One of the reasons the CDC's authoritarian approach to dispensing swine flu vaccines is ineffective is that a series of "feed-forward" failures can occur, such that the shortage causes people to become frantic in the short-term and to direct their attention elsewhere in the longer term. I saw one news article in which the author was saying that the state health department basically doesn't appear to trust anyone enough to provide them with the actual information about the locations of the flu clinics. The person was basically saying that the people at the health department are afraid people are going to storm the clinics, in effect, and, therefore, have been restricting information about the locations of the clinics. As a result, the so-called high-risk groups are not getting the vaccines. And now that there's supposedly a "downturn" in the numbers of cases (many of the cases discussed in the Fall were not, in fact, influenza cases, in my opinion, as discussed in many past postings), the CDC has basically lost their chance to vaccinate a lot of people. The so-called high-risk groups are not, really, substantially more likely than anyone else to experience a complication from the flu, given the wild quality with which otherwise healthy individuals' liver or kidney function, for example, can deteriorate in response to a flu infection. There are endless reports of "healthy" people having to go in to get dialysis treatments or being on the verge of liver failure from influenza, given all the hemolysis and thrombogenicity, etc.
I tried using the Google flu shot finder thing, and it didn't work at all. Maybe I used it incorrectly and need to try it again. It looks like very few people would be able to find swine flu vaccines, these days. In any case, I'm going to try to get the live attenuated swine flu vaccine tomorrow, at the U. We'll see if there's room for a little bit of flexibility. I'm not expecting to get one, but it doesn't hurt to try. But there's a strange kind of attitude that seems to accompany that kind of CDC-based authoritarianism. This ties into the concept (a good one, in my opinion) that one should never pass up a chance to vaccinate someone, and it's this assumption that the CDC is going to actually be able to get people's attention when there isn't a shortage of vaccines. There are just all sorts of invalid assumptions underlying their approach, and it's been a failed approach. They wound up with vast numbers of unused vaccines in the 2004-05 season, when they rationed vaccines. Even if they had a perfect system for dispensing the vaccines, there would still be all sorts of problems.
I'm surprised that the CDC and other health officials can't communicate information about effective approaches to hand disinfection. Maybe people still wouldn't get benefit from it, given that so many people end up having to or choosing to touch their faces, etc. But it's not that complicated. A lot of research has shown that it takes a long time (45-120 seconds) and a lot of scrubbing to remove, to an acceptable degree, something like rotavirus from one's hands with soap, but the 62-65-percent alcohol gels don't require any more than 20-30 seconds, at most, and are substantially more reliable, in my opinion, based on the research. There's tons and tons of research on the issue. One thing I was getting at with the last posting is that I think there can be this tendency of people to not want to wash their hands for a long time or disinfect them, for fear of becoming "the boy who couldn't stop washing," as the title of the book went, or something along those lines. ("Suh-loppy boy. Now, do like I tell you and go wash them @#$%&$ HANDS, boy, and do it before you sit down for supper and do your chores, too, like I done when I was a boy. By God, it was good enough for me.") I have no idea what that means, but hand-washing is associated with obsessive-compulsive disorder in a sort-of-specific way. I suppose people might not think it would make a difference to use the alcohol-based sanitizer gel. In a lot of the articles on infectious disease transmission, researchers go through all of these scenarios and calculate the numbers of virions that could be transferred from one surface to another, at each step along a chain of events that might allow for the transfer the virions. I just think it's good to be able to get in the habit of thinking about that, in case one wants to make use of the thorough infection-control methods at specific times. For example, as I've said before, cleaning surfaces, in my opinion, is never going to be as effective, in controlling the transmission of viruses, as hand disinfectant use and individual behaviors are likely to be, in my view. One can't cover the entire surface with disinfectant, and there's research showing, for example, that some high percentage (I forget the number) of home health care workers can have rotavirus on their hands at any one time. One needs to take that seriously in considering the effectiveness of "cleaning a whole building" or cleaning surfaces at all. The person doing the cleaning can essentially, transport the virus from one surface to another, and that could bypass the supposed 5-10-minute limit on the survival of influenza on the hands. Thomas et al. (2008) [Thomas et al., 2008: (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2394922/pdf/0076-08.pdf)(http://www.ncbi.nlm.nih.gov/pubmed/18359825)] found that some strains of influenza A virus can live for 17 days outside of a host, on money ("banknotes"), when respiratory mucus is present along with the virus. A lot of the articles have estimated that influenza viruses can only survive for 6-12 hours on porous surfaces, and money would be an example of that type of surface [Collignon and Carnie, 2006: (https://www.mja.com.au/public/issues/185_10_201106/col10881_fm.pdf)(http://www.ncbi.nlm.nih.gov/pubmed/17115953)]. I just wouldn't be inclined to think of these things in terms of strict rules, given that some of these methods for evaluating the capacity of influenza to survive on surfaces can be problematic, depending on the precise conditions (i.e. the presence or absence of respiratory mucus, etc.). Some viruses that cause GI symptoms can live for months at freezing temperatures and remain infectious. I saw one article reporting the survival of a virus for six months outside a host, at cold temperatures, and many of those GI viruses can live for more than a week outside of a host.
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