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US HHS H1N1 Flu Information
WHO Influenza Update
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Monday, July 13, 2009

Influenza Update H1N1-(swine)

MedPrep Consulting Group LLC
Dr. Stuart B. Weiss 
 INFLUENZA UPDATE
WHO PANDEMIC ALERT LEVEL 6
July 13, 2009
 
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What are we learning from the Southern Hemisphere?
As the H1N1 (swine) flu season continues in the Southern Hemisphere, case numbers continue to rise and it appears that the H1N1 (swine) flu is the dominant circulating virus.
 
 Current Situation:
  • Cases continue to rise in the Southern Hemisphere. There are currently 94,512 confirmed cases in the world although many countries have stopped active testing.
  • In many countries the new H1N1 virus is causing between 90% and 98% of flu cases and is becoming the dominant virus at this time.
  • Vaccine development continues. CSL, the only flu-vaccine maker in the Southern Hemisphere announced that it will start human studies on a 2 dose vaccination regimen on July 22nd. The doses will be given 3 weeks apart.
  • Millions of Argentines are staying home from work due to flu illness and concerns. School winter vacation has already been doubled. The government is urging people to avoid crowds. Pregnant and other vulnerable government workers have been sent home for 15 days
  • Bolivia has extended the school winter break, Peru has started the winter school break a week early.
  • Three cases of Tamiflu resistant virus have been reported. Two patients were on Tamiflu when the resistance developed, the third patient was not.
  • 6 Companies are working on an H1N1 vaccine including Sanofi-Aventis, Novartis AG, Baxter International Inc, GlaxoSmithKline, Solvay and nasal spray maker MedImmune, now part of AstraZeneca. Clinical trials in the U.S. will start soon.
HOUSEKEEPING ITEM: 
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ANALYSIS:
  
There are several developments that are interesting to watch in the Southern Hemisphere. First is the fact that the new H1N1 (swine) flu virus is becoming the dominant circulating strain, pushing aside regular seasonal flu. We will need to watch closely to see if this pattern continues through their winter. The problem for the Southern Hemisphere countries is that the seasonal flu vaccine that they currently have is not effective against the new H1N1 (swine) virus, the strain that is causing most of the illness. 
 
The second development is a bit more predictable. Worker absenteeism has increased due to fear and illness and because schools are being closed. Many winter school vacations have been extended. We should anticipate that same response in the Northern Hemisphere next winter.
 
In the United States, Federal officials are considering a mass flu vaccination program involving 600 millions doses of vaccine, 2 shots for each citizen. That is a massive undertaking with many logistical nightmares. The Federal government is ramping up for a bad flu season this year.
 
The fact that the new H1N1 (swine) flu virus is still spreading in the warmer Northern Hemisphere and the rapid spread through the Southern Hemisphere should lead you to seriously plan for a bad flu season. Hopefully, an effective, safe vaccine for the new H1N1 (swine) flu virus will be available before the flu season returns in the Northern Hemisphere.
 
Lastly, the development of Tamiflu resistant strains was in the news last week. Two of the cases were in patients receiving the medication. The development of Tamiflu resistance is not unexpected in patients on the medication. The third was in a 16 year old girl who traveled from San Francisco to Hong Kong who had not been on Tamiflu. This was more concerning as it could have represented the emergence of a resistant strain however, multiple viral samples have been tested and no other resistant strains have been identified leading experts to believe that these were sporadic isolated events. This will need to be watched as the flu season continues.
 
 
In a previous update, I wrote about a new modeling software project that we are involved with that will allow you to assess your company's current state of readiness as well as help determine your trigger level. This will take the place of tying your plans to the WHO Pandemic Phases. Our team just returned from a meeting with our collaborating team at Georgia Institute of Technology (Georgia Tech) and we are very excited about this work. The new formula and modeling platform will assist you in your planning and implementation phases. I will write more about this as we get closer to release. 
 
 
 
ADVICE:
  • Ensure that someone follows the developments of H1N1 (swine) over the next few months. This is still an evolving outbreak. No one knows how the new H1N1 (swine) virus and the other circulating flu viruses will react. It looks like the new H1N1 (swine) is the dominant virus but that could change.
  • Communicate with your Southern Hemisphere offices. If you have offices or employees in the Southern Hemisphere it is very important to communicate with them. They are going through the worry and stress over H1N1 (swine) that we went through in May. Share with them strategies to prevent the spread of illness (hand hygiene, cough/sneeze etiquette, social distancing, etc.). Let them know that you are concerned about their wellbeing and are following the situation.
  • Continue your planning efforts. Over the next few months in the Northern Hemisphere, you should be planning for continuity of operations during a significant employee shortage and with interruptions in supply chain. Anticipate that the Northern Hemisphere will have a bad flu season with many business interruptions. Anticipate that we may not have vaccine available for the new H1N1 (swine) flu virus at the beginning of the flu season. Take time to look at HR policies on sick time and return to work. Look at how you will handle employees that come to work sick or are exposed to sick workers. There is some CDC guidance on this or you can contact us for assistance. Take time to figure out how you will implement social distancing and hand hygiene. Think about your cleaning needs.  
  • Develop a trusted source for important medical information and analysis. If you have a corporate medical director, include them in the planning process. If you do not have this resource in-house, find someone now that you can call on. We can serve as your Virtual Medical Director if you wish. See below for information.
 
Virtual Medical Director
If you don't have a corporate medical director, we'll be your medical director. 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. Contact us for further information.
 

 
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
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