Vital Systems Security

DemfromCT — a blogger on DailyKos — has another interesting post on school closure and pandemic preparedness. It is about many things, among more information on exercises that show that in the US school closure may not be in time to help much, and an interesting comparison with a recent minor outbreak in Hong Kong, where, apparently, parents held students home from school in a “precautionary” fashion before a decision was taken to close schools. Also interesting is the mention of the role that blogs and the internet more generally would play in a pandemic.

The special issue of Interfaces journal from 2006 was entitled: Homeland Security: Operations Research Initiatives and Applications. You might find some of the papers interesting, since they touch on broad range of topics discussed on this blog. Some of the topics are bio-security/terrorism, emergency response and critical infrastructures. The article number 6 is especially interesting, since the author starts by drawing a direct link between homeland security and the genealogy of operations research expertise that we have been tracing in OEP research.

Despite recent spikes in H5N1 avian influenza activity in humans and birds, there have been fewer bird outbreaks in fewer countries this year [2007] than in 2006, according to a preliminary report from the United Nations Food and Agriculture Organization (FAO).
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All: I am happy to make another introduction to our little group. Benjamin Hickler is a student in the joint Med. Anthro program at UCSF. He comes to us via Paul’s seminar, and is now engaged in fieldwork. He recently sent me a description of his project — of very great interest — that I thought I would be great to share and discuss. Read on to see it!

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I haven’t had a chance to read this yet, but thought it was interesting: An Investor’s Guide to Avian Flu Found it on the UPMC Center for Biosecurity site in a page they have for a 2005 conference on avian flu and the private sector.

A quick follow on Dale’s post. I just wanted to direct attention to the nice posting from demfromct at dailykos on pandemic preparedness, emergency response, and related matters. A recent post addressing the National Response Framework included this choice graphic on pandemic flu authorities and responsibilities that seemed too good to let slip past. Note the dead bird in the upper left. (What is going on with that bird exactly? Maybe just resting? Hanging upside down? Etc.) Dynamic org. charts of emergency response certainly have come a long way since U.S. Civil Defense in 1950.

A recent trilateral powwow originally designed to focus on economic and security issues across Canada, Mexico and the United States, has become the principal venue through which said countries are coordinating their pandemic preparedness efforts. What this coordination entails is an interesting question. A recent piece from the informative CIDRAP news service describes a recently released report detailing some of the issues the countries see themselves facing. One issue (comprising one chapter in this report): critical infrastructure. One strategy to tackle the problem of critical infrastructure protection: Resiliency. None of this is surprising or new. What is interesting, to me anyway, is how these concepts will ‘operate’ or be actualized in practice in and across these different national contexts. Is there such a thing as North American Critical Infrastructure? How about North American Resiliency?

For some reason, all of this calls to mind the notion of “regionalization”, which has been pushed — albeit not very hard — by a number of federal agencies and states which foresee advantages to realizing efficiencies in preparedness efforts — check out an example from AHRQ here. These efficiencies are based not only in economics, per se, but in geographies as well. Counties have banded together, as have states, in a variety of different emergency services and disaster preparedness contexts (e.g., one EMS agency covering several counties; states and counties signing mutual aid agreements in times of need, etc.) for decades. The dynamics of multinational ‘regionalization,’ I suspect, is substantially different.

If you’re excited about tamiflu and steadily growing stockpiles, consider this:

“To date, most patients with H5N1 have been treated with Tamiflu. Studies of Tamiflu for use in H5N1 influenza have produced varying results. Two studies of patients with H5N1 influenza in 2004 and 2005 revealed no difference in outcome between those who received Tamiflu and those who did not. However, some of the patients received an antiviral only later in the disease, and the studies were not large enough to produce meaningful conclusions. ‘The numbers are so small that it’s hard to know whether Tamiflu is efficacious at mitigating disease, but it’s all we have, so it’s worth trying because it has very limited toxicity’ says Stephanie Black, MD, assistant professor of medicine at Rush University Medical Center in Chicago.” The good thing about Tamiflu is that it doesn’t do any harm, in other words.

“A 2007 study of the effectiveness of Tamiflu in improving the survival rate of ferrets exposed to the H5N1 virus found that giving the drug within 4 hours of exposure (ie, before illness) resulted in 100% survival. When the treatment was delayed 24 hours after exposure, a higher dose was needed to achieve the same result.” 4 hours, 24 hours: this is obviously not a very realistic temporal frame for pandemic times.

The practice of stockpiling Tamiflu makes preparedeness visible, tangible, and countable. “You can count on it,” as an expert phrased it. At the same time, neither the federal nor state governments have been willing to invest in things like ventilators and hospital beds. In this domain a different rationality prevails: The rationality of prioritization.

The cautious city of Edmonton decided to add ginseng product to its pandemic influenza stockpile. A waste of public funds? Why ginseng and not ventilators, for instance? - Two comments. First, the common cold is not the same thing as the flu. The two are mixed up in the article to the point where it is not clear what this is all about. Second, the study mentioned in the article was conducted midway through the influenza season when subjects may already have been exposed to the circulating strain! Of course, if you can refer to a “randomized, double-blind placebo-controlled study” it sounds terribly scientific - and helps sell your product.

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MILVAX, or vaccines.mil, is the military’s vaccination related website. It includes this crossword puzzle and a variety of other interesting stuff, like a map of regional analysts. I’m sure people like Lyle are hip to this, but I was quite impressed, given the generally sad state of web resources in this domain. That is, of course, coming from citizen weirdness like this…