Re: Limits on Social Contact Helped Fight Flu Pandemic

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It took a study to tell us the obvious?Lee <jackalope_lepus@...> wrote: Limits on Social Contact Helped Fight Flu Pandemic08.07.07, 12:00 AM ETTUESDAY, Aug. 7 (HealthDay News) -- In a finding that could savecountless lives in the next flu pandemic, U.S. researchers havediscovered that such public health measures as quarantines, schoolclosings and bans on public gatherings reduced the death toll in thegreat influenza outbreak of 1918-19.A pandemic is feared if a flu strain -- such as avian

flu, which haskilled some people in scattered outbreaks, primarily in Asia --mutates so that it passes easily from person to person. Currentvaccines and people's immune systems aren't prepared to protectagainst such a new infectious virus -- exactly the situation thatoccurred when a new strain called Spanish flu struck the world in1918-19, killing 40 million people, 550,000 of them in the United States."Public health people have been talking about the risk of a flupandemic for some time," said study lead author Dr. Markel,director of the University of Michigan Center for the History ofMedicine. "Even though it's now the 21st century, it would still takeroughly six months once a pandemic starts to have enough vaccinemanufactured and distributed."Specialists at the University of Michigan worked with experts at theU.S. Centers for Disease Control and Prevention on non-medicalprotective measures

taken in 43 cities. They studied public healthrecords, newspaper reports and other chronicles of activity from Sept.8, 1918, through Feb. 22, 1919."We paired with CDC to see whether things like quarantines and schoolclosings could do anything to reduce the toll," Markel said. "Wetraveled through the country, looking at state archives, collectingtwo newspapers a day from each city and getting information fromfederal and state sources, combing all of this to create a database onincidence. Lo and behold, we found that those cities that respondedearliest and sustained their response did best."For example, St. Louis closed schools and canceled public gatheringsearly in the pandemic and maintained those measures for 10 weeks.Statistics showed that St. Louis had a markedly lower number of fludeaths than other cities.The findings are published in the Aug. 8 issue of the Journal of theAmerican Medical

Association."Here is something we could apply," Markel said. "These old-fashionedmethods hopefully could buy us time until a vaccine could be createdand put in the arms of people who need it."But what worked in the United States of 1918-19 might not work today,said Philip Alcabes, associate professor in the School of PublicHealth at Hunter College in New York City."The world is a dramatically different place," Alcabes said. "We don'thave people working in big factories where there are a lot of peopleunder one roof. We commonly use private transportation. We havesmaller families. We live in suburbs, where the pathogen is not aslikely to be transmitted as quickly as it was then."The new study is "a very, very good piece of historical epidemiology,"Alcabes said. But, he added, "It's not clear that the interventionsthat were effective against the flu in 1918 are relevant to thepreparations we are

making today."Markel countered that the world is not that different in basic ways.Children still have runny noses and poor respiratory habits, peoplestill pass the virus from one to another in the same way. The studyprovides evidence that basic public health measures can slow thatpassage of germs, he said."No one has even gotten any evidence that it works in the past,"Markel said. "You don't want to do a multibillion dollar policy unlessyou're sure it works."Guidelines on such measures would be recommended by the federalgovernment and carried out by the states, Markel said. The states areworking with the federal government to cover implementation, he said.http://www.forbes.com/forbeslife/health/feeds/hscout/2007/08/07/hscout607107.html . Do one thing every day that scares you. Eleanor

Roosevelt

[Guest guest]

Got to be to give the obvious credibility. The real question is

whether one study is enough.

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> It took a study to tell us the obvious?

[Guest guest]

Even those who know better often don't. A case in point - Scene: Patient's bedside. Doctor is changing patient's wound dressing using perfect technique, leaves contaminated stuff for nurse (me) to clear away (normal procedure). Doctor makes beeline for the door. Me to doctor: Doctor, excuse me, but you'll want to wash your hands before leaving the room. Doctor washes hands hurriedly. I shake my head in dismay. Lee <jackalope_lepus@...> wrote: Got to be to give the obvious credibility. The real question iswhether one study is enough.>> It took a study to tell us the obvious? . Do one thing every day that scares you. Eleanor Roosevelt

[Guest guest]

....

Seems like you are on the way to having the same appalling conditions

as here, where MRSA and other diseases is rampant in hospitals

because of a lack of cleanliness.

I put this down to who they are employing to do these cleaning jobs,

(ignoring the doctors for a minute) Immigrants who have no real

understanding of what to clean and when, because of their limited

knowledge of the English language.

Mike.

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[Guest guest]

I do have to say, though, that in the hospitals I worked in (I'm now retired from clinical practice) our cleaning people did a sterling job. They were sometimes more conscientious about not spreading infection than were the docs and some of the nurses.Mike <mikesey_97@...> wrote: ....Seems like you are on the way to having the same appalling conditions as here, where MRSA and other diseases is rampant in hospitals because of a lack of cleanliness.I put this down to who they are employing

to do these cleaning jobs, (ignoring the doctors for a minute) Immigrants who have no real understanding of what to clean and when, because of their limited knowledge of the English language. Mike.> >> > It took a study to tell us the obvious?> > > > > > > > . Do one thing every day that scares you. Eleanor Roosevelt> . Do one thing every day that scares you. Eleanor Roosevelt

[Guest guest]

Hi Mike That's a rather sweeping statement and I must take issue with it!! I think you'll find that the major causes of increased infection rates in British hospitals are:- 1. Doctor/nurse handwashing practices on wards (and in GP surgeries for that matter) are SCANDALOUSLY bad. You would have thought it would be second nature for doctors and nurses to wash their hands between patients on ward rounds. Think again! 2. Many hospitals either have no infection control policy or, if they do, they are not implemented effectively (they sit on shelves in managers' officers). 3. Most hospitals have outsourced their cleaning and the commercial contractors basically can't deliver on their promises. This has basically been a massive money saving exercise for the hospitals. I'm not sure you can blame the whole thing on the fact that some

cleaners are immigrants with a poor grasp of English. I've seen commercial cleaning contracts in action close up and I can tell you that they are rubbish. Even when the cleaners are British!! 4. The overuse of antibiotics by clinicians has allowed bugs and viruses to mutate at an alarming rate, so that they are now practically immune to antibiotic intervention. "Healthy" people can normally fight off MRSA (which is around us everywhere, not just in hospitals), but obviously it strikes in hospitals which are full of ill people with suppressed or compromised immune systems. 5. I bet you're already sorry you asked me to join this group, so I'll shut up now. Cheers Fi xx .Mike <mikesey_97@...> wrote: ....Seems like you are on the way to having the same appalling conditions as here, where MRSA and other diseases is rampant in hospitals because of a lack of cleanliness.I put this down to who they are employing to do these cleaning jobs, (ignoring the doctors for a minute) Immigrants who have no real understanding of what to clean and when, because of their limited knowledge of the English language. Mike.> >> > It took a study to tell us the obvious?> > > > > > > > . Do one thing every day that scares you. Eleanor

Roosevelt>

Answers - Get better answers from someone who knows. Try

it now.

[Guest guest]

Hi Fiona,

Doctor/nurse handwashing practices on wards (and in GP surgeries for

that matter) are SCANDALOUSLY bad? There goes medical tourism to

Britain. If the universites are so good then why are they not

following the most basic precaution? If true, this is indeed a

scandal! Have you seen any articles on this? If so, I would like to

archive one in our site files.

Most hospitals have outsourced their cleaning??? To private firms?

Sounds like Reagan and Margaret Thatcher were taken too

seriously. If we can get rid of Bush, it will take America many years

to recover from the Republicans, and it sounds like Britain is in the

same situation.

We are delighted to have you in this group, and welcome to the group!

It was getting altogether too quiet around here. Please do post.

I bet you're already sorry you asked me to join this group, so I'll

shut up now.

[Guest guest]

Hi Fi.

I note what you say and in some respects agree with it, especially

the part about employing private contractors to clean, and provide

the meals in hospitals. The people employed, however in some parts of

the country seem to be immigrants who can't speak English, so

consequently can't read special notices or indeed digest the rules of

hygiene. Perhaps having low standards themselves in their natal

country they just do what they have always done. This employment of

immigrants, most of them from the Indian sub-continent and middle-

east, give trouble in most of the fields where they are used as

cheaplabour, ie: the Post office, where large numbers of Passports

and credit cards have gone missing, and provenly so, stolen as a

racket. The passport office will not now even use the Royal mail.

The food industry too, suffers from the use these people; the cases

of food poisoning of their customers, notably in the pre-packed

frozen food market, as supplied to supermarkets, has increased,

seemingly from a lack of basic food hygiene. Cases of this have been

well-documented using secret filming by TV reporters and newspaper

journalism.

In hospitals, there have been calls to return to the previous status

quo of a few years ago, like bringing back the office of Matron, who

once supervised the cleaning of the hospital and of course the health

care of the sick in her hospital;she took responsibility and of

course was always on site, so to speak.

Now nobody is in overall control, and the hospitals are run by Silly

pen-pushers whose only motivation is cutting the hospital(s) budget.

" Damn the Sick, let us close this hospital and let patients travel

many more miles just to find an A & E department " would seem to be

the current attitude.

Apart from all this, I agree with you, and acknowledge that you are

in the Health care system so should know what you're talking about,

particularly as you actually see the over-use of anti-biotics. I

think that the low standards apparently inhabiting the NHS is an

indicator of general sloppiness prevalent in the whole country,

stemming from government level.

See you, later!

Mike x.

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now.

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