Conversation with Kansas City Nurse Administrator Regarding Flu Preparations

Disclosure: I am an educational administrator in a school district located in the Kansas City metropolitan region.

I just completed a very interesting informal conversation with a Kansas City, MO hospital nursing administrator regarding preperations for H1N1 and seasonal influenza.

Some highlights of our conversation:
- The influena cessation period normally runs in a 12-week cycle, but currently has been consistently showing new reports in children of H1N1 strain

- Information of influenza strains are reported to CDC and state officials

- In event of "pandemic," all information is to be reported directly to military

- Military personnel would operate hospitals; hospital personnel would work directly under the supervision/authority of military officials

- Response plans have been created to shutdown clinics and outpatient centers, to reassign medical personnel to hospital to tend to influenza patients

- CDC has made presentations to hospital personnel about the lack of equipment (ventilators etc.) They have been trained/prepared to make decisions
regarding "life or death." Hospital personnel will need to make decisions about which patients receive priority for care; many will be too extreme for proper care

- Admitted the H1N1 flu vaccine needs much study and she would not authorize her own children to be a part of the experimental program

- Initial stockpiles of H1N1 vaccine will not be available until mid-October at earliest, if then, and IS FAR TOO LATE by that point

[edit on 5-8-2009 by MOFreemason]

MOFreemason, thank you for sharing your story with us all!...please keep us posted if you are able to find out anything more. I, for one, think what you have just shared is extemely important....

Now this is interesting, which leads me to a few questions. They aren't directed at you just general concerns.

1) Where are they going to get enough military personnel to conduct this operation?

2) Is this going to be a mandatory vaccination?

3) If people in the medical field are having doubts about this vaccine, then what the implications of it?

4) What will be the circumstances for the gov to call it a pandemic?

5) What will happen if the the trial test of the vaccine goes horribly wrong and people refuse to take it?

I'm sure there are more questions that I haven't even thought of. Thanks for the heads up there.

Originally posted by Hastobemoretolife
Now this is interesting, which leads me to a few questions. They aren't directed at you just general concerns.

1) Where are they going to get enough military personnel to conduct this operation?

2) Is this going to be a mandatory vaccination?

3) If people in the medical field are having doubts about this vaccine, then what the implications of it?

4) What will be the circumstances for the gov to call it a pandemic?

5) What will happen if the the trial test of the vaccine goes horribly wrong and people refuse to take it?

I'm sure there are more questions that I haven't even thought of. Thanks for the heads up there.

Good questions, just wish I could have an answer for you based on our conversation.

The only question I can remotely address is #2. From the sound of it, there would not be a mandatory vaccination since she basically stated by the time the stockpiles are distributed, it will be way way way late for so many to even be effective.

She also indicated the reason the CDC stopped "testing" for H1N1 is because by the time a person showed symptoms, went to the doctor, was tested, and lab results came back...they would have infected so many people by that point, it would serve little use. (Not her opinion, the CDC she was referencing from a training.)

Well, didn't WHO already say it was a pandemic? Or is this a pandemic called for the US?

I, too, feel the worst of this scenario lies in the vaccine, not the flu itself.

Here's some food for thought. My other half doesn't not read on forums such as this and dismisses alot of what I say. He does not watch news. We were discussing something the other night and somehow the swine flu got brought up and he said, "there is no 'swine flu', it is intentional biological warfare". So when he says things like this I pay a bit more attention but I told him the same thing I will say here. Catching the flu does not scare me, but the vaccination scares the crap outta me and you will NOT see me jumping in line to get one, nor will I be taking my daughter for one either.

This is scary. I wish more people in the medical field would speak out about this. I mean, surely they have to know, right??

Originally posted by opal13
Well, didn't WHO already say it was a pandemic? Or is this a pandemic called for the US?

I, too, feel the worst of this scenario lies in the vaccine, not the flu itself.

Here's some food for thought. My other half doesn't not read on forums such as this and dismisses alot of what I say. He does not watch news. We were discussing something the other night and somehow the swine flu got brought up and he said, "there is no 'swine flu', it is intentional biological warfare". So when he says things like this I pay a bit more attention but I told him the same thing I will say here. Catching the flu does not scare me, but the vaccination scares the crap outta me and you will NOT see me jumping in line to get one, nor will I be taking my daughter for one either.

This is scary. I wish more people in the medical field would speak out about this. I mean, surely they have to know, right??

Your sentiments similar to mine--this isn't a discussion based on "is it, or isn't it?!!?" My fears stem from potential governmental and/or military response.

In regard to your opening "is it already a pandemic?" question...you are correct, the WHO has already declared it a pandemic level 6. In order for the military to assume operations of select hospitals, they must deem it a "pandemic" based on the number of cases reported to the CDC by hospitals and states.

Interesting stuff. Its so hard to figure out whats being blown out of proportion and whats being swept under the carpet.

I am involved in higher education safety that has a residential population on the east coast.

Back in April and May there was a flurry of conference calls and such that I sat in on with local state health officials as well as CDC folks.

The one thing that struck me immediately is how they would switch back and forth between what they were seeing and then what the CDC was saying. If it was a question that was "good" news...they would go into some specifics. But if it was a hard question or something that led down a road of not necessarily good news, then it was referred to statements off of the CDC website. Literally, to certain questions they were just reading off the same website anyone could look at.

I finally gave up trying to gleen any kind of worthwhile info out of them when they finally admitted that the CDC was changing its definitions on a "nearly hourly basis." Meaning that they were changing "suspected" case definitions and such to keep from triggering a bigger response.

I know the proposed plans I was involved in 2 years ago, had certain chicken little provisions kicking in at the first confirmed human to human transmission case in the continental US, and by the time it was confirmed in region we were supposed to be doing the old duck and cover thing from the 50's.

So its really hard to tell whats hype and whats underplayed. And I hate to ask too many "ATS" type questions for fear of getting cut out of the loop.

But tomorrow is another meeting with some local officials, who interestingly initiated this meeting to discuss our response and working together to address the H1N1 flu planning.

Anything I get and can report without compromising myself or sources will be passed along.

I will say this though....the thought of people encouraging a pregnant woman to get a new and untested vaccine is strange and extremely suspicious in my opinion.

reply to post by XKrossX


Please do keep us posted. I'm very interested in the various response plans of agencies around the country.

I'm concerned and curious...I assume many ATS members are as well.

reply to post by XKrossX


Yes, me too.

My daughter is starting school in three weeks. Vaccinating her with this is not an option for me. Just good old fashioned hand washing, plenty of antibacterial and natural stuff to strengthen the immune system. Luckily she's not a kid to get sick easily.

I think back in April and May when alot of this was first coming out, they had no idea what was what, or how many or where. A big cluster.

Another thing that makes my spidey senses tingle is all of a sudden, they quit talking about it and now it's gonna be HUGE and pushing vaccinations.

Ok...my meeting is this afternoon, but I did get a synopsis of the HHS webcast from August 4th.

This was a public webcast off of the www.flu.gov website, so take it for whats its worth.

I am still going over it but I'll pull out a few things that you all are likely interested in.

• In terms of disease surveillance and tracking, CDC works closely with international partners and we’re learning a lot from Australia, Chile, and Argentina. We continue to monitor very closely what is happening in the US. Based on models, approximately 1 million cases today in the US.

• Decisions about school closures are best made at the local level. Hopefully schools won’t need to close, but it is a possibility. Schools need to think about how to keep kids learning even in the event of a closure. When the vaccine becomes available the hope is that schools will be a part of the solution and serve as vaccination sites.

• Department of Ed. will do its best to empower local jurisdictions to make appropriate decisions. Decisions on school closures won’t be made at the federal level. Information sharing across the country will aid decision making. Checking flu.gov is important.

Q: What can individuals do to be prepared?
A: Cover coughs and sneezes. Stay home if sick. Wash hands. Take care of planning at the family level-- Will I stay home to care for sick child? Can my workplace handle high absenteeism? Know where to get information locally in your community.

Q: If you get the seasonal flu vaccine, will you need a booster?
A: No. When the seasonal vaccine is available, get it. H1N1 will become available later in the season and it will likely require two doses.

• In terms of H1N1 vaccine, President/Congress agree that we need a public, voluntary vaccination campaign. Staffing will likely come from state/ local officials. Conversations are already in the works about establishing mass vaccination sites, rather than administering vaccinations solely in clinic/hospital settings.

• Preparations need to be ongoing even though flu may not be in the media as frequently as it was during the spring. HHS, DHS working with state/local partners to discuss issues from the spring.

Q: What is the best way to determine when/if a school closing is necessary?
Aept. of Ed will do its best to provide as much information as possible to inform decision making, but it will need to be decided on a case by case basis at the local level.

Q: Will there be a differentiation between guidance for seasonal flu vs. novel H1N1?
A: Seasonal and novel flu are both serious and will likely look the same in their symptoms. There is no real need to differentiate. The guidance will be the same—stay home if ill.

Q: During a vaccine campaign, are police officers included among people who should be first to get vaccinated?
A: They are in a top tier according to the current guidance. We are continuing to revaluate the guidance over the summer.


Q: When will the vaccine information statement be available?
A: It is already on the website (flu.gov) for the seasonal vaccine and is currently being drafted for H1N1. If we had seen H1N1 before April, we likely could have combined the strain, but we didn’t have it soon enough this year. In the future it could probably be combined in the seasonal vaccine.

Q: Will there be adequate seasonal flu vaccine?
A: Yes, we believe there will be adequate supply. We have low take-up rates, particularly among some of the most vulnerable populations. If in high-risk category, please get the vaccine and do it early.

Q: Can I receive both vaccinations at same time?
A: Yes, we are expecting that to be fine, but it’s being looked at in special study. It will be in different arms, but on the same day.

.....will post some more shortly....character limit...

Again...all of this was transcribed by someone else sitting in on the webcast but I dont know who. I wish I could give the proper credit.

Q: Will there be several types of vaccine (i.e. without adjuvant)?
A: It has been documented that there is not a reason for concern related to the thimerosal preservative in multi-dose vials. However, single-dose and nasal spray vaccines will be available without thimerosal.

Q: Will fire departments be involved in vaccination campaigns?
A: Maybe. It depends on the locale and locally driven decisions. In early July, state teams were asked to come to NIH to meet with HHS/CDC/Dept. Ed. They were asked to return to their states to conduct statewide conversations on these very issues. The best possible partnership is to make decision locally and then cooperate back up/down the line.

Q: What is considered a high fever?
A: Usually, think of 100.4, but also think through issues of whether you need to see a doctor or not. Call your doctor when needed, but not for everything. We need to protect doctors and the emergency room to be available for more severe illness. Look for worrisome signs – blue, irritable, lethargic, not eating. Look for what else might be going on. Is a person pregnant or have asthma or diabetes? Someone with those conditions may need to go to a hospital more quickly. We are working to set up triage systems and info will be available at the flu.gov link.

Q: What are the recommendations for colleges and universities?
A: Washing hands, covering your mouth. If a student is sick, stay home. Going in to the fall, we are working with the higher ed. community. We want to be thoughtful, practical.

• There are challenges in a dorm setting. Students go home to close company. We are hoping colleges are thinking about this. Are there sick rooms? Can a sick student be moved out? There is a need to think about where to allow kids to recover and not share illness with everyone else in the dorm.

Q: What resources are available to the state/local level?
A: $7.5 billion appropriation to cover the costs of preparing for H1N1 including a vaccination campaign. Dollars have been shared, but what we’re really looking at is a public campaign. People won’t be required to purchase the vaccine. It will be voluntary, but people won’t have to worry about insurance paying for it or getting to a site. There are discussions about having parents sign releases for children ahead of time, being ready when the vaccine is available.

• Wash hands. Get a flu shot. Make sure kids are up on their regular vaccinations.
• Now is the time for schools to be coordinating with local health departments. Even though there is a current lull in the media, we need to be planning now to be ready for fall.
• We know more now than we did in April and we continue to learn. We will keep flu.gov updated and will keep the public as informed as possible.


Like I said...its from the government, so some may wish to take it with a grain of salt, but its not quite as spun as some of the other articles in the media right now in my opnion.

That gives me a little hope, I plan to ask about our schools vaccination policies when they return mid august, so I will report back my findings.

I am watching closely for the first sign of a mandatory vaccine if they are to attend, if so I must be able to teach them from home wouldnt you think? I mean if a child has mono or something they send work home for the student I dont see why this would be any different.

It is just so sketchy, and if other children do take the vaccine will they end up being walking perti dishes for infecting others not vaccinated?

So many questions not enough answers that are reliable and consistant. I love my children and do not want to do this voluntarily, but I also dont want the children taken away for their own safety... and then forced into something even they know is untested and want no part of.

Someone asked in the thread where the military would get all the medical personnel.

This is pretty much basic information, no real secrets here being given out here.

Every battalion in the Army has an Aid Station embedded/attached to it. Most have an officer that acts as the 'doc' (more like a Nurse Practitioner), and there is a rotating group of supporting medic trained personnel, mostly platoon strength.

There is usually also a Medical Company on every post as well, filled with medics who can set up field hospitals and the like. Not to mention they also support the larger on base clinic(s) where soldiers whose medical needs are much more serious than the embedded aid station can handle.

Then there are training cadre's who are constantly training more medics, nurses and OR staff to support the Army, largely to fill losses due to ETS, PCS, Retirement and so on.

The next lower level of medical support is from soldiers who either are Combat Lifesavers or quickly trained to be. Combat lifesavers are soldiers who are picked for additional training in how to handle traumatic injuries, and to give IV fluids, and if need be shots. They are also taught the basics of triage.

Then at the lowest level of medical support that might come from the Army is the individual soldier.

Each soldier receives a basic if not superior (in some cases) level of training in first aid, cpr, and casualty transportation. Easily comparable in many cases to that of the First Aid taught by the American Red Cross. Also they go through refresher training on a yearly basis as part of their MOS skill training.

Can the Army quickly be cross trained to where a huge percentage of its troops can be Combat Lifesavers; yes. One thing the Army does well is train a lot of personnel in a short time frame. Can the Army provide heavy duty logistical support of a medical nature? Yes they can. Also the Army is trained to be able to operate in NBC environments, of which a pandemic certainly qualifies.

Given the conspiracy themed nature of ATS, we often only look at the fact that the Military in general, carry guns and follow orders. However, everyone only focuses on the threat that they might bring, but seldom the humanitarian support they can bring as well.

Hopefully we won't need to see the Army deployed as a medical support force, or as others might fear, a peace keeping force. However, they are suited to handling both roles.

M.



[edit on 6-8-2009 by Moshpet]

Well, on the surface nothing really came out that shook me in my boots at my meeting.

Right now my locals are really more about prevention aspects. The mantra was....

Wash your hands
Cover your cough/sneeze
Stay home if you feel sick

As of right now deaths are not really a concern with the virus as it is. More how to keep critical operations going when you have 30-40% absenteeism. With the tough questions being how do you get people to stay home when they feel sick while still keeping the well people incentivized to come to work and not just say they are sick. As well what do you do when you send someone home so they dont infect everyone else, yet they dont have sick leave and do they get paid...etc. And even if the person is feeling well, what if they have to stay home to care for a child or other relative.

The word also was, dont count on the vaccine. Likely by the time the H1N1 vaccine makes it around to the average US citizen we are likely already going to be well embroiled in the outbreak. And even if it gets around in time there is no plan for forced vaccination as even a rule for any strata of public or private employee or student.

So although it didnt seem quite so dire as far as severity, (i.e. mortality rate) it will likely hit large portions of the population as it is easily transmittable and people have very little immunity to this strain.

So from my perspective, as it is now its not likely we are going to need to stock up on body bags, but it sounds like it will definitely be another blow to the economy in the aspect of lost work time and delays in all aspects of society and infrastructure.

Of course, at the end as we were all breaking up and leaving, one of my collegues said, "well of course unless it mutates" to which everyone started shushing and pretending that its not a possibility.

I'll pop back in if I can remember any other info that was timely and interesting.

And of course if anyone has any questions or if I typed anything confusing, please let me know and I'll do my best. Not to mention I can always follow up with some of my contacts if I dont know the answer.

Got my duct tape and plastic... I'm ready for anything that comes my way.

Originally posted by ShortBus
Got my duct tape and plastic... I'm ready for anything that comes my way.

Don't forget a few rations and essentials in your home though, in addition to the duct tape and plastic.