A Journey Through The World of Pandemic Influenza

A Brief Personal Note

Once again we have hired someone to take the Head Accountant's position at my "day job". His report date is this coming Monday morning. Once again it is my hope that my life will get back to what passes for normal, although it will still be hectic for a month or three as the New Guy is brought up to speed and we work on two major projects that have had to be side-lined as we struggled along with only the two of us running the department.

Heck who knows? Maybe this guy will actually have the gumption and courtesy to show up.

At this stage that's all I'm asking… just show up.

 

SZ

Fifty Percent Staffing Level

Tomorrow we will be half way through the month of March, and tomorrow I hope to "put February to bed" at work.

For those that do not know, or may have forgotten, I work in the accounting department of a Vacation Rental Company that is wholly owned by a publicly traded Holding Company. The department started the year with a staffing level of four, a controller, his "second" (me), and two others.

At the beginning of January one of my coworkers announced his unexpected and immediate retirement and I absorbed his duties in their entirety. Then in February the controller left us. My department has been running with a staff of two. But since we are a subsidiary of a publicly traded company the reporting that we have to generate and submit to our corporate office is federally mandated (Sarbanes – Oxley, commonly known as SOX) and rigidly scheduled to meet those federal mandates.

 

It is widely suggested, as well as supported, that businesses and organizations will find themselves operating at somewhere around a fifty percent staffing level during a moderate to severe influenza pandemic, something I can relate to personally. Although I do not work in a business or industry that will find itself operating during a time of pandemic, and accounting is not exactly an "essential service", although, to be sure, money will still have to flow, I thought I would share with you a few of the things that I learned and equally enlightening, what had to happen to support my efforts and success.

 

I had an existing broad base of knowledge of all aspects of the department, database, and accounting software, however, since I am not the controller there were reporting functions, data collations, and spreadsheets that I only had a basic superficial knowledge of. I found myself hour-by-hour struggling to comprehend how "this or that" fed into "this or that", often getting it wrong any number of times until I finally managed the logic of the data flow and plopped the right number(s) in.

I had adequate basic knowledge of the myriad functions. I had a well established and proven matrix to follow. I had an entire company at my beck and call to support my stupid ill-informed questions. I had our software programmer made available to me at a moment's notice to assist with database malfunctions and miscellaneous support questions. I had a General Manager that "baby sat" me for two weeks, checking on me every other hour offering encouragement, cheerleading, offers of providing anything else that I might find myself requiring (within a business framework of course), at one point in the process the entire company was "booted off" the server for several hours so that I could have its resources all to myself, and lastly, I was determined to succeed.

And even with all of that, with every resource and advantage I could be given, I was only able to just manage. Perhaps a better way to state my point: The only way I could have been in a better position to succeed was to have my former boss standing over my shoulder walking me through the processes.

 

During a moderate to severe pandemic those who find themselves struggling to perform the duties of two or three missing colleagues will probably not [read surely not] have all of the wonderful support that I had. Many will not have a clear "play book" to refer to as they find themselves struggling with unfamiliar processes and procedures. And, unlike my situation where it was "just numbers" those struggling people may hold someone else's health, or even more frightening, life in their hands with their actions.

After my experiences these past three weeks I have a band new appreciation about how impossible those tasks will be – and my concern about our critical infrastructure has deepened considerably.

 

The good news from a personal perspective is that our new "third body" reports on March 24^th, a week from Monday. We will then be all the way up to a seventy-five percent staffing level, and after this that will feel wonderful indeed, as that will be manageable under the new organizational structure.

So all the "bad stuff" is behind me, with the caveat as long as our new accountant actually shows up on the 24^th.

I know I've said that I was back to posting before and then almost instantly made a liar, but I'm saying it yet again, this time I hope successfully with only life's normal interruptions and breaks for sanity.

 

SZ <Exhausted but pleased with accomplishing the impossible with a great deal of wonderful support>

 

 

Yet Again

Yet again my life was turned upside down. By now it has begun to feel normal. My boss turned in his resignation and without dwelling on it – life is not especially blog friendly.

There is a promising candidate being interviewed tomorrow so wish me luck.

But I will admit – I'm beginning to think there's some sort of cosmic conspiracy going.

 

SZ

 

Super Tuesday

No Pandemic or Avian Influenza post today so that I can feed my love of politics. Today being the all important, and oh so exciting (at least to us political junkies), Super Tuesday Primaries/Caucuses for the US Presidential race.

 

SZ

A Lesson in Real Life

This post will be more a recap of why I had pretty much dropped out of Flublogia for a month, but as always, I will try to tie what happened into a general PanFlu perspective.

On January 2^nd my counterpart at work (what I call my "Day Job" and what pays my bills) announced his immediate retirement and the fourth member of my four member department had to go out on emergency medical leave. This left my boss and me to run the entire department just as we were facing end of fiscal year requirements.

I tend to lean to being a Type "A" person, highly driven and action oriented. To say that my life during the month of January became all about my job would not exactly convey the fact that I was pretty much reduced to work and a few hours of sleep each day. I would occasionally drop into Flublogia to glimpse the overall situation but with all the demands on my time and attention I really lost touch; I no longer had my fingers on the pulse of the virtual world that is Flublogia.

The thing that I found most illuminating for me was the simple fact that my life had so many "here-and-now" demands that I was nearly buckling under I just didn't care about some theoretical threat in the distant realm of "maybe".

Upon reflection I found this fascinating.

I have found it difficult to impossible to understand how so many people could turn a blind eye to such a potentially catastrophic event. I found out how easily it can and does happen.

Being someone who at least believes I know and understand the myriad potentials we would face during a severe pandemic I very consciously turned away from pretty much everything AI and PanFlu at the exact moment that threat levels were rising as significant new outbreaks in new geographic locations were occurring. If I could do it with an intrinsic understanding how much easier is it for someone who has a superficial, at best, grasp of the potentials?

 

The traditional Navajo concept of hózhó encompassing beauty, balance, order and harmony distills, at least to me, to the concept of grace, or gracefulness: handling life and all that it throws at us with grace.

During the month of January my life was decidedly out of balance and chaotic. Grace and gracefulness were nowhere to be found within my tiny personal universe. But, isn't that what we will each have to face and deal with should a severe influenza pandemic strike anytime in the near future? We will each have to do what I did: buck up and just do what has to be done in the tiny personal universe that represents our individual lives.

The degree that our lives will become unbalanced and lacking in grace will be a direct reflection of our in-place knowledge and preparations. Unlike the situation I found myself in at the beginning of January we will have had plenty of time to inform and prepare ourselves.

The fact that life in general often affords us little to no time, or inclination, to peer into our futures for potential threats on the horizon will offer us no comfort or succor should we face the worst. Instead we have to adjust like I had to do. Sometimes we have to reach inside ourselves with deliberateness and find that new point where hózhó leaves little room for chaos or the unattended necessities.

While I will probably never attain that perfect place where there is nothing but hózhó I have at least realigned enough to be back at the optimal operative point for me. Now, I have the daunting task of catching up.

 

One last personal note:

A heartfelt Thank You to all of you who dropped me a line to check up on me or to let me know that my cyber voice was missed. It was much appreciated during a time that found me not only stretched to my capacity but coinciding with an all-time low PanFlu morale in general. I drew strength from knowing that others were standing watch and that even during a time when I had to withdraw the invisible web of connectedness to "Fellow Travelers" gave me comfort.

 

A Prime Directive Forgotten

In the month of December I took an unexpected and protracted hiatus from my humble blog. You see, sometime early on in the month I suffered what I term a "buckling of the knees". I lost hope. I lost sight of the fact that Pandemic Influenza preparation, information dissemination and education, as well as event watching and analysis is a marathon and not a sprint.

I had naively thought that PanFlu preparation and awareness was a cumulative, always forward moving, positively accretive process. In the month of December we seemed to suffer one blow after another to our "message". After an unusually slow summer and fall official word was coming down about how the pandemic threat from H5N1 had abated. That was the "message" that people who are not "flu obsessed" were hearing and hanging their hats on. Suddenly a difficult task, being heard and taken with any seriousness at all, went from being difficult to impossible.

Coupled with feeling the futility of the message, I was also struggling with an understanding of knowing that even with all the ground we in Flublogia have gained it will not be enough. Not enough by a large and agonizingly deadly margin.

Suddenly, it just all seemed futile.

 

As a highly visual person my mind's eye tended to see an image of Salvador Dali's Metamorphosis of Narcissus when I thought about the process of pandemic information dissemination and preparation.

Nothing elegant, graceful, or beautiful, and yet the discordant symmetry, reflection, and juxtaposition are none the less evocative of "process". It is also the image that I often "see" when I follow the goings-on in Russia as she continues her metamorphosis from communism to democracy.

Tenacity, perseverance, and opportunistic luck is shown by the flowering narcissus having rooted, and even found the nurturance to bloom, in the egg shaped stone on the crumbling and decrepit "reflection in stone" of Narcissus.

Flublogia is a reflection of society at large, albeit one of discordant symmetry. We are them, they are us, and yet—we, the inhabitants of Flublogia, are also "other", in mathematical terms: a (unique) subset within the whole. We have heard a warning and taken it with seriousness, oft, deadly seriousness—as we measure the potential threat in human lives. We have heard a message that others seem to be deaf to.

 

But it was our "uniqueness" that I stumbled over. You see, I have come to believe that all of those capable of understanding, or hearing the message if you will, of the real potential threat of a severe influenza pandemic, and all that it could mean, already understand it. Further, that it would take an escalation of the threat to bring new people to the issue with any seriousness.

Sadly, I fear that the next escalation of events may well be the pandemic, thus affording no opportunity to take constructive and meaningful action based on this newly acquired understanding. Boiled down: I lost hope that anything I did would make a difference, or has made a difference. My words are read by those who already understand.

 

Egypt showed me the fallacy of my logic. Blissful ignorance and disregard of a clear and present danger, even when it jumps up and bites you in the hindquarters, can be overcome. Again, perhaps with inelegant and asymmetric grace, but with constructive and positive action never the less.

 

Many months ago I made a comment to a poster on one of the forums that it was not our job or responsibility to save the world, we had not been tasked with that obligation, and how terribly presumptuous to assume any one of us carried that burden. Another favorite phrase of mine: The bucket I carry is filled with my own water, and it's pretty much all I am capable of carrying… please carry your own.

 

After much personal reflection I have come to the conclusion that my "bucket" contains a requirement for me to keep at this—whatever this is, irrespective of its effectiveness. And, although I am suffering an acutely felt abandonment of muse, I am an optimist at heart, an optimist that hears the clarion call of responsibility. Even if my responsibility isn't to save the world, I feel it is my responsibility to continue to "speak", to continue to chip away at the crumbling stone statue reflecting Narcissus in the hopes that the flower of understanding will take root and receive enough sustenance to bloom. Presumptuous? No doubt. I am, admittedly, a rather presumptuous person.

 

It was the framing of this post that led me to dig up the quote from Horace that I used recently, refreshing my memory on his intent behind the words sapere aude. A more modern interpretation could be thought of as "Dare to think for yourself". But Horace's original meaning was so apropos to the situation in Egypt that I chose to use it in the previous post. In fact, this posting was originally titled Sapere Aude! with the more modern "flavor".

 

My "bucket" may not contain anyone else's water, but hopefully, it will help provide an informative "drink" whenever someone is ready to come to the issue of pandemic influenza should they happen to stumble upon me and my presumptuous offerings.

 

So, I guess I haven't lost all hope after all, but I do ask for longanimity as I struggle a bit with this bucket of mine.

 

SZ

The Last Day of 2007

There is a quote that I am personally rather fond of:

"Life's journey is not to arrive at the grave safely in a well preserved body, but rather to skid in sideways, totally worn out, shouting '...holy shit...what a ride!'" – Anonymous

That handily sums up my 2007, so there is no need to bore anyone with details.

 

As is often said around the cyber flu community PanFlu (Pandemic Influenza) preparation and information gathering, as well as its dissemination, is a marathon, not a sprint. But someone failed to tell me that it was all up hill, occasionally with daunting headwind.

 

As I was considering the framing of this post it reminded me of an old song by Chicago, Does Anybody Really Know What Time It Is?

As I was walking down the street one day
A man came up to me and asked me what the time was that was
on my watch, yeah
And I said
Does anybody really know what time it is
I don't
Does anybody really care

What time does it read on the Pandemic Clock? Does anybody really know what time it is?

December has found us at a confluence of conflicting data-streams.

The first, WHO officials stating that progress has been made (which I fully agree with) and that H5N1 has slowed its frightful and inexorable march around the globe (which I fully agree with), and finally, that human cases had slowed in 2007—they had. The threat posed by H5N1 was not felt as acutely as in past years.

Second we have seen a veritable explosion (in comparison) of human cases during the month of December. Pakistan and Egypt are front and center with Indonesia the ever faithful and consistent handmaid.

 

Since human cases first appeared in Egypt they have had the "feel" of "different" to me and have engendered far more concern than the Indonesian cases, even though there are far more of them, and far more consistently deadly.

Theresa42 posted an update on the recent Egyptian cases along with what summary information currently available, since I would have no hope of doing half as well I will just use her great post from FluWiki. One of the important standouts of this data is the wide range of ages. Traditionally, the children and young women were victims, not so in Egypt. A change in victim's ages may indicate a change in the virus itself.

EGYPT - Detailed summary

SUMMARY OF CONFIRMED AND SUSPECTED CASES IN EGYPT SINCE DEC 25

5 confirmed cases / 4 deaths:

Oula Yunis Ali Mohamed (25F) - d. Dec 25, 2007

- from Beni Haroun village in Beni Suef governorate, south of Cairo
- admitted to Beni Suef hospital on Friday, Dec 21, with high fever, breathing problems and pneumonia
- diagnosed (test results came back) the day she died, Dec 25
- in contact with birds thought to be infected with bird flu
- relatives being checked/tested / mentioned in one article that her mother, specifically, was being tested
- brother of victim said that they went to one doctor who diagnosed bronchitis, but when she didn't get better they went to another doctor in a "special hospital" who sent her to the hospital in Beni Suef
- 39th case / 16th person to die of bf in Egypt

Attorh Hanim Ibrahim [aka Hanem Atwa Ibrahim] (50F) - d. Dec 31, 2007

- from Damietta governorate ("from Al Ngdi's land in the region of Ezbet meat in Damietta district")
- admitted to Damietta hospital on Monday, Dec 24 with high fever, breathing problems and pneumonia
- husband reports she began showing symptoms on Dec 24
- transferred to Cairo's Abbasiyah hospital
- reported on Dec 31st to be in critical condition
- in contact with birds thought to be infected with bird flu; husband reports that she keep poultry and that two days before she became ill, ten of her poultry had died
- husband and children tested and put under observation for 7 days
- 40th case

Nora Aboul Abbas Mohamed (21/22F)

- from "Center Worries" in Al Minufiyah governorate (also reported:  "from the belonging village of Barhim [Braheem], to Minuf center")
- admitted to Minuf hospital on Wednesday, Dec 26 with high fever and difficulty breathing
- transferred to Cairo's Abbasiyah hospital on Dec 27
- father reports that she began showing symptoms on the night of Dec 25 and that she had found dead poultry in her shop that morning
- reported on Dec 31st to be recovering in intensive care
- poultry seller, in contact with birds thought to be infected with bird flu
- family being tested
- 41st case

Fatma Fathi Mohamed (25F) - d. Dec 30, 2007

- from Daqahliya governorate
- admitted to local hospital on Dec 27 with high temperature and difficulty breathing; transferred to Mansoura hospital on Dec 29
- suspected of handling sick domestic birds
- 42th case / 17th person to die of bf in Egypt

Firdaus Mohamed Hadad (26F) - d. Dec 31, 2007

- from Al Minufiyah governorate
- hospitalized on Saturday, Dec 29
- high fever, difficulty breathing, pulmonary infection
- reportedly in contact with sick birds
- 18th death / 43rd case

12 suspected cases reported in the last week / 1 death:

Dec 30 -

Mohamed Khalil Abdul Qawi (40M) - Beheira governorate - reported Dec 30 - from the village of Ezbet Alhouci Bbrem Center Kom Hamada
Nader Said Babylonian (5M) - Al Minufiyah governorate - from the village "Alaptanon"
Ahmad Abdulmohsen (6M) - Al Minufiyah governorate - from the village "Kafr Tunbdi" at the centre of Shebin Mound

*Note that the two boys are from the same governorate as confirmed case Nora Aboul Abbas Mohamed above.

Dec 31 -

Amiriya north of Cairo:

Salah Eddin Mohamed Ali (43M) - d. Dec 29 - schoolteacher - had acute pneumonia - kept roof-top birds

Al Minufiyah:

Abdul Rahman Ibrahim (57M)
Abed Rabbo (50M?)
Mohammad Ferdous (36M)

Alexandria:

Faten (23F)

Port Said:

Reza Abdalmugod Abdilkadir (25M) - husband of Radwan
Radwan - wife of Reza
Mohammed (9M) - son of Reza & Radwan
Rajab (5M) - son of Reza & Radwan

 

So, the New Year will find us watching Egypt with intense interest, irrespective of the year-end assessments that want to tell us that H5N1 is less of a threat than it was at the beginning of 2007.

 

SZ

Who Speaks and Holiday Weekend Miscellanea

I have spent a number of days nostril deep in tackling concepts of DNA, and by extension, RNA—influenza's genes are made up of RNA, as well as a more structured understanding of virology. As with much of what I do or know in my life it's "enough to get me in trouble" but not really enough to do me much good. Those of you who may have wondered why I wasn't on the forums that I am known to inhabit with such regularity that is the reason. Enforced "nose to the grindstone".

 

Who Speaks?

I write and participate on the flu forums under the pseudonym SophiaZoe, an iteration of my original pseudonym of ZoeSophia from back when IRC had its heyday, "Life's Wisdom". Since the inception of this blog two other "Sophia Zoes" have shown up with a web presence. That doesn't bother me in and of itself, obviously, I was drawn to the name so they may have been as well, or, it might actually be their name unlike my use of it. But I take a certain pride in "being unique" and I would abhor being mistaken for someone else, not to mention that the other SZs might not appreciate being mistaken for me.

 

Anonymity is an ongoing concern, both in general on the internet, and in the Cyber Flu Community specifically. Some have chosen to drop the comfort and security that anonymity affords and step into the public's view. Not many, but some. I gave up my anonymity back in the spring and haven't regretted the decision. What I have regretted is that I have a certain "web presence" under my pseudonym so even though I would like to switch to my real name I feel it is important to maintain SophiaZoe for the sake of continuity.

I will, however, content myself with "introducing" myself to all of you, as the next best thing.

Debi Brandon

48 years of age

Wife, mother, grandmother

 

The picture was taken with the crappy camera that comes with the Iphone. Honestly, it is so crappy that I don't understand why they even bothered to include it. Oh, and for the record: While I do have gray hair, which I wear with pride, it's not as gray as it appears in the photo, strange lighting and crappy Iphone camera. However, I thought it added a certain "air of distinction" and rather liked the effect so this is the picture I chose to share.

 

As it says in my "About" page on this blog I was a police officer back in my "younger days", I married a cop, I am the daughter, sister, and mother to others, past and present. I have seen heroic goodness, heart-rending tragedy, and frightful depravity; often the family conversations would curl the toes of most people. I exist in an insular and "unique world", and unavoidably, sometimes that "uniqueness" shines through.

My formal education was in Computer Science, but that was so long ago that technology has left me in the dust. Now when something goes wrong with one of my computers I turn to the Geek Squad—or buy a new one. Speaking of which: my "work-horse" laptop went to visit The Geek Squad and I am working on my "travel laptop", a Vista based machine. Vista—what a crappy OS—I spend more time re-booting than I do accomplishing anything.

While I will continue to post under the pseudonym of SophiaZoe, I did what to introduce myself, as I no longer feel that anonymity is necessary or especially helpful to the furtherance of PanFlu information exchange.

 

Debi (aka: SZ)

Thanksgiving in America

Today is the day we celebrate Thanksgiving in America. A day when most families gather around a table strained with weight of a feast lain before them. A day to offer thanks for our blessings.

 

To all of my readers in America: Happy Thanksgiving. I hope this day finds you surrounded by the love and laughter of friends and family.

To my Fellow Flubies: Aside from my own family, you are the greatest blessing that I count.

 

Please remember, as you gather in celebration, the firefighters, paramedics, police, doctors, nurses, deployed and TAD military personnel, who are away from their family and friends protecting and safeguarding ours.

 

SZ

ReadyMom(s.com) Goes National

I have been progressively "under the weather" these last few days and utterly swamped at my day-job to boot. I fear I am going to be paying the proverbial Piper for pushing myself beyond my physical, mental, and emotional limits of late.

I did want to write at least a few brief comments and observations about the wonderful thing that has been happening in Washington DC over this last few days.

On FluWiki you will find a wiki diary entitled "ReadyMoms Are Taking The Message National"

ReadyMoms.org - Family Preparedness Solutions
A grassroots initiative to promote pandemic and all hazards preparedness, at the American Public Health Association Annual Meeting & Exposition in Washington, D.C. November 3-7, 2007.

The work of "Readymom" in promoting community preparedness for pandemics and all hazards has been a source of inspiration for many.  For those of you not familiar with the amazing things she has been doing, here's the story of how it all got started.  Then their next big triumph, at the 4th of July fair, sharing a tent with the Red Cross.  Read about this amazing day here, and how others got inspired and empowered to run events on their own, very successfully I must add!

 

ReadyMom, the inspiration for the name of what has become an entire Action Group, first became known to me the beginning of September 2006 when she joined an online forum I was an administrator of. At that time she was an energetic and intelligent Flubie who was concentrating on her own preparations and learning.

By the spring of 2007 she was taking the message of personal preparation and education to the public in her area. Six months later, having had progressively greater responses and positive feedback she finds herself, supported by a couple of Cyber Flu Community luminaries, in Washington DC where her message, and those with her is being received with glowing welcome. Grassroots in a veritable sea of corporate and governmental exhibitors and the positive feedback just keeps rolling in.

There are a number of members of the cyber flu community who engage in their own educational and engagement campaigns, this blog is a humble and small example. SusanC, of FluWiki, who was instrumental in the ReadyMoms.org birthing and the current exhibit, has literally trotted the globe in her efforts, DemFromCT, also of FluWiki, is a regular conferee at pandemic events, Mike Coston (Fla_Medic) of AvianFluDiary, and Crawford Kilian of H5N1 are the best known and most looked to by people from all over the world. But as ReadyMom has demonstrated, an "average citizen" can accomplish remarkable things.

I would like to share with you something that was posted on the above FluWiki diary :

Ordinary Individuals Doing Extraordinary Things

What you folks are doing is truly incredible, not just for the impact you are having by spreading the word, but almost more importantly, both there and here, for showing people what can be done by individuals working together.

The sense of creeping futility that fills our lives when it comes to the large and complicated problems of our day can rob us of hope.  It can rob us of the will to act.

No hope, no will.  No will, no progress.

But even the smallest hope of even the possiblity of progress can open up the gates and unleash endless waves of determination and creativity, if only that hope can be seen. 

You folks are lifting that hope up like a big old flag and waving it around for all you are worth.  It sounds like its getting seen there.  I know its getting seen here.

And just as this is all true for getting out the message on planning and preparedness, it is also true for responding to a pandemic.  It is now and will be then, up to us. 

Good on you.  Good on you.  Good on you. 

ITW(Joel J)

 

By the time I was half-way through reading the post my eyes were threatening to spill over.

 

SZ