Archive for April, 2009
Three months ago I blogged about the Conficker worm and its relevance for emergency managers. Since then, I’ve rumours that a number of health agencies were still having problems with their email systems. The reason I raise this again, is that now, with a large national response to a potential pandemic taking place, one hopes that Conficker has been well and truly removed from all Health systems (both Ministry and DHB).
If Conficker is still impacting on health agency IT systems during this period of increased activity, then honestly, heads need to roll at MOH.
I see that a few newspapers have been bandying about the $24b potential impact a pandemic could have on New Zealand’s economy. In case anyone is interested, the report1 is available for download here.
- Buckle, R A; Douglas, J; Szeto, K L. (2006). Impacts of a Potential Influenza Pandemic on New Zealand’s Macroeconomy. The Treasury. [↩]
I’d like to make a quick point about readiness, particularly pandemic preparedness in the current media rush around swine flu.
After Y2K, many people complained that it amounted to nothing – there were no significant events that came out of it. This was a direct result of all the work that was put into fixing at-risk systems and likely many millions of person-years work. Had we not put all that effort in, it could have been very different.
Likewise, if swine flu does not amount to much, this may also be likely in large part to the massive amount of risk reduction and readiness that has been put in place over the last five years or so. There has been a massive amount of investment in pandemic influenza planning, general emergency management planning, and pandemic exercises (here in New Zealand at least Exercises Makgill and Cruickshank).
My point is that we shouldn’t behave like that this is going to be a 1918 Spanish Flu event (althought caution always suggested that the risk is there) and the end of the world as we know it (as some on Twitter might think so). With SARS, and Avian Influenza being prominent over the last few years, these have allowed many governments and health agencies to better prepare for an event such as swine flu. All this preparedness will improve our collective response to a potential pandemic. There are resources, trained people, plans and processes in place, and being used. I believe that all the work of the past few years will place us in a much more robust position to face this threat.
Ten of the New Zealand students that returned recently from Mexico have been confirmed to have Influenza A. Influenza A is apparently an indicator of swine flu, but further tests will be required to confirm that any of them have swine flu.
Well, it has been a lot of work for the admins, the mentors, and the students, but it has paid off. The Sahana has been awarded 10 projects in the 2009 Summer of Code. We have some great projects lined up! The include:
- Person Registry for Sahana
- Warehouse Management
- Disaster Victim Identification
- J2ME clients for form data collection in the field
- Optical Character Recognition for scanning forms
- Peer to peer synchronisation of Sahana servers
- CAP Aggregation and Firefox CAP plugin
- CAP Editing and Publishing
- Mashup/Aggregation Dashboard
- Theme Manager
Having been neck deep in the process; working with others to set up our assessment process, coming up with ideas (I’m stoked to have two students working on CAP ideas that came out of my earlier suggestion), and reviewing each and every of the 45 proposals we recieved, it has been exciting to get so many projects accepted.
I think that by the end of the year, we are going to have some great new functionality available in Sahana. Even more, I hope we’ll attract more open source developers to our ever growing community!
I’ve wasn’t going to write about the current events in Sri Lanka, but I just wanted to add a voice of support to comments made recently12 by Sanjiva Weerawarana on his blog. I’ve known Sanjiva since mid-2005 when I got involved with the Sahana project that started in Sri Lanka following the Tsunami. I’ve just returned from 6 days in Colombo in late March.
The brief point I want to make is the following. For years, the international community appears to have ignored what has been happening in the LTTE controlled territory in the north and east of Sri Lanka. It was the Sri Lankans that had to deal with many suicide attacks, even some including LTTE controlled jets.
Finally, the Sri Lankans had to take action, and they have. After the global community hadn’t shown any will to resolve the issue. The way that the LTTE have embedded themselves in the civilian Tamil population has made it inevitable that there will be fatailities when going after the LTTE.
However, over the past few months, the Sri Lankan military has effectively reduced the control and influence of the LTTE significantly and restricted them to an increasingly small stretch of land. So much so, the end game is almost here.
My point is that now is not the time for the international community to come wading in and act all righteous about the civilian casualties in the north. To stop the Sri Lankan military now may allow the remaining LTTE to get away, and or regroup. This is the time when the military needs to continue and finish the LTTE off. To stop now, would mean that all of the civilian and Sri Lankan military lives that have been lost to date would have been in vain. They would have been wasted.
No, let the military finish the job, and ensure that all the lives lost were not in vain. To force proceedings to stop now would be akin to stopping the Gulf War in 1991, and then having to go back in another 10 years later to finish the job properly.
The international community has had its chance to assist resolution and failed. Sri Lanka needs to be able to finish what the LTTE started.
On a personal note, it was interesting comparing the state of Colombo from my trip there in late March (2009), to my trip there in September 2005. In 2005, the military presence was transparent. This time round it was as overt as it could possibly be. Countless green sandbag bunkers on every main road, and soldiers everywhere. It seemed to almost be a different city – defined by the military presence. I was staying at the Colombo Hilton in the Fort district, and of course we had the Army headquarters and Government buildings all around us. Of course this meant we were in the safest part of the country. This was clearly a result to the more recent attacks3 against Colombo waged by the LTTE.
With the announcement in the past few hours that there are potentially cases of swine flu in New Zealand, the media has mentioned that both the Ministries of Health and Foreign Affairs and Trade have been monitoring and providing advice on the situation. However, if you visit their websites there is no obvious and easy link to take you to a page for more information. Although to give MFAT some credit, if you follow the safetravel.govt.nz link, you will find more information there.
Given the current heightened interest being shown in swine flu, it is a pity that both of these agencies aren’t providing clearly visible links on both of their home pages to locations where more information can be obtained.
Update: 2009-04-27 13:57 Great to see that the Ministry of Health now has a lovely big banner across the front of their website with a link to further information. Now they just need to implement an RSS feed so that interest parties can subscribe to receive all updates in a feed reader.
The link will take people to the MOH Mexican Swine Influenza Updates page.
Just came across this article via Twitter – but H1N1 may (let me emphasis the may) have been brought back to New Zealand (@1624) by some schools students that have recently returned from Mexico.
Twenty-two students from Auckland’s Rangitoto College, may have been infected with the Swine Flu, which the World Health Organisation warn could start a global epidemic… Up to six have been showing flu like symptoms, but the test results won’t be confirmed until Monday.
More details available on Stuff (@1713, updated @1920). Of course, it could just as well be standard travel lurgi as well. It sounds as though more information should be made available later tonight when the test results are back.
It is interesting watching the various mashups being created by people to plot the cases of Swine flu as it appears to spread. One thing that has struck me is is the poor use of symbology to attempt to communicate the desired information.
The first Swine Flu map that appeared on Google was fairly readable, however the author had decided to use a contrary means to identify fatalities. Whilst black is commonly used during triage as a means of identifying a death, this neocartographer has decided to use a black dot in the symbol to signify that they are living and the removal of the dot to signify a fatality. Of course, when I first looked it the map my instant read was that black dots represented fatalities.
Within the last few hours, a second mapmaker has come along and tried to correct some of the errors that the first created – namely they have now adopted black to symbolise a fatality, however the new torso icon really makes it hard to get a good overview of what has happened, and all the black markers in Mexico are completely unreadable.
Perhaps the brief takeaway message from this is that some authority that is actually well versed in cartography for pandemics should have a system in place whereby they can make this information available – with well thought through, and designed cartography. There is clearly a desire for it as these mashups indicate.
Update: I thought I better have a go myself. So here is my first attempt. I took this information from the WHO Media Release. This first effort was just to get some of the case and fatality numbers out there. I decided to take an aggregated approach and use one icon per city/town. To give a slightly better representation, I had to take one of the Google Maps markers and produce scaled-down versions to represent the cities with far lower numbers of cases and fatalities. Next step later this afternoon may be to map some of the other figures – e.g. the reports in the United States from those that were infected in Mexico. I’ve also included a reference table if you click the marker, which will contain a list of figures as at various times. There is also a link to the source used for those figures. I think this approach will result in a much less cluttered map. I could look at using colour better as well. Red could be used to represent cities where there have been fatalities, and yellow where there have only been cases, but no fatalities. As reports move more towards countries and states, it will be less appropriate to maintain a city/town based approach. This then probably means that a move to polygons is required to better indicate the affected areas, as states/countries don’t lend themselves to a point-based approach.
View WHO report of Influenza-like Illness in a larger map
Finally, the Wikipedia article on the current influenza event has now received its own page.
I heard about this on the radio earlier today, and have now been watching the uptick in interest upon Twitter, and thought I’d capture some of the pages and articles that have been coming up on ‘Swine Flu’ for reference.
- US Center for Disease Control – Home page for Swine Flu
- World Health Organisation – Influenza-Like Illness in the United States and Mexico (20090424)
Reference & Maps
- WIkipedia – Swine influenza, the current Mexico and US outbreak
- Google Maps – Swine flu in 2009
- EpidemicFlu.com – Map of confirmed deaths, confirmed cases, and possible cases in Mexico and the US.
- Veratect – a good timeline of what has happened to date.
What is concerning in the WHO press release is this:
The majority of these cases have occurred in otherwise healthy young adults. Influenza normally affects the very young and the very old, but these age groups have not been heavily affected in Mexico.
This is something that occurred in the 1918 pandemic. Here is an excerpt (p.23) from Rice1.
Why was the 1918 flu so deadly? And why did it kill mostly young adults in the prime of life? … Burnet surmised that the high mortality among young adults may have been in direct porportion to their healthiness. Comptempories often remarked on the fact the 1918 flu struck down robust outdoor types more readily than pale unfit weaklings… It may be that the adult body over-reacts to what us usually only a mild illness in children. Burnet suggested that something like this had happened in 1918, that fast-breeding flu viruses triggered a panic reaction in the patient’s immune system, causing massive over-production of antibody, leading to dangerous imbalances in the bloodstream which invited seconday infection.
The fact that the fatalities in Mexico to date have been healthy and young adults should be cause for concern.
- Rice, G. W. (2005). Black November – The 1918 influenza pandemic in New Zealand. Canterbury University Press. [↩]