**NOTE: NAMES HAVE BEEN CHANGED**
Long day of revising the rough draft of the monthly report. Dory looks over it and has many changes to make b/c some data can’t be used in graphs.
For example, we can’t use 2008 data because of incompleteness and inaccuracy of reporting and thus we can’t compare this year’s 2009 data to 2008 data.
Dory also gives me a guideline/book she wrote, like a Epi 101 manual. I read the chapter about charts and graphs because that is basically what I am doing. Then we talk about a lot of other things… I ask a lot.
Vaccine production – The reason I am doing this is because developing countries are often the source of influenza strains and virus strains need to be collected to produce seasonal flu vaccines. The samples that are obtained are submitted to specially-designated WHO centers around the world. Meetings are held speculating that upcoming flu season’s actual flu strain. There is a vaccine for the northern and one for the southern hemispheres. There were incidents where developing countries withheld their samples because they were not getting the vaccines and also the vaccines were resold to them at high prices. Negotiations occurred and a certain number of vaccines now goes to designated countries and there are fixed prices for some as well. Makes sense to me. The developed countries, while they try to help developing countries, often have programs and initiatives that would benefit them.
Tamiflu is given as a treatment in the US within 24-48 hours of onset of clinical symptoms. Here in a developing country, it is not preferentially given. People are told to drink fluids and get lots of rest and stay at home to avoid infecting others. I think about how lucky I am that I have ready access to Tamiflu, even though the US has a tiered system of who gets the drug first in a major pandemic outbreak. I am in tier 4, with the rest of the population. Health care professionals are in tier 1. So the main ethical issue with this is that all human life is valued equally – no one country has more value over another. But then again, money does talk. There was an article on CNN about an American student group in Beijing quarantined because one of the kids came down with H1N1 (I can’t find the article to post here). One of the girls’ mother (who is a writer and works at the White House) began freaking out and called all the politicians, state officials, friends, Beijing contacts, etc to make sure that her daughter was ok. She freaked out that her daughter wasn’t given Tamiflu when she came down with a slightly elevated temperature and went to the hospital. She demanded that Tamiflu be given to her daughter b/c that was the standard of care in the US. The girl texts the mom with messages like “they are letting me have pizza later.” The mom’s friends visit the girl and brings a DVD player and movies. The girl then feels well enough to run around the hallways of the hospital. I felt so ashamed for the mother. The only thing the kids missed was seeing the Imperial Palace. They had food, drinks, access to technology and communication, access to health care, probably the best health care in Beijing, considering all the public media attention on this. For the mother to go to politicians and use her network to make sure her daughter was safe by her standards was beyond ridiculous. It is basic common sense that you do not allow more people to be infected. Think about the throngs of tourists visiting the Beijing Imperial Palace. People from all over the world, thousands of visitors, imagine how quickly an outbreak could occur. I encourage people to stop, be cautious, and think rationally.
Then Dory and I talk about pressing issues in Cambodia. Malaria not as big a concern as dengue fever for me. Dengue hemorrhagic fever affects the young and healthy; the incubation period (time of infection to onset of clinical symptoms) is 1-2 weeks; no vaccine for this; basically not a good thing to get.
I leave work after 7 PM and then am too tired to work out, which I’ve been meaning to do since I got here.
dude i bet you're fitter than you've ever been -- all that walking and sweating!
ReplyDeletehmm yea you're definitely opening my eyes about how epidemics and stuff are handled differently everywhere. it's kind of insane how h1n1 is getting so much press, but like malaria and dengue fever aren't? swine flu is like the normal flu! aka it passes! but i guess dr. nemo was right in saying that if they can get a system enacted to better deal with h1n1, the treatments for other diseases will also fall in place. one can only hope.. sigh.
okay i am not good at actually talking about pressing issues, so i will crack a joke. actually no. i tried to make up a joke but i couldn't. it went like this: what did one peanut say to the other peanut? look mom, a talking peanut! (but that makes no sense! i think i confused that from another, actually funny, joke..)