State preps to relocate quarantined H1N1 victims-"Your home is not acceptable"(Maybe a nice camp?)

"The Iowa Department of Public Health has determined that you have had contact with a person with Novel Influenza A H1N1," the form reads. "The Department has determined that it is necessary to quarantine your movement to a specific facility to prevent further spread of this disease.

"The Department has determined that quarantine in your home and other less restrictive alternatives are not acceptable," the document continues, before listing mandatory provisions of compliance with relocation to a quarantine facility.

I’ll try. Honestly, there is nothing to this. I’m chairman of a country board of health and have worked on the quarantine policy. Actually, the counties, not the state, have the authority to quarantine. We developed the policy sometime ago as part of our flu pandemic planning. We are not quarantining for H1N1 in our county, or in any county that I know of. I believe the form in question is a tool that the state has that can be used if you can’t quarantine someone in his/her home. The most likely reason for this would be a homeless person. We certainly don’t want to ever have to quarantine anyone. Most people would cooperate if necessary and would simply stay in his/her home. However, we have to make sure any quarantined person has food, water, basic care, etc. so it would be quite an undertaking. We do have the ability to use law enforcement if necessary. This would be in the case of someone having a contagious disease that it dangerous who is not willing to cooperate.

I guess you haven't been out here in the boonies where having a cell phone may give you a warm fuzzy feeling, but you aren't going to get any service.

There are plenty of dead zones in the midwest that I know of personally, and I'd wager most anywhere else past the end of the sidewalk it is much the same.

Any involuntary mass relocation and concentration of people in a "facility" or "facillities", well, give it any name you want. Let them take their phones, their valuables if that makes them feel more secure.

I am not running in circles screaming hysterically, but I am damned suspicious of this administration and their motives/actions, and am not beyond suspecting that measures were put in place either carelessly by former administrations, nor that both parties have been working toward a common goal.

The greatest destruction of rights in the last century was performed for 'our own good', and that continues apace.

Here is a link to a DHS Word document titled, Uncertainty Analysis of Pandemic Influenza Impacts on National Infrastructure Supplement to the National Population and Infrastructure Impacts of Pandemic Influenza Report from October 15, 2007.

From the "Major Steps" section of the chapter on Home Isolation and Quarantine (emphasis is mine)

On page C-18 (128th in the Word doc)

Develop adequate statutory authority and administrative procedures for all movement restrictions and monitoring measures for confirmed and suspected pandemic influenza cases and their contacts
Implement protocols for imposing, maintaining (including enforcing when applicable), monitoring, and terminating home isolation or quarantine
Set up monitoring/contact systems to ascertain and record compliance and health status of quarantined persons
Address where those who refuse to submit to home isolation/quarantine shall be held and who will care for them
From "Required Resources" section
On page C-19
• State and local law enforcement agencies, with assistance from their state’s National Guard as needed, may be needed to enforce quarantines. Based on the Severe Acute Respiratory Syndrome (SARS) experience, which showed that most people will comply, it is anticipated that a majority of individuals will comply with quarantine or isolation orders.
From the "Problems and Issues" section
On page C-20
Requirements for success of this intervention include the prompt and accurate identification of an ill person in the household for isolation, identification of their contacts for quarantine, voluntary compliance with isolation and quarantine by household members, commitment of employers to support the recommendation that employees living in a household with an ill individual stay home, the ability to provide needed support to households that are under isolation or voluntary quarantine (such as food, supplies, and medications), guidance for infection control in the home, and actions to enforce involuntary isolation and quarantine when needed (such as guards, bracelets, and facilities).

A wonderful doctor in L.A.’s extremely intelligent take on H1N1:

Greetings!
I have seen more children and adults with influenza-like illness: 104 degree fevers, muscle soreness, sore throat and negative tests for strep, than in any summer I can remember. I haven’t used the “flu swab” to test anybody, but I’m sure that many if not most of these sick people had Swine Flu. They all felt miserable, and they are all feeling just fine now.

Preventing outbreaks of this “novel H1N1” influenza may be a mistake of huge proportions. Yes, sadly, there will be fatalities among the 6 billion citizens of the planet. Tens of millions of cases of any illness will lead to morbidity and mortality, but this is completely (tragically) unavoidable. The consequences of not acquiring immunity this time around, however, could be really terrible and far outweigh a mass prevention program.

Here’s my rationale for not using Tamiflu: If (if, if, if) this virus circles the globe as the rather innocent influenza it now appears to be, but mutates and returns as a very virulent form of influenza, it will be quite wonderful and life-saving to have formed antibodies against its 2009 version. These antibodies may be far from 100% protective, but they will help. This is incredibly important but being ignored in the interest of expediency.

In 1918, it appears that influenza A (an H1N1, by the way) did this globe-trotting mutation and killed millions. The times and state of medical care are not comparable, but a milder parallel occurrence is possible. Perhaps this happens every 100 years or so, perhaps every three million.

Whenever possible, we should form antibodies against viruses at the right stage of their existence and at the right stage of our lives (For example, chickenpox in childhood and EBV/mono in early childhood. There are many other examples.) Getting many viral illnesses confers lifetime immunity, and very few vaccines do.

Tamiflu is a very powerful drug with little proven efficacy against this bug, and with its major side effect being tummy upset. I’m not using it at all. Psychiatric side effects are also possible.

I also won’t be giving the flu shot to the kids and parents in my practice unless there are extraordinary risk factors. I anticipate giving none at all this year. I doubt that there will be any really large problems with the vaccine, but I also doubt any really large benefits. As I said, I think that this year’s version of this particular H1N1 is as “mild” as it will ever be and that getting sick with it this year will be good rather than bad. The chances that a new “flu shot” will be overwhelmingly effective are small.

I consider this, and most seasonal and novel influenza A vaccines, as “experimental” vaccines; they’ve only been tested on thousands of people for a period of weeks and then they’ll be given to hundreds of millions of people. Not really the greatest science when we’re in that much of a hurry. Yes, one can measure antibodies against a certain bacterium or virus in the blood and it may be associated with someone not getting sick, but there are very few illnesses common enough or enough ethics committees willing enough to do the right tests. That is, give 1000 people the real vaccine and 1000 placebo shots, expose all of them to the disease and see who gets sick. Seriously. I know it sounds terrible.

This is, obviously, a difficult public discussion because it touches on the concept of benefits and risks, again, of morbidity and mortality. Few public officials have the courage or inclination to present all facets of this difficult decision. I give vaccines to my patients every single day, but I always err on the side of caution. Implying that this is a dangerous new shot is not scientifically or statistically correct and represents hyperbole and even dishonesty on the part of the so-called “anti-vaccine” camp.

It sure isn’t “sexy” to suggest handwashing, good nutrition, hydration, extra sleep and so on. It’s not conventional to suggest astragalus, echinacea, elderberry and vitamin C. Adequate vitamin D levels are crucial, too.

I just think that giving this new H1N1 vaccine is not the cautious nor best thing to do.
Best,

Jay Gordon, MD FAAP

http://www.drjaygordon.com

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