Influenza Update - December 21

Pandemic H1N1 Update Dr. Stuart B. Weiss INFLUENZA UPDATE Dec 21, 2009 SUBSCRIBE: Click button at bottom or send email to: sbw1@MedPrepGroup.com Influenza activity contines to fade down to seasonal levels in the U.S. Pandemic H1N1 activity in the U.S. and around most of the world continues to decline with some notable exceptions, namely India and parts of the Russian Federation. Current Situation: The CDC confirmed that the number of states reporting widespread influenza activity continues to decrease, from 14 states down to 11. The number of people visiting physicians in the US for influenza-like illness has decreased again this week. The number of pediatric deaths has decreased as well. The WHO reports that influenza activity has decreased or plateaued in much of the world with some exceptions: Europe: Activity is declining across Europe except in parts of southeast Europe and the Russian Federation. Asia: East - transmission remains active but declining. West & Central Asia - Increasing activity in Kazakhstan and Kyrgyzstan. Activity in the Middle East have peaked. Southeast Asia: India, Nepal, Sri Lanka and the Maldives continue to show increasing flu intensity. Africa: Limited data shows continued activity across the continent (except in South Africa where it is summer) Southern Hemisphere: Little to no activity. Vaccine Update: The CDC reported that almost 100 millions doses of vaccine have been released. Approximately half of the states across the U.S. are relaxing their vaccination guidelines to include anyone who wishes to be vaccinated. Several scientists wrote that the U.S. should honor its commitment to donate 10% of its vaccine supply to poor third world countries. Secretary Sebelius said that the U.S. will honor its commitment. The WHO reports that it will donate vaccine to its first three recipients, Afghanistan, Azerbaijan and Mongolia. China's death toll leapt by more than 30% in recent days which is raising alarm with the approaching Lunar New Year or Spring holiday. This is the biggest and most important holiday and millions of people crowd the roadways, trains and airports to return home. HOUSEKEEPING ITEM: If you get this Alert through a mailing list and not directly from us, subscribe by clicking the button at the bottom or send an email to me at sbw1@MedPrepGroup.com ANALYSIS: Officials in the government continue to encourage everyone to get vaccinated as do I. As I wrote about a few weeks back, activity continues to be a problem in India so if you have business processes outsourced to India, make sure your contingency plans have been updated. We have much experience auditing these types of plans so if you need assistance, give us a call. ADVICE: Get vaccinated. It is a safe vaccine. Keep one eye on the virus looking out for a third wave. It is too early to tell if one will occur. Review your plans for offices in areas with intense or increasing influenza activity. TOOLS: Pandemic and Infectious Disease Plan Audits - Having outside experts review your pandemic plans may bring you new insight into planning areas that need work. Take this opportunity to review your pandemic and other infectious disease plans. Think about inviting us in to bring a new set of expert eyes to take a look at your plans. Corporate Exercises - Validating your plans through the use of well planned exercises remains an important tool in the business continuity toolkit. We are experts in developing and facilitating exercises customized to the needs of our clients. Virtual Medical Director - If you don't have a corporate medical director, our Virtual Medical Director program may be a good solution for you. Our Virtual Medical Director service provides you with 24 hour access to physicians and experts trained in emergency medicine, disaster medicine, business continuity, occupational health and mental health crisis management to give you situation updates, analysis and advice. We have affordable decision support plans that you can enroll in. Pandemic Planning Assistance - We have a policy matrix, policy toolkits, FAQ's, posters, employee educational materials, a trigger based action plan template . We can help you jump start your planning or take a look at your current plans with a fresh set of eyes. Not preparing now would be a serious mistake. If you have any questions or concerns that we can help you with, please feel free to reach out to me. My email is: sweiss@MedPrepGroup.com MedPrep Consulting Group is internationally recognized as a leader in pandemic, disaster and business continuity planning, training and exercising. We have resources and expertise that you can count on. Ask us about our Virtual Medical Director Program. Dr. Stuart Weiss is the CEO of MedPrep Consulting Group. For more information, visit www.MedPrepGroup.com Stuart Weiss, MD, CBCP MedPrep Consulting Group LLC

Influenza Vaccine Recall - December 15

Pandemic H1N1 Update Dr. Stuart B. Weiss INFLUENZA VACCINE UPDATE Dec 15, 2009 SUBSCRIBE: Click button at bottom or send email to: sbw1@MedPrepGroup.com Non-safety Recall of Pediatric H1N1 (2009) Vaccine Today, the CDC announced a recall of some lots of Sanofi Pasteur H1N1 Pediatric (.025ml for 6-35 month olds) vaccine in pre-filled syringes. Current Situation: The CDC reports that routine testing of the potency (strength) of vaccine in three lots of pre-filled pediatric vaccine fell slightly below the required strength and was being recalled. Vaccine manufacturers routinely test vaccine lots after they are released to make sure that they maintain their potency. According to the CDC, the potency is only slightly below the required potency. This only affects certain lots of pediatric vaccine in pre-filled syringes intended for 6-36 month olds. HOUSEKEEPING ITEM: If you get this Alert through a mailing list and not directly from us, subscribe by clicking the button at the bottom or send an email to me at sbw1@MedPrepGroup.com ANALYSIS: There is basically nothing to do about this. If your young child received the recommended two doses of vaccine, the CDC says that they are protected since the potency was only slightly below the required level. Since there is no safety issue, there is nothing to worry about. For further information, here is the link to the CDC site: http://www.cdc.gov/h1n1flu/vaccination/syringes_qa.htm If you have any questions or concerns that we can help you with, please feel free to reach out to me. My email is: sweiss@MedPrepGroup.com MedPrep Consulting Group is internationally recognized as a leader in pandemic, disaster and business continuity planning, training and exercising. We have resources and expertise that you can count on. Ask us about our Virtual Medical Director Program. Dr. Stuart Weiss is the CEO of MedPrep Consulting Group. For more information, visit www.MedPrepGroup.com Stuart Weiss, MD, CBCP MedPrep Consulting Group LLC

Influenza Update - December 14

Pandemic H1N1 Update Dr. Stuart B. Weiss INFLUENZA UPDATE Dec 14, 2009 SUBSCRIBE: Click button at bottom or send email to: sbw1@MedPrepGroup.com Give yourself an early holiday gift, get vaccinated. As influenza activity in the U.S. and much of Europe continues to wane and vaccine stockpiles continue to increase, now is the time to get vaccinated for H1N1 (2009) before the winter wave arrives. Current Situation: The CDC confirmed that the number of states reporting widespread influenza activity has decreased again, from 25 states down to 14. The number of people visiting physicians in the US for influenza-like illness has decreased again this week. the CDC released new projections indicating that approximately 50 million American have gotten pandemic H1N1 or about 15% of the U.S. population. The flu has resulted in about 200,000 hospitalizations so far, a number that equals a usual entire flu season (and we are only in December), and approximately 9820 deaths with 1,090 children, 7450 adults 18-64 and only 1280 people over 65. This is markedly different from the usual flu pattern. The number of new influenza cases on college campuses increased after the Thanksgiving break. It had been dropping for the past several weeks. The WHO reports that while there is slowing of influenza activity in North America and most of Europe, activity continues across the northern hemisphere: Europe: Activity has peaked or is peaking across Europe except in France where activity is still rising. East Asia: Increasing influenza-like illness in Japan and northern China. Hong Kong and Chinese Taipei are showing increasing activity after a previous peak. South and Southeast Asia: India and Sri Lanka continue to show increasing flu intensity. Africa: Limited data shows continued activity across the continent (except in South Africa where it is summer) Southern Hemisphere: Little to no activity. Vaccine Update: The CDC reported that 73 millions doses of vaccine has been released. Many states across the U.S. are relaxing their vaccination guidelines to include anyone who wishes to be vaccinated. CDC reported 16 additional pediatric deaths this week due to flu related complications. Two studies came out showing a disparity in death rates among ethic minorities. A study in Illinois showed the death rate in Blacks and Hispanics to be twice the rate of Caucasians. A second study in New Mexico showed a higher death rate in Native Americans. There are many factors that may have contributed to this and it will take more time to sort this out. A new study looked at the death rates for this pandemic. The death range, depending on how it is calculated, ranges from slightly above a typical flu season to markedly less than a typical flu season. More time will be required to come to more definitive numbers. Another study looked at immunity and suggested that many people many have some partial immunity which explains that large number of cases but the low death rate. There was a report in the British Medical Journal and investigated by a British Television station looking into the usefulness of Tamiflu to prevent serious complications of seasonal flu. After reading the articles and the rebuttals, it seems there is much more being written about access to data than about the usefulness of Tamiflu. this report focused on seasonal flu and did not discuss pandemic flu. the bottom line is that more transparency in study data is necessary in the future. The USDA licensed the first pig H1N1 (2009) vaccine that can be used by pork producers. It is produced by Pfizer Animal Health division. HOUSEKEEPING ITEM: If you get this Alert through a mailing list and not directly from us, subscribe by clicking the button at the bottom or send an email to me at sbw1@MedPrepGroup.com ANALYSIS: I had the opportunity to speak to a large group of legislators this past weekend about H1N1 (2009). One of their main questions was whether we are done with the flu or will there be a third wave. While it is impossible to know for certain, there are several factors which makes me think we may not be through with this flu. First, if you look back at the 1957 flu, there was a great big peak in early winter which died down nicely and then renewed its attack rate in February/March 1958. Second, if we look at the illness rate on college campuses after Thanksgiving break, when students returned from home, we saw a bump in the number of cases and Christmas break is rapidly approaching. Third, only 15% of American have gotten the illness and have immunity. Even if you add in the immunity that some older American have, and the folks getting vaccinated, we still have a large number of people who are susceptible in this country (probably more than half our population). Taken together, it seems like it is likely that we will have another wave. So although I don't have a crystal ball, I continue to advise clients to keep their eye on this problem and keep their pandemic planning efforts up to date. This is what I told the legislators as well. I also reminded them that influenza viruses are notorious for mutating. This virus has remained stable so far but that is another unknown in the equation and another reason to keep your planning efforts on track at some level. Lastly, if you think this is a mild flu, just look at the pediatric death rate. We have almost 1100 kids that have died already from H1N1 (2009) complications. That is many times the normal number of children that died of flu. So although most people recover uneventfully, this is taking a hard toll on our children. ADVICE: Get vaccinated. It is a safe vaccine and now that there is enough, it should be not problem to get you and your family and co-workers vaccinated. Speak to your doctor or visit a local health clinic. Do it now. Take this opportunity to compile lessons learned over the past 8 months. Look at what worked and what didn't work and revise your plans. This breather we are having is a gift you should take advantage of. If I am correct and we have a third wave, if you have updated your plans, you will be ready. TOOLS: Pandemic QuickStart - If you need to quickly bring your company up to speed with its pandemic planing efforts, we can help with our quickstart resources. Virtual Medical Director - If you don't have a corporate medical director, our Virtual Medical Director program may be a good solution for you. Our Virtual Medical Director service provides you with 24 hour access to physicians and experts trained in emergency medicine, disaster medicine, business continuity, occupational health and mental health crisis management to give you situation updates, analysis and advice. We have affordable decision support plans that you can enroll in. Pandemic Planning Assistance - We have a policy matrix, policy toolkits, FAQ's, posters, employee educational materials, a trigger based action plan template . We can help you jumpstart your planning or take a look at your current plans with a fresh set of eyes. Not preparing now would be a serious mistake. If you have any questions or concerns that we can help you with, please feel free to reach out to me. My email is: sweiss@MedPrepGroup.com MedPrep Consulting Group is internationally recognized as a leader in pandemic, disaster and business continuity planning, training and exercising. We have resources and expertise that you can count on. Ask us about our Virtual Medical Director Program. Dr. Stuart Weiss is the CEO of MedPrep Consulting Group. For more information, visit www.MedPrepGroup.com Stuart Weiss, MD, CBCP MedPrep Consulting Group LLC

Influenza Update - December 8

Pandemic H1N1 Update Dr. Stuart B. Weiss INFLUENZA UPDATE Dec 8, 2009 SUBSCRIBE: Click button at bottom or send email to: sbw1@MedPrepGroup.com Will pandemic H1N1 continue its downward trend or will it follow the pattern of 1957. Only time will tell. As influenza activity continues to wane and vaccine stockpiles continue to increase, now is the time to encourage people to protect themselves by getting vaccinated. Current Situation: The CDC confirmed that the number of states reporting widespread influenza activity has decreased again, from 32 states down to 25. The number of people visiting physicians in the US for influenza-like illness has decreased for the fifth straight week although the overall number is still high for this time of year. The number of deaths due to flu is still above the epidemic threshold for the United States. 99% of all sub-typed virus in the U.S. is still pandemic H1N1. The number of new influenza cases on college campuses dropped again this week. The WHO reports that while there is slowing of influenza activity in several parts of the world, activity continues across the northern hemisphere: Western and Northern Europe: Activity has peaked or is peaking. Numbers of new cases has plateaued in many parts. Central Europe (from Baltic to Balkan countries, from Germany to Romania): Influenza activity continues to increase Eastern Europe: Activity seems to be peaking and leveling off in most of eastern Europe. In the Russian Federation, activity remains high with an increasing trend. East Asia: Increasing influenza-like illness in Japan and southern China. Decreasing activity in northern China. South and Southeast Asia: India, Nepal and Sri Lanka continue to show increasing flu intensity. Africa: Influenza activity continues across the continent with co-circulation of seasonal H3N2 and pandemic H1N1 Southern Hemisphere: Countries in temperate zones continue to show little to no activity, most countries in tropical zones have decreasing activity. Vaccine Update: The CDC reported that 73 millions doses of vaccine has been released with 10 million more expected this week. Some states are reporting a surplus of vaccine and are relaxing their vaccine criteria to include all citizens. Liquid Tamiflu shortage is easing as Roche reported that more Tamiflu suspension is being shipped. CDC reported 17 additional pediatric deaths this week due to flu related complications. Vietnam reported another H5N1 (Bird flu) case in a 33 year old male who eat duck blood pudding. From Pro-Med: "raw blood soup (tiet canh in Vietnamese) is a dish made with raw blood of ducks or geese (sometimes pigs), with peanuts and herbs on top. This is the typical protein-rich breakfast of the country people in Northern Vietnam, but is dangerous because of the H5N1 bird flu virus. It is made by taking fresh blood and sticking it in the refrigerator to gently congeal. Raw blood soup is a Vietnamese dish that makes very little effort to appeal to the taste buds of the non-Vietnamese diner. Usually you will find a few chopped peanuts scattered on top of your blood dish but that's as far as it goes for fanciness. Blood soup has the oddest texture and tastes strangely metallic." For the curious (& unsqueamish) an image of plates of duck soup is available at www.loupiote.com/photos/87750125.shtml . HOUSEKEEPING ITEM: If you get this Alert through a mailing list and not directly from us, subscribe by clicking the button at the bottom or send an email to me at sbw1@MedPrepGroup.com ANALYSIS: The number of flu cases continues to trend downward in the U.S. and Canada as well as western and northern Europe. The question is whether this will continue through the remainder of the flu season or will we see a pattern similar to the 1957 pandemic where there was a surge at the beginning of the school year followed by a waning period which ended with a new surge in December. Or will we see seasonal flu begin to circulate as is occurring in parts of Africa. Its too early to know but it is important to keep your eye on this evolving situation. The report of the first new case of H5N1 in Vietnam in the past 6 months reminds us that H5N1 is entrenched in the bird population in southeast Asia and although much of our attention has been on pandemic H1N1, you should not forget to keep some attention of that virus as well. ADVICE: If you live or work in a state that has relaxed its immunization criteria, encourage employees to be vaccinated. Pandemic H1N1 is still causing serious illness across the U.S. and Canada and the vaccine is proving to be extremely safe. Take this opportunity to review your work from home program. There have been several reports released recently about the common pitfalls associated with work from home programs especially as it relates to the "last mile". Review potential problems with your IT staff. Also take a look at which outside critical vendors/contractors need access to your network and make sure that they will be able to get in. TOOLS: Pandemic QuickStart - If you need to quickly bring your company up to speed with its pandemic planing efforts, we can help with our quickstart resources. Virtual Medical Director - If you don't have a corporate medical director, our Virtual Medical Director program may be a good solution for you. Our Virtual Medical Director service provides you with 24 hour access to physicians and experts trained in emergency medicine, disaster medicine, business continuity, occupational health and mental health crisis management to give you situation updates, analysis and advice. We have affordable decision support plans that you can enroll in. Pandemic Planning Assistance - We have a policy matrix, policy toolkits, FAQ's, posters, employee educational materials, a trigger based action plan template . We can help you jumpstart your planning or take a look at your current plans with a fresh set of eyes. Not preparing now would be a serious mistake. If you have any questions or concerns that we can help you with, please feel free to reach out to me. My email is: sweiss@MedPrepGroup.com MedPrep Consulting Group is internationally recognized as a leader in pandemic, disaster and business continuity planning, training and exercising. We have resources and expertise that you can count on. Ask us about our Virtual Medical Director Program. Dr. Stuart Weiss is the CEO of MedPrep Consulting Group. For more information, visit www.MedPrepGroup.com Stuart Weiss, MD, CBCP MedPrep Consulting Group LLC

Influenza Update - November 30

Pandemic H1N1 Update  Dr. Stuart B. Weiss   INFLUENZA UPDATE Nov 30, 2009   SUBSCRIBE: Click button at bottom or send email to: sbw1@MedPrepGroup.com We've had a relatively quiet holiday week as pandemic flu activity continues to decrease across the U.S. but the kids keep taking a heavy hit. While we sit back and relax a bit in the U.S., other countries are not so fortunate. This could be a nice break for us before seasonal flu arrives.  Current Situation: The CDC confirmed that the number of states reporting widespread influenza activity has decreased again, from 43 states down to 32. The number of people visiting physicians in the US for influenza-like illness has decreased for the fourth straight week although the overall number is still very high. 99% of all sub-typed virus is still pandemic H1N1. The number of new influenza cases on college campuses dropped again this week. The number of new cases was down 37% from last week. The WHO reports that while there is slowing of new cases in North America, activity continues in other areas of the world: Europe: The pandemic death toll in Europe has nearly doubled every two weeks over the past 6 weeks. Three countries report very high flu intensity: Italy, Norway and Sweden. Nine countries report high flu intensity: Bulgaria, Denmark, Germany, Iceland, Ireland, Lithuania, Luxembourg, Poland and Portugal. East Asia: Japan's number of new cases is stable with a slight decrease in activity in urban areas. Mongolia continues to show intense flu activity although the number of new cases seems to have peaked. India, Nepal and Sri Lanka continue to show increasing flu intensity. Southern Hemisphere: Countries in temperate zones continue to show little to no activity, most countries in tropical zones have decreasing activity (except Ecuador and Venezuela). Vaccine Update: Novartis unveiled its cell-based vaccine production facility last week. It is the first such facility in the U.S. and will be running by 2011 with full production capability in 2013. It is located in Holly Springs, N.C.  CDC reported 27 additional pediatric deaths this week due to flu related complications.  The CDC confirmed that a West Virginia physician was sick with pandemic H1N1 twice, once in April and once in October. The CDC estimates that the current case fatality rate for the pandemic H1N1 virus is 0.018% which is about 100 times less lethal than the 1918 pandemic flu virus China reported two confirmed cases of pandemic H1N1 in dogs adding that species to the list of susceptible species which includes Birds, Cats, Ferrets, Pigs and Humans.  Egypt reported another H5N1 (Bird flu) case in a 3 year old male.   HOUSEKEEPING ITEM:  If you get this Alert through a mailing list and not directly from us, subscribe by clicking the button at the bottom or send an email to me at sbw1@MedPrepGroup.com       ANALYSIS:    Clearly we have decreasing pandemic activity in the U.S. although the increasing number of pediatric deaths is quite concerning. I still strongly recommend that eligible children receive the extremely safe pandemic flu vaccine.   For those of you that have outsourced business processes to India, I want to spend a moment discussing that. Many of our clients have partnered with Indian firms or have offices in Chennai, Bangalore, Hyderabad, Mumbai, etc. to perform important business functions. Based on the rising flu intensity in that region (India, Nepal, Sri Lanka) and the weak public health system throughout India, we would strongly suggest that you develop business continuity plans around losing some or all of those assets for a period of time. You must answer the question of how you will maintain those outsourced business processes should there be a prolonged and widespread disease outbreak.   Lastly, there was an interesting article published in Virology that speaks to the origin of the pandemic virus. The virologist who wrote the article analyzed the virus and claims that there is a suggestion that this wasn't a naturally occurring virus but was instead created in a lab. This same virologist made this assertion earlier but it was dismissed and he has made it again. This will be interesting to follow.     ADVICE: If you have overseas offices or use overseas companies for important business processes, it is important to develop contingency plans for how you will take over critical outsourced functions if overseas offices are closed due to flu. We are seeing a decrease of flu cases in the U.S. but that is not true in other countries. This is especially important in India. We have experience in this area if you need assistance. Take this opportunity to remind employees about proper hand hygiene. If you put up posters last April about hand hygiene, change them or move them. People do not pay attention to something that has been hanging on a wall for months. Lastly, don't take your eye completely off H5N1 as Egypt reported yet another case this week.   TOOLS: Pandemic QuickStart - If you need to quickly bring your company up to speed with its pandemic planing efforts, we can help with our quickstart resources.   Virtual Medical Director - If you don't have a corporate medical director, our Virtual Medical Director program may be a good solution for you. Our Virtual Medical Director service provides you with 24 hour access to physicians and experts trained in emergency medicine, disaster medicine, business continuity, occupational health and mental health crisis management to give you situation updates, analysis and advice. We have affordable decision support plans that you can enroll in.   Pandemic Planning Assistance - We have a policy matrix, policy toolkits, FAQ's, posters, employee educational materials, a trigger based action plan template . We can help you jumpstart your planning or take a look at your current plans with a fresh set of eyes.         Not preparing now would be a serious mistake.       If you have any questions or concerns that we can help you with, please feel free to reach out to me. My email is: sweiss@MedPrepGroup.com       MedPrep Consulting Group is internationally recognized as a leader in pandemic, disaster and business continuity planning, training and exercising. We have resources and expertise that you can count on. Ask us about our Virtual Medical Director Program.   Dr. Stuart Weiss is the CEO of MedPrep Consulting Group. For more information, visit www.MedPrepGroup.com   Stuart Weiss, MD, CBCP MedPrep Consulting Group LLC

Influenza Update - November 22

Novel Influenza H1N1 Update Dr. Stuart B. Weiss INFLUENZA UPDATE Nov 22, 2009 SUBSCRIBE: Click button at bottom or send email to: sweiss@MedPrepGroup.com Okay, it seems official. The U.S. novel H1N1 has peaked for the moment but all the news is still not rosey. While the situations seems to be improving in the U.S., the number of influenza cases is still way up and in other parts of the world, there is no sign of a peak yet. Current Situation: The CDC reports that 43 states now report widespread flu activity, this is down from 46 states last week. The number of people visiting physicians in the US for influenza-like illness has decreased for the third straight week although the overall number is still very high. The WHO reports that while there is some slowing of new cases in the U.S., Canada continue to show intensifying disease. In other areas of the world: Europe: Transmission is widespread and increasing across Europe especially in north, east and southeast Europe with some dramatic recent spikes in eastern Europe. A peak seems to have occurred in some western Europe countries especially Iceland, Ireland, UK and Belgium. Central/Western Asia: Increased disease in Kazakhstan, Uzbekistan and parts of Afghanistan. this is affecting troops and Afghan security forces. East Asia: Japan's numbers of new cases is slightly decreased. Some experts suspect large numbers of cases in China. There is also seasonal H1N1 and H3N2 circulating in China Southern Hemisphere: Temperate zones showing little to no activity, tropical zones have variable activity Vaccine Update: Supply shortages of H1N1 vaccine continue as 11 million doses of vaccine were released last week. This brings the total to 54.1 million doses. CDC reported 21 additional pediatric deaths this week due to flu related complications. 2/3 of the children had underlying medical problems such as asthma, cerebral palsy or muscular dystrophy. There were two clusters of patients in hospitals with Tamiflu resistant novel H1N1 viral infections. One cluster was in the UK and another was in the U.S.. At a news conference late last week, the CDC mentioned a mutation in the novel H1N1 virus was found in Norway. This mutation may make the virus live easier deep in lung tissue. Researchers at the USDA found that the novel H1N1 virus has changed enough that it doesn't infect birds well or spread between them easily. Egypt reported another H5N1 (Bird flu) case in a 21 year old male who was involved with slaughtering chickens. HOUSEKEEPING ITEM: If you get this Alert through a mailing list and not directly from us, subscribe by clicking the button at the bottom or send an email to me at sweiss@MedPrepGroup.com ANALYSIS: Its now been three weeks in a row that the number of cases of people visiting their physicians for influenza like illness has decreased and in fact, several television network news stories last week interviewed hospital folks who reported less emergency department and clinic visits. It does indeed appear that we have peaked and are on the downswing of this wave. I say wave because there are some reports of a second wave starting in some countries already. As indicated by the virus mutation, the clusters of resistance and the virus's adaptation to humans, this is far from over. In fact, in many parts of the world, the numbers are still markedly increasing. This decrease in the U.S. gives us a chance to take a deep breath but I can't stress strongly enough that planning efforts should continue. It is not time to let down your guard as there is no evidence to support that position this early in the flu season. The highest travel time of the year is approaching and people from different parts of our country and the world will be coming together. We will have to watch to see if this changes the viral patterns. I have done several webinars and talks this past week in different parts of the country and had many questions about the novel H1N1 vaccine. My advice remains the same. It is an extremely safe vaccine and I recommend it to everyone who is eligible. Use this lull in public attention to have eligible people vaccinated. Go on the Goggle flu site and find where vaccine is available. ADVICE: In the U.S. this past week, there were congressional hearings on making sick time mandatory as a way to fight H1N1. Don't wait for congress to act, review your H.R. plans and make some decisions on how you will handle employees who are out sick with the flu or those that stay home with sick family members. Review the American With Disabilities act and decide what screening questions you can ask. It may be challenging to keep interest in this topic as your C-suite executives have seen the news stories about flu having peaked. Remind them that even though we have peaked, this is one of three expected waves and we still have markedly increase flu cases across the U.S. even thought the numbers of new cases seem to have peaked three weeks ago. Lastly, don't take your eye completely off H5N1 as Egypt reported yet another case this week. TOOLS: Pandemic QuickStart - If you need to quickly bring your company up to speed with its pandemic planing efforts, we can help with our quickstart resources. Virtual Medical Director - If you don't have a corporate medical director, our Virtual Medical Director program may be a good solution for you. Our Virtual Medical Director service provides you with 24 hour access to physicians and experts trained in emergency medicine, disaster medicine, business continuity, occupational health and mental health crisis management to give you situation updates, analysis and advice. We have affordable decision support plans that you can enroll in. Pandemic Planning Assistance - We have a policy matrix, policy toolkits, FAQ's, posters, employee educational materials, a trigger based action plan template . We can help you jumpstart your planning or take a look at your current plans with a fresh set of eyes. Not preparing now would be a serious mistake. If you have any questions or concerns that we can help you with, please feel free to reach out to me. My email is: sweiss@MedPrepGroup.com MedPrep Consulting Group is internationally recognized as a leader in pandemic, disaster and business continuity planning, training and exercising. We have resources and expertise that you can count on. Ask us about our Virtual Medical Director Program. Dr. Stuart Weiss is the CEO of MedPrep Consulting Group. For more information, visit www.MedPrepGroup.com Stuart Weiss, MD, CBCP MedPrep Consulting Group LLC

Influenza Update - November 15

Novel Influenza H1N1 Update  Dr. Stuart B. Weiss   INFLUENZA UPDATE Nov 15, 2009   SUBSCRIBE: Click button at bottom or send email to: sweiss@MedPrepGroup.com Perhaps there is a small light at the end of the tunnel Its way too early to say for sure but there are some early signs that flu activity may have peaked in the US and is slightly declining.   Current Situation: The CDC reports that 46 states now report widespread flu activity, this is down from 48 states last week. The number of people visiting physicians in the US for influenza-like illness has decreased for the second straight week although the overall number is still very high. The WHO reports that while there is some slowing of new cases in the US, Canada has reported sharp increases over the past three weeks and there is increasing activity in several European countries as well as some regions in eastern Asia. The huge outbreak in the Ukraine continues to be a big problem for that country. They are estimating that there have been over 1 million cases there (the country only has 48 million people). There have been sharp increases in flu activity in some Middle Eastern counties including Israel and Afghanistan as well as increases in eastern Asia including China and Japan. See the WHO update at: http://www.who.int/csr/don/2009_11_13/en/index.html for more details. Vaccine Update: Supply of H1N1 vaccine continues to be a problem in the US. As we wrote about earlier, there are significant delays in shipment of vaccine from manufacturers. Several manufacturers this week stated that they will be shipping much more vaccine shortly and will meet their US government commitments. Although the US Government had originally predicted that we would have 60-80 million doses by this point, only 41.6 million have been shipped. Around the world, millions of people have received the vaccine and it continues to be a very safe vaccine. CDC changed the way it tracks and counts pandemic H1N1 cases increasing the numbers included in the case counts. The new, more inclusive counts are: There have probably been around 22 million cases of pandemic H1N1 illness in the US Approximately 98,000 people have been hospitalized for flu related illnesses There have been 3900 deaths with 540 pediatric deaths The breakdowns are as follows: Cases: 0-17 = 8 million cases, 18-64 = 12 million, 65+ = 2 million Hospitalizations: 0-17 = 36,000, 18-64 = 53,000, 65+ = 9000 Deaths: 0-17 = 540, 18-64 = 2920, 65+ = 440 The new CDC counts do not indicate any change in the disease, just a more accurate counting of the cases.     HOUSEKEEPING ITEM:  If you get this Alert through a mailing list and not directly from us, subscribe by clicking the button at the bottom or send an email to me at sweiss@MedPrepGroup.com       ANALYSIS:    Although it is way to early to make any predictions, the fact that visits to physicians for influenza-like illness has dropped for the second week in a row and the number of states with widespread flu illness has dropped by two may be pointing to the US having peaked a few weeks ago with this wave of the influenza pandemic. Remember that cases are still markedly rising in some parts of the world and we may still see significant supply chain interruptions around the world. But before you start thinking that the worst has passed us, it is important to understand that it is way too early to decide that. We will need to continue to watch this disease carefully as it unfolds in the coming weeks to know if we have peaked in the US.   As you continue your pandemic planning efforts, you should take a look at a good document that the University of Minnesota's Center for Infectious Disease Research and Policy (CIDRAP) put out last week. Based in large part on the September summit, CIDRAP, in collaboration with the Society for Human Resource Management (SHRM) released a new toolkit: Doing Business During an Influenza Pandemic: Human Resource Policies, Protocols, Templates, Tools, & Tips. It is definitely worth a read. The toolkit is available free of charge as a PDF document: http://www.cidrapsource.com/hrtoolkit   ADVICE (we continue to recommend the following): Keep yourself informed on what is going on. We will help you do that through our Business Alerts but you may want to also subscribe to ProMed and look at the CIDRAP site frequently. This virus is spreading and adapting and you need to anticipate problems. If you have finished writing plans and policies, think about validating those plans or policies with an external audit or small drills and exercises.   Watch out for pandemic fatigue. With all the information flowing out there and the blogs and webinars and seminars and notices its easy to get overloaded and tired. Pick a few trusted sources and stick with them.   TOOLS: Pandemic QuickStart - If you need to quickly bring your company up to speed with its pandemic planing efforts, we can help with our quickstart resources.   Virtual Medical Director - If you don't have a corporate medical director, our Virtual Medical Director program may be a good solution for you. Our Virtual Medical Director service provides you with 24 hour access to physicians and experts trained in emergency medicine, disaster medicine, business continuity, occupational health and mental health crisis management to give you situation updates, analysis and advice. We have affordable decision support plans that you can enroll in.   Pandemic Planning Assistance - We have a policy matrix, policy toolkits, FAQ's, posters, employee educational materials, a trigger based action plan template . We can help you jumpstart your planning or take a look at your current plans with a fresh set of eyes.         Not preparing now would be a serious mistake.       If you have any questions or concerns that we can help you with, please feel free to reach out to me. My email is: sweiss@MedPrepGroup.com       MedPrep Consulting Group is internationally recognized as a leader in pandemic, disaster and business continuity planning, training and exercising. We have resources and expertise that you can count on. Ask us about our Virtual Medical Director Program.   Dr. Stuart Weiss is the CEO of MedPrep Consulting Group. For more information, visit www.MedPrepGroup.com   Stuart Weiss, MD, CBCP MedPrep Consulting Group LLC