Global & Disaster Medicine

Archive for the ‘Pandemic’ Category

“According to a new U.S. Army report, Americans could face a horrifically grim future from climate change involving blackouts, disease, thirst, starvation and war. The study found that the US military itself might also collapse. This could all happen over the next two decades…..”

Vice

“…….The report, titled Implications of Climate Change for the U.S. Army, was launched by the U.S. Army War College in partnership with NASA in May at the Wilson Center in Washington DC. The report was commissioned by Gen. Milley during his previous role as the Army’s Chief of Staff……..

1885-1894

The two most prominent scenarios in the report focus on the risk of a collapse of the power grid within “the next 20 years,” and the danger of disease epidemics. Both could be triggered by climate change in the near-term………

The report also warns that the US military should prepare for new foreign interventions in Syria-style conflicts, triggered due to climate-related impacts. Bangladesh in particular is highlighted as the most vulnerable country to climate collapse in the world…..

“The permanent displacement of a large portion of the population of Bangladesh would be a regional catastrophe with the potential to increase global instability,” the report warns. “This is a potential result of climate change complications in just one country. Globally, over 600 million people live at sea level.”

Sea level rise, which could go higher than 2 meters by 2100 according to one recent study, “will displace tens (if not hundreds) of millions of people, creating massive, enduring instability,” the report adds……..

Annual Temperature Anomoly

Annual Temperature vs Average

 


A World At Risk: Latest scientific report out of the WHO

Daily Mail

“No country is fully equipped to deal with the next global pandemic,…….

Scientists say an outbreak of a flu-like illness could sweep across the planet in 36 hours and kill tens of millions due to our constantly-travelling population.

But a review of health care systems already in place across the world found just 13 countries had the resources to put up a fight against an ‘inevitable’ pandemic…….”

A world map shows areas that were most, more and least prepared for a global pandemic. Greenland (in grey) was not studied


J-IDEA, the Abdul Latif Jameel Institute for Disease and Emergency Analytics will rapidly respond to emergencies such as epidemics, extreme climate events, and natural and humanitarian disasters.

Imperial College

“…..J-IDEA will tackle crises, such as Ebola and MERS, alongside longer-term global priorities, including the impact of climate change on health, using cutting-edge data science and public health research to deliver policy insights.

The new institute brings together the world’s foremost epidemiologists, biostatisticians, medics and data scientists as they break down barriers between academic expertise and on-the-ground impact. ….”

J-IDEA

“……J-IDEA brings together over 200 researchers working on global health within Imperial College’s School of Public Health. Partnering with governments and international institutions, J-IDEA advances methods and real-world application of data analytics to identify and support effective actions and high priority investments into population health globally – both in responding to crises but also in identifying the cross-cutting investments which will build strong and resilient health systems better able to meet future health challenges and threats…..”


New Zealand, Australia and Iceland could act as island refuges to save humanity from extinction in the event of a catastrophic global pandemic and researchers have ranked 20 island nations which could act as refuges from which large-scale technological society could be rebuilt.

UOtago

“……The researchers say that for such a strategy to succeed, preparations must be made ahead of time. They suggest that New Zealand consider investing in resiliency measures and rehearse the rapid introduction of border controls...…”

In the journal:

Risk Analysis DOI: 10.1111/risa.13398

The Prioritization of Island Nations as Refuges from Extreme Pandemics

Matt Boyd and Nick Wilson

Abstract:  “In this conceptual article with illustrative data, we suggest that it is useful to rank island na-

tions as potential refuges for ensuring long-term human survival in the face of catastrophic

pandemics (or other relevant existential threats). Prioritization could identify the several is-

land nations that are most suitable for targeting social and political preparations and further

investment in resiliency. We outline a prioritization methodology and as an initial demon-

stration, we then provide example rankings by considering 20 sovereign island states (all with

populations greater than 250,000 and no land borders). Results describe each nation in nine

resilience-relevant domains covering location, population, resources, and society according

to published data. The results indicate that the most suitable island nations for refuge status

are Australia, followed closely by New Zealand, and then Iceland, with other nations all well

behind (including the relatively high-income ones of Malta and Japan). Nevertheless, some

key contextual factors remain relatively unexplored. These include the capacity of the juris-

diction to rapidly close its borders when the emerging threat was first detected elsewhere,

and whether or not large subnational islands should be the preferred focus for refuge design

(e.g., the Australian state of Tasmania, the island of Hokkaido in Japan, or the South Island

of New Zealand). Overall, this work provides conceptual thinking with some initial exam-

ple analysis. Further research could refine the selection of metrics, how best to weight the

relevant domains, and how the populations of prioritized island nations view their nation’s

selection as a potential refuge for human survival.”

AUSTRALIA

NEW ZEALAND

ICELAND

MALTA

JAPAN

CAPE VERDE

BAHAMAS

TRINIDAD/TOBAGO

BARBADOS

MADAGASCAR

CUBA

MAURITIUS

FIJI

MALDIVES

SRI LANKA

COMOROS

SOLOMON ISLANDS

JAMAICA

PHILIPPINES

VANUATU


Quack pharmacists around the world are fueling future superbug pandemics

Bureau of Investigative Journalism

“……Despite recent attempts by the Cambodian government to crack down on illegal pharmacies, these sellers fly under the radar. Most do not have any qualifications that would allow them to prescribe the cocktail of drugs they give patients, the researchers from the London School of Hygiene and Tropical Medicine and the University of Health Sciences found.

The invisible sellers had many misconceptions about antibiotics and dispensed them incorrectly, researchers said. Most openly admitted they sold them in response to patients’ demands, rather than medical need, leading to overprescription. They believed that antibiotics were necessary for colds and diarrhoea, and sold short courses of the drugs. They also sold antibiotics designed for humans to people wanting to give them to their cattle, chickens and dogs.

One seller said she learned about medicines during the Khmer Rouge regime and incorrectly believed antibiotics should be smeared into wounds. She said: “We break them into small pieces and pour them on wounds on our legs.”

This kind of misuse speeds up the creation of drug resistant bacteria, or superbugs, which are predicted to kill 10 million people by 2050 if no action is taken…..”


Rubbing hands with ethanol-based sanitizers may not be effective hand hygiene after all.

ASM

“……the researchers from the Kyoto Profectural University of Medicine found that ethanol-based disinfectants, or hand sanitizers, would have be in contact for at least 4 minutes with the influenza A virus before killing it, a much longer duration than typical use. After 2 minutes of use, the virus was still active...….”

Ryohei Hirose, Takaaki Nakaya, Yuji Naito, Tomo Daidoji, Risa Bandou, Ken Inoue, Osamu Dohi, Naohisa Yoshida, Hideyuki Konishi, Yoshito Itoh
“…….If there is insufficient time before treating the next patient (i.e., if the infectious mucus is not completely dry), medical staff should be aware that effectiveness of AHR (rubbing) is reduced. Since AHW is effective against both dry and nondry infectious mucus, AHW (washing) should be adopted to compensate for these weaknesses of AHR…….”

Project BioShield over 15 years of progress

ASPR

Project BioShield Evolution: Fifteen Years of Bridging the ‘Valley of Death’ in the Medical Countermeasures Pipeline

Author: By Dr. Robert Kadlec, Assistant Secretary for Preparedness and Response
Published Date: 7/17/2019 12:15:00 PM
Category: Innovations; Medical Countermeasures; National Health Security;

Saving lives in a public health emergency requires cutting-edge medical countermeasures: medications, vaccines, diagnostics, and more. In some types of emergencies, like an act of bioterrorism, some of those medical products have no commercial market. People don’t use an anthrax antitoxin every day – thank goodness. Yet that lack of commercial market also means pharmaceutical or biotech companies had only one possible buyer for their products: the federal government for stockpiling.

In 2004, Congress passed the Project BioShield Act to create a market for products necessary for disaster response but with limited or no commercial market. The Act provides HHS with a multi-year special reserve fund to support late-stage development and manufacturing, and the financial resources to buy these life-saving medical products for the American people to use in public health emergencies. In this way, Project BioShield is a critical part of the U.S. strategy for biodefense and our commitment to the American people.

Last month, Congress took action to further strengthen Project BioShield as part of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 (PAHPAIA). PAHPAIA increases the budget authorization and provides ten-year funding for product development. We know next-generation medical countermeasures aren’t developed overnight – in fact, getting a product across the finish line takes many years. Multi-year funding helps BARDA continue building the strong public-private partnerships needed to spur innovation and provide the private sector with the stability needed to produce potentially lifesaving medical countermeasures.

For example, smallpox is one of the most consequential infectious diseases in human history, responsible for nearly 300 million deaths in the 20th century alone. It is also a high-priority threat requiring federal agencies to develop strategies and countermeasures against this threat. Thanks to our partners at NIAID and DoD and the support of Project BioShield, last year our industry partner was issued an FDA approval for a treatment for smallpox via the animal rule. At present, there are now over 2 million treatment courses in ASPR’s Strategic National Stockpile to protect Americans in the event of a smallpox national security emergency.

However, we have found over the past 15 years the most practical and cost-effective approach is, whenever possible, to look at products that not only can be used for emergencies, but also have uses in daily medical care, such as burn care, the radiation effects cancer patients encounter, or seizures.

In some cases, we’ve worked with companies to expand indications for existing products. For example, three medical countermeasures are now FDA-approved to treat patients suffering bone marrow and blood cell damage from acute radiation syndrome. All three of these products were already licensed drugs used to treat patients undergoing radiation therapy for cancer. Project BioShield funding was used to conduct the critical studies needed to expand the indications for these products so they could also be used to treat the damage caused by acute radiation syndrome in a radiation emergency. Using such drugs is helpful in emergencies because healthcare facilities already stock the drugs, and clinicians are already familiar with using them.

We are using Project BioShield to support other new products with commercial market potential. For example, we supported a large study of a seizure treatment because seizures are one of the potentially deadly effects of nerve agents. The product is used commonly in preparing patients for surgery and for epileptic seizures; thanks to Project BioShield, the product is now approved as an antiseizure medication for status epilepticus and has been added to the Strategic National Stockpile for use in a chemical emergency response.

For 15 years, BARDA has been proud to partner with industry to develop cutting-edge medical countermeasures. Our country is better prepared to respond to health security threats because of Project BioShield. We look forward continued collaboration as we work to develop and produce medical countermeasures that can be used to save lives in the event of an emergency.


Baloxavir showed broad-spectrum in vitro replication inhibition of 4 types of influenza viruses

Mishin VP, Patel MC, Chesnokov A, De La Cruz J, Nguyen HT, Lollis L, et al. Susceptibility of influenza A, B, C, and D viruses to baloxavir. Emerg Infect Dis. 2019 Oct [date cited]. https://doi.org/10.3201/eid2510.190607

“…….Baloxavir displayed broad antiviral activity against diverse influenza viruses, including all 4 types and animal-origin influenza A viruses with pandemic potential. Our findings suggest that baloxavir might offer the first therapeutic option against influenza C virus infections. Further studies are needed to provide comprehensive assessment of baloxavir susceptibility by using a large panel of representative influenza C viruses. Ongoing monitoring of baloxavir susceptibility of emerging avian and swine influenza A viruses with pandemic potential is needed to inform clinical management and public health preparedness efforts...…”


Canadian pandemic influenza preparedness

Canada Pandemic Prep Document

Abstract

Henry B on behalf of the Canadian Pandemic Influenza Preparedness Task Group. Canadian pandemic influenza preparedness: Public health measures strategy. Can Commun Dis Rep 2019;45(6):159–63. https://doi.org/10.14745/ccdr.v45i06a03

“Public health measures, also known as non-pharmaceutical interventions, are basic actions aimed at slowing the community spread of a communicable disease outbreak. In the event of an influenza pandemic, public health measures and antiviral drugs are the only tools available to mitigate the effects of the pandemic during the months before a vaccine becomes available. The Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health Sector (CPIP) outlines how federal, provincial and territorial governments will work together to ensure a coordinated and consistent health sector approach to pandemic influenza preparedness and response.
This article summarizes Canada’s pandemic public health measures strategy, as described in the recently updated CPIP Public Health Measures Annex. The strategy builds on lessons learned during the 2009 H1N1 pandemic.

Key elements of the public health measures strategy include individual measures (e.g. hand hygiene, self-isolation when ill), community-based measures (e.g. school closures, cancellation of mass gatherings), management of cases and close contacts, travel and border-related actions and public education. Factors that influence the effectiveness of public health measures in a pandemic include the pandemic epidemiology, timing of implementation, how the measures are used (i.e. alone or in combination), their scalability and flexibility and public compliance. The CPIP is an evergreen guidance document and the Annex will be updated as new information warrants.”


CDC: The pandemic mass grave in Brevig Mission, Alaska (1918)

Site of the mass grave in Brevig Mission, Alaska, where 72 of the small village’s 80 adult inhabitants were buried after succumbing to the deadly 1918 pandemic virus. Photo credit: Angie Busch Alston.


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