piece about where the swine flu will strike next.

Now They Want Sebelius

Looks like we may have a Health and Human Services Secretary by tomorrow, just in time to get started in the middle of a flu outbreak and fears of a pandemic. Funny how the GOP finally agreed to end the obstruction right at this time, ay?

On the flip side of this, I agree with Brian Beutler that the continued obstruction of Dawn Johnsen is troubling.

In fact, Dawn Johnsen's nomination to head the Justice Department's Office of Legal Counsel seems to be, if anything, in more trouble than does Sebelius'. There have been rumors of a Johnsen filibuster for weeks now, and outside groups, both pro-confirmation and anti, have been lobbying Congress as the process has all-but-ground to a halt. (Just today, the groups People For the American Way, Alliance for Justice, National Women's Law Center, and NARAL Pro-Choice America hosted a conference call for reporters during which former OLC-chiefs Walter Dellinger (who served under Clinton) and Douglas Kmiec (who served under Reagan and George H.W. Bush), along with Johnsen's Indiana University colleague Aviva Orenstein, made the case for a quick confirmation.)

Now, keep in mind that Sebelius will be a cabinet-level official while Johnsen will not, and in that sense it's plausible that Democrats have prioritized a vote on Sebelius' nomination in order to make Obama's cabinet whole. But it's also plausible that Senate Majority Leader Harry Reid (R-NV) isn't as sure he can clear the cloture hurdle if the question on the floor is on the confirmation of Dawn Johnsen. More on the apparent disparity as I learn it.

Especially given the release of the OLC memos justifying torture and the display of how important that office is to upholding the rule of law, we need Johnsen in that seat now more than ever.

...Sebelius will still need 60 votes, by the way, though it appears safe that she can get them.

Playing Politics With People's Lives

Well that sure was smart.

Sen. Susan Collins (R-ME) was apparently unwilling to be seen as endorsing such "funny" sounding priorities as flu "preparedness" in an economic recovery package. Perhaps in an attempt to prove her fiscal conservative bona fides, Collins repeatedly insisted that (Rep. David) Obey's pandemic preparedness funding did not belong in the bill:

COLLINS: There's funding to help improve our preparedness for a pandemic flu. There is funding to help improve cyber security. What does that have to do with an economic stimulus package? [CNN, 1/31/09]

COLLINS: I think everybody in the room is concerned about a pandemic flu. But does it belong in this bill? Should we have $870 million in this bill? No. We should not. [MSNBC, 2/5/09]

After the funding was stripped, another moderate Republican attempting to appear tough on "unnecessary" spending in the recovery package, Sen. Arlen Specter (R-PA), endorsed Collins' crusade against the pandemic preparedness funding on Fox News:

MS. KELLY: Okay. $780 million for pandemic flu preparedness, in or out?

SEN. SPECTER: Out. Very important projects, I took the lead along with Tom Harkin on some massive funding for pandemic flu, but it belongs in our regular appropriations bill.

The argument for putting flu preparedness in the stimulus was that an outbreak at a time of economic downturn would be devastating, not to mention the fact that anything that spends money to buy anything is stimulus, and the money is gone for state and local public health for flu pandemics:

Hamburg said there is no more pandemic preparedness money in the pipeline for state and local public health. "The $600 million that was made available in December 2005, in the fiscal year 2006 emergency supplemental bill, the last of those dollars went out the door this past August," he said.

In addition to the cutoff of pandemic flu funding, public health agencies have seen their "all hazards" preparedness funding drop about 25% since 2005, Hamburg said.

TFAH and its partners are advocating for another $350 million specifically for pandemic readiness and additional money for other public health emergencies, he said.

There is likely, especially now, to be additional funding in the FY2010 budget, and maybe even an emergency appropriation. But right now, we have no money in the pipeline for flu pandemics, DURING a possible flu pandemic (I don't want to get too hyperbolic, because the severity remains to be seen).

This outbreak is also occurring at a time when we have no Health and Human Services Secretary, thanks to:

The Service Employees International Union has launched an online petition criticizing Republicans for delaying the confirmation of a Health and Human Services secretary in the face of a swine flu outbreak.

The union accuses Senate Republicans of delaying the confirmation of nominee Kathleen Sebelius to “curry favor with extremist outside groups” and depriving the department of leadership as the nation confronts a potential flu pandemic.

“This is simply unacceptable,” the union says on its website. “This disease is spreading as we speak, but right now, a Bush-appointed accountant is running the department. We need an HHS secretary NOW. Sign the petition telling the Senate to vote immediately to confirm Gov. Kathleen Sebelius. If we don't act, the swine flu might just turn into another Hurricane Katrina.”

To Republicans, governance comes last. Winning a cable news debate comes first. The country suffers.

Sign the petition.

Oink

US declares public health emergency for swine flu

Yikes. Haven't followed this closely while up at the CDP convention, but this will be an example of how strained the public health system truly is in this country. We're not prepared for the normal course of events, let alone an emergency.

More when I can digest it.

...Hilarious. Secessionst Gov. Rick Perry, suddenly mindful of the value of the federal government, asks the CDC for help and antiviral medications to potentially deal with a swine flu outbreak.