Are You There Yet? - No!

We want to call this Flu-oogle to talk about Google's not quite there yet flu shot finder. The problem isn't so much GOOGLE as its the places that actually give out the vaccines. We're "flu policing" again - and really we don't want to. But with the World Health Organization's report on Women's health, this being Veterans Day, and Aunt Pearlie's sister whom we called "Daughter" was an honored Army servicewoman we couldn't ignore this story. Google has a flu shot finder for the country that will eventually be available through the flu.gov site of the Center for Disease Control and Prevention (CDC).

The problem with the GOOGLE or Flu-OOGLE if you will isn't the OOGLE it's the "G" the governments with which they have to get the information. It's as inaccurate as the I-phone apps meant to inform. The original information is faulty or rather inaccurate.

The "Flu Shot Finder" only goes to the state's or county's website which you would think would make it more accurate and in a sense that is true. However most of that means that the county "has no public H1N1 or seasonal clinics scheduled." For "non-breeding" women this isn't helpful at all. We're still not there yet! To inquire because of WHO - we wish we could:

"say to you this afternoon, however difficult the moment, (Yes, sir) however frustrating the hour, it will not be long..." - Martin Luther King, Jr.

DC Department of Health (DOH)

Thursday, November 12 5 pm - 9 pm
Cardozo Senior High School
Ballou Senior High School

"To say that the future will be different from the present and past may be hopelessly self-evident. I must observe regretfully, however, that in politics it can be heresy. It can be denounced as radicalism or branded as subversion. There are people in every time and every land who want to stop history in its tracks. They fear the future, mistrust the present and invoke the security of a comfortable past, which in fact, never existed. It hardly seems necessary to point out in the United States, of all places, that change, although it involves risk, is the law of life." - Robert F. Kennedy

Saturday, November 14
8 am - 1 pm
Eliot-Hine Middle School
Kelly Miller Middle School
Hardy Middle School

MD Calvert County
November 14, 2009
H1N1 (Swine) Flu Vaccination Clinic
9:00 am – 1:00 pm
Calvert Fairgrounds

Cecil County
At this time, the Cecil County Health Department has no public H1N1 or seasonal clinics scheduled.

"An Atheist believes that a hospital should be built instead of a church. An atheist believes that deed must be done instead of prayer said. An atheist strives for involvement in life and not escape into death. He wants disease conquered, poverty vanished, war eliminated." - Madalyn Murray O'Hair

Charles County
Vaccine will be provided from 3:00pm to 7:00pm (or until the supply of vaccine is gone) ** Cars of clinic attendees will not be permitted in the parking lot until all school buses depart at 2:45
November 12 - Thursday **4:30 to 7 pm Picowaxen Elementary School -Priority Only
**New time and location
*** Cars of clinic attendees will not be permitted in the parking lot until all school buses depart at 3:45.
November 16 - Monday 3:00 pm to 7:00 pm Indian Head Pavillion
November 18 - Wednesday 9:00 am to 7:00 pm Department of Health Offices
November 24 - Tuesday 3:00 pm to 7:00 pm Charles County Government Center

Dorchester County
Updated 11/6/09
SEASONAL FLU INFORMATION: Currently out of vaccine. When additional supplies arrive we will advertise on this site and in local papers.

“If I am not for myself, then who will be for me? And if I am only for myself, then what am I? And if not now, when?” - Rabbi Hillel

Frederick County
Community Clinics for Priority Groups- By Appointment Only
Vaccination Date: November 12, 2009, 12:00 pm - 4:00 pm
The appointment line for the November 12th H1N1 flu clinic is now closed. The Health Department will announce dates for additional clinics in the near future.
If a caller does not receive a call back within 4 hours, all appointments have been scheduled.

"But this is the great danger America faces. That we will cease to be one nation and become instead a collection of interest groups: city against suburb, region against region, individual against individual. Each seeking to satisfy private wants." - Barbara Jordan

Baltimore MD
Pre-register for upcoming clinics that will be scheduled this month. If you are in one of the priority groups, complete the online form. Someone will contact your within 10 business days to schedule your appointment(s).
Thursday, November 12 - 11 a.m. to 7 p.m.

VA All Counties
Vaccine will be available for the general public at pharmacies, health care provider offices and local health departments in December. We will add clinic dates and times as they become available. Please check back for regular updates.

We only included the more current days, links and locations. We'll try to keep up with the information as it becomes more available. We don't know and aren't being told when everyone will have access to their own protection. It is good to know that this is still fairly early for our health and that the numbers (though not ALL the people are being saved) are starting to shrink especially in our area from epidemic proportions to normal proportions. Unless you're related to the dead or dying. Protect yourself. Don't despair - you are not alone. We are with you. We can and must demand to do better.

When Pigs Die!

Just as some jurisdictions are starting to begin the claim that the swine flu is starting to decline in severity - a claim which we vehemently are in opposition. What is true is that the deaths aren't substantially greater but that's in terms of overall deaths. What we maintain is that the deaths are preventable and unnecessary. What we maintain is that we don't want to be in those numbers. Just when, we will admit is in other parts of the country, they are starting to claim the worst is over we have the following from the World Health Organization (WHO) reporting: "Clinical signs such as coughing and diarrhoea were observed in a pig farm located in T’ai-Tung County on 19 October 2009."

The American Veterinary Medical Association (AVMA) reported to the World Health Organization that: "On November 5, Taiwan submitted a report to the World Animal Health Organization (OIE) confirming 2009 H1N1 in a swine herd in T’ai-Tung County. Illness was first observed on October 19 and tests confirmed 2009 H1N1 influenza on November 2. Clinical signs observed included coughing and diarrhea. All pigs have recovered from the illness."

What it hasn't done is gotten more severe. It's the most severe flu in over fifty (50) years but it hasn't gotten worst. "The World Health Organization has issued a statement that extensive testing has shown that the 2009 H1N1 influenza virus has not mutated to a more virulent form. In addition, the WHO emphasized that H1N1 infections in pets were "isolated events and pose no special risks to human health."

This H1N1 (swine flu) is not like other flus. This flu is different. From WHO we offer the following evidence:

"(U)nder the right conditions, influenza viruses from different species are capable of mixing and swapping genes (this is called reassortment), resulting in a new virus."

"(I)t is very uncommon for flu viruses to jump between species. However, on October 9, 2009, a USDA laboratory confirmed 2009/H1N1 infection in a ferret."

"On November 4, the Iowa State Veterinarian and the Iowa Department of Public Health announced that a pet cat was confirmed infected with the 2009 H1N1 flu virus. The cat's owners were ill and the cat developed respiratory symptoms shortly afterward. The cat has recovered and there is no evidence at this time that the cat passed the virus to any people."

"Keep in mind that dogs currently have their own flu virus, the H3N8 influenza (canine influenza) virus, going around. So far, this flu virus has only been spread from dog to dog. Dogs infected with the canine influenza virus show the same symptoms as dogs with kennel cough – fever, lethargy, loss of appetite, coughing, and maybe a runny nose."

"There is not a licensed and approved 2009 H1N1 vaccine for pets. The human H1N1 vaccine should not be used for pets. The canine influenza vaccine, which protects dogs from the H3N8 flu virus, will not protect pets against the 2009 H1N1 virus and should not be used in any species other than dogs."

We are not pigs, some of us have been accused of some unclean behavior and have eaten in a way to suggest we could have eaten less, but we aren't animals of the farm variety. Domestic maybe but that's debatable. There is a licensed and approved vaccine that can protect us. We just have to get access to it. What we do stress is that each life is precious and each death tragic. Retention and prevention should be our most pressing mission inspite of our couch like and unhealthy eating habits. We still want to live to make more bad unhealthy decisions.

We will leave you with this ONLY because yesterday was Sunday and we churched. While looking for a way to join the two stories we discovered this bible quote from the New Testament the eighth (8th) chapter of Luke: "Jesus asked him, “What is your name?” “Legion,” he replied, because many demons had gone into him. And they begged him repeatedly not to order them to go into the Abyss. A large herd of pigs was feeding there on the hillside. The demons begged Jesus to let them go into them, and he gave them permission. When the demons came out of the man, they went into the pigs, and the herd rushed down the steep bank into the lake and was drowned.

Is that weird or what?

We're No Doctors but

...we know doctors. There is something we can do. It's not Center for Disease Control and Prevention (CDC) approved but even the CDC believes that using some alternate means other than waiting on the vaccine isn't unacceptable behavior.
Our doctors are the international physicians from the World Health Organization (WHO) because they haven't been wrong yet. Tracing their actions and suggestions the CDC has lagged behind in suggestions made by the WHO.

Studies show that early treatment, preferably within 48 hours after the first sign of symptoms, appear associated with better clinical outcome.

For patients who initially present with severe illness or whose condition begins to deteriorate, WHO recommends that treatment with oseltamivir should start immediately, no matter when illness started and without waiting for laboratory results.

For patients at risk for serious disease, including those with certain underlying medical conditions, WHO recommends treatment with either oseltamivir or zanamivir as soon as possible after the onset of symptoms and without waiting for the results of laboratory tests.

In all cases, where oseltamivir is unavailable or cannot be used for any reason, zanamivir may be given.

Or we can just wait our turn to either get sick and survive which is the most likely scenario. We mean, after all, who expects to die. The Washington Post and the local jurisdictions Departments of Health (DC, MD, VA) each have their own schedules and neither the three (3) small meet.

Total Doses Shipped as of*	10/28/09
District of Columbia Maryland Virginia	49,000 306,900 489,700
TOTALS	579400

There is open reciprocity - meaning you can wait in line in three (3) states for the vaccine without being a resident of state of the line you choose. We're of course, overlooking the other alternative which will go without saying. But you know what it is!

One of the great things about this nation is the ability to choose. That's what makes this the greatest nation on the face of the planet. The second thing that makes this the greatest nation on the face of the planet is that we can and often DO do better!

That's a Fact, Jack! (or Jill)

...as the case may be. We're not sexist! Just paraphrasing Bill Murray from STRIPES (1981). We heard pandemic when the World Health Organization (WHO) said it. We knew what the word meant and when everybody said don't worry and don't panic we knew different. We knew not to panic but concerned we were and said. In that vain we have to call you attention to the numbers that some might be frighten by in the latest report from the online journal Emerging Infectious Diseases gave Associated Press (AP), Reuters, Wall St Journal, and WedMD which had the very scary headline: "140 Times More Early Swine Flu Than Reported."

"Here's the thing" to quote Monk. As scary as the headlines might be we think it's worst than that. Two things happened. One the Center for Disease Control and Prevention (CDC) changed its graphics concerning the numbers and how the numbers are reported. They reset their figures and started only publicly counting the deaths of children. The numbers were worst than reported.

"Through July 2009, a total of 43,677 laboratory-confirmed cases of influenza A pandemic (H1N1) 2009 were reported in the United States, which is likely a substantial underestimate of the true number. Correcting for under-ascertainment using a multiplier model, we estimate that 1.8 million–5.7 million cases occurred, including 9,000–21,000 hospitalizations." (PDF)

The latest report is based on figures that are restricted based on the suggestions of the CDC. Under what you can do to stay healthy: "Stay home if you get sick.

JURISDICTIONS 2009 2008 2007 District of Columbia Baltimore, MD Richmond / Norfolk, VA 97 627 208 67 680 179 54 541 191 DEATH TOTALS WEEK 41 932 926 786

CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them." It's right under their first suggestion: "Get vaccinated." No where does the CDC suggest that you go to your local hospital for treatment or to report your illness. Their suggestion is to hide yourself. Do not disclose your illness. Keep it quiet.

The report deals with estimates from "April–July 2009" this was when the pandemic was at is smallest. Stories abounded on the how "much ado about nothing" although every such story ignored the fact that this virus started earlier than flu ever starts. The CDC and history showed that the apex for infections occur in February so even having a vaccine available by October would protect more American than ever before. You'd be ahead of the game. It was wrong.

The CDC has changed its charts only once before in reporting the number of deaths as a result of the H1N1 flu. The first time they reported only verified number of infection. Now they admit "virtually everything that's circulating now is the 2009 H1N1 influenza strain." (CDC).

That's why we say and agree with the report that the numbers are larger but we think that a pandemic is a PANDEMIC and the number will be worst IF we don't get the vaccines distributed much sooner. Pregnant women and children are important. Extremely important - unfortunately in a sinking boat (a pandemic) every man / woman for themselves. To remind everyone the government only has ten (10) per cent of the available vaccine.

Notice the second change by the Center for Disease Control and Prevention (CDC) the charts used to show the reported infections makes it difficult to determine the weeks reported and makes no comparison to prior years as earlier charts showed. The report is based on the smallest amount of reported cases. The actually numbers are consistent with pandemic numbers.

(O)ver the next several weeks it should become more easily available. And as I've been saying each day we are seeing forward progress. We're expecting a lot of vaccination effort this is weekend in a number of places. - Anne Schuchat, the CDC Director Of The National Center For Immunization And Respiratory Diseases (HEAR)

There are shortages because the for profit industry has sufficient supplies. The general public has shortages. We're in line for the discount vaccines, the left overs.

"The commercial sector is increasing production of the Tamiflu and, of course, there is also Ralenza available. Important to say that capsule production is what is -- has really been increased. There are more and more capsules being made or shipped out. And what we want parents to know is that capsules are fine for kids, even kids that can't swallow pills because there's a way for the pharmacist or for you at home to convert that capsule into a liquid." - Anne Schuchat, (CDC) the Director Of The National Center For Immunization And Respiratory Diseases (HEAR)

This isn't any kind of conspiracy and we don't mean to even suggest such a thing so: "Calm Down!" We love conspiracies but we agree most (read most) people will survive their infections. Our suggestions has been to tell someone for your own protection and have someone to check on you when infected. To which we'd like to update that information with IF you have private insurance and IF your doctor has access to Tamiflu the "antiviral" get it! Recent research shows that the antivirals reduce the symptoms and speeds recover. Yes it can create other problems and indeed this H1N1 may be a result of that (speculation - ignore).

We could be wrong but we don't think so!

GERD! James Gerd!

We used a college homecoming weekend dinner to hold a staff meeting and the question of why no GERD stories arose. We couldn't think of any reason other than the lack of recent studies on the subject. Lo and behold we find a recent H1N1 death attributed to symptoms that included GERD:

"A 52-year old man is Santa Rosa County’s first confirmed death associated with H1N1 Swine Flu, according to the county’s health department."

"The man died September 11, according to information released Tuesday from the Santa Rosa County Health Department. Health officials were notified of his death September 28, when the results of additional lab tests were received. The man had hypertension and GERD (gastroesophogeal reflux disease). In keeping with Florida Department of Health policy, no additional information was released."

“The death of a loved one under any circumstances is always a tragedy,” said Sandra Park, A.R.N.P., interim administrator for the health department. “Our hearts and prayers go out to his family and friends at this difficult time.”

"The man was admitted to the hospital on September 4. At that time, a rapid flu test for H1N1 was performed and the result of that test was negative. Additional testing, however, confirmed that the man was ill with H1N1."

We're not trying to be the "flu police." We're concerned about the lack of information being presented to us by our local jurisdictions when we have proof positive that the information is false in relations to the flu. What we don't understand is why the jurisdictions refuse to give us the full and unvarnished truth. Reading daily obituaries shows deaths that the local health departments don't or refuse to report. Most disturbing are the reports that the standard H1N1 test return negatives when autopsies reveal positives results. That type of information is better presented to the living than the dead.

CBS News reports what a doctor tells his patients in this two (2) week old report from Dr. Jonathan LaPook: "Smoking and obesity both increase acid reflux and must be addressed. I tell my patients to limit alcohol, caffeine, chocolate, peppermint, and fatty foods (I know, basically anything that gives them even an iota of pleasure in life). I also suggest keeping a food diary to try to identify culprits such as tomato-based products or certain spicy foods. If their symptoms resolve then they can try to reintroduce the things they miss the most. Elevating the head of the bed can sometimes help."

Research physician, Dr. Ronnie Fass, reported in Renal and Neurology News on the latest drug treatment for GastroEsophageal Reflux Disease: “Patients with diabetic gastroparesis and symptomatic documented GERD may have trouble adhering to treatment because of difficulty swallowing, the need for treatment when they do not have water available, or the need for a portable way to take medication...”

The new drug treatment evaluated by the doctor: "...Metozolv ODT, which rapidly melts on the tongue, gives these patients a new choice that may be more convenient than traditional metoclopramide tablets, Ronnie Fass, MD, Professor of Internal Medicine at the University of Arizona added. “Patients with diabetic gastroparesis and symptomatic documented GERD may have trouble adhering to treatment because of difficulty swallowing, the need for treatment when they do not have water available, or the need for a portable way to take medication.”

The National Post's Dr. Yoel Abells writes that: "Gastroesophageal reflux disease (GERD) is quite common. Epidemiologic studies suggest incidence rates are increasing and that up to 20% of the adult population suffers from this condition to varying degrees..."

"...Complications associated with acid reflux disease arise from the irritating effect the stomach contents have on anatomical structures. For example, the acidic contents can inflame the vocal cords, resulting in hoarseness, or spill into the lungs causing hyperreactivity of the airways and an ensuing cough. Asthma can worsen as a consequence of GERD. Up to 5% of individuals suffering from chronic GERD develop Barrett's esophagus, characterized by changes in the cells lining the esophagus. Although rare, over time, this condition can lead to esophageal cancer."

That such a common occurrence can be present in an uncommon virus seems more than a matter of chance. From its first typing by the World Health Organization (WHO) and the Center for Disease Control and Prevention (CDC) have maintained that pre-existing conditions can present opportunities for the relatively harmless virus can cause complications that could lead to death. Originally the time line for infections to complications that could lead to death was over ten (10) days. Current deaths have reduced that timeline from ten to five (5) days with the fifth day being the date of death for some individuals. Most individuals do survive - this isn't about the relatively healthy - this is about those who are most susceptible. You and I.

FLU WHAT WHY?

We asked all of the Region 3 jurisdictions as defined by the Center for Disease Control (CDC) to share with us the number of deaths from swine flu to determine which suffered the ten (10) deaths that reported for the week. Surprisingly not all responded to our "non-media" request. The ones who did didn't equal the total reported as "pediatric" deaths. We've long since determined that the numbers were far greater than reported and growing - but not in a "sky is falling way" but in a if you knew you'd panic needlessly. From all our research panicking is needless.

The World Health Organization (WHO) reports that: "Most people recover from infection without the need for hospitalization or medical care." For us that means catching the flu isn't a death sentence as a treatment is readily available to prevent death. The flu is rather difficult to acquire. The CDC and Pennsylvania State Health Department (H1N1INPA) say: "The virus can live on hard and soft surfaces anywhere from 2 to 8 hours after being touched by an infected person. 2 to 8 hours!"

How each jurisdiction addresses the problem should be our concern. Ours has a plan that we believe is wholly inadequate. Ours isn't the one. This story was the headline today: "Cincinnati-area hospitals are placing restrictions on visiting due to the spread of the H1N1 (swine flu) virus, the Greater Cincinnati Health Council said. Beginning Monday, most area hospitals are allowing visitors ages 14 and older only. People with respiratory symptoms, including fever and coughing, are also not permitted to visit, according to a news release. Cincinnati Children’s Hospital Medical Center is limiting visitors to parents and guardians only, according to the release."

We immediately went to the Ohio Department of Health which has virtually no information on current rates of infection or deaths. The only thing we could find was this from the ODH Director Alvin D. Jackson, M.D. in a memo (PDF) provided to public health colleagues: "Director's Journal Entry, In Re: Reporting of Influenza A H1N1... Effective immediately, I order health care providers, laboratories, and local health departments to consider influenza A HlN1 as non-novel and to report cases pursuant to paragraph (B) of section 3701-3-O2 of the Ohio Adm. Code."

It's not a novel or unusual virus anymore. It's bad! It's really bad. Even though the World Health Organization (WHO) says: "The main route of transmission of the new influenza A(H1N1) virus seems to be similar to seasonal influenza, via droplets that are expelled by speaking, sneezing or coughing. You can prevent getting infected by avoiding close contact with people who show influenza-like symptoms (trying to maintain a distance of about 1 metre if possible)..."

To recap a Cincinnati Children's hospital has developed emergency procedures for a problem that the state's Department of Health doesn't acknowledge exists. That's the problem or rather that's what we think is part of the problem.

We're suspicious. The individuals who have died from this flu don't seemed to be grouped together or are they? Did the first individual who died in the jursidiction come in contact somehow in someway through someone who distributed the flu to the second individual who died? Transmission appears to be difficult and we accept that but this information blackout or in Virginia's "pre-existing conditions" case seems odd.

Why do we trust the World Health Organization (WHO) is because: "WHO continues to track the evolving infectious disease situation, sound the alarm when needed, share expertise, and mount the kind of response needed to protect populations from the consequences of epidemics, whatever and wherever might be their origin."

The World Health Organization was the first to warn of the pandemic when the US including the CDC were slow to react and the number had prior to the season begun to approach previous years totals.

So what do we in our suspicious mind think you should do? If you took a flu shot last year get your regular shot this year. Or if you didn't it shouldn't hurt to get one this year. We don't believe that the shots give you the flu. We believe WHO who asks and answers the question: "Should I take an antiviral now just in case I catch the new virus? No. You should only take an antiviral, such as oseltamivir or zanamivir, if your health care provider advises you to do so. Individuals should not buy medicines to prevent or fight this new influenza without a prescription, and they should exercise caution in buying antivirals over the Internet."

We're not parnoid. We're just cautious. We trust but we believe in verification. WHO says and we say: "The new influenza A(H1N1) appears to be as contagious as seasonal influenza, and is spreading fast particularly among young people (from ages 10 to 45). The severity of the disease ranges from very mild symptoms to severe illnesses that can result in death. The majority of people who contract the virus experience the milder disease and recover without antiviral treatment or medical care. Of the more serious cases, more than half of hospitalized people had underlying health conditions or weak immune systems."

We've seen the real numbers and when we inquire and are given bogus numbers we have to ask - why the lie? That's our real concern. When I've asked you a question that I already know the answer to and you give me false info. That's the concern. How can you trust what can't be verified? (Oh, my God! We're paraphrasing Ronald Reagan! We're going to hell.)