Thai Health Experts Tell People To Avoid Public Places

[george]

INFLUENZA 2009

Health experts tell people to avoid public places

BANGKOK: -- As the type-A (H1N1) virus spreads and claims more victims, the chorus to halt all forms of public life seems to be growing more strident.

"The transmission rate of the new flu virus from humans to humans will be drastically decreased if people across the country, including patients with flu-like symptoms, stay home and do not participate in any social gathering for two weeks," said Dr Tippawan Nagchinta, a health expert from the United States Centres for Disease Control and Prevention (CDC).

Tippawan, who is a consultant from the CDC to the Field Epidemiology Training Programme, urged the government to tell people to avoid crowded places in order to slow down the increase in the H1N1 virus' fatality and infection rates.

She was speaking after a meeting with top-level health officers and experts from the country's leading medical schools in Bangkok at the Public Health Ministry.

If the government shuts down public spaces where people meet and hang out, including schools, cinemas and theatres, morbidity would immediately decrease, she said.

This lesson has already been borne out in the US, where infections among students were reduced rapidly after the CDC ordered some schools, where infected cases were found, to stop operating for two weeks, she said.

If the government could not ban all public areas, it should pick those places with the most cases, she said.

Deputy Prime Minister Sanan Kachornprasart also said he personally believes it was now time to call off all classes to control the spread of the 2009 flu.

"The suspension should last two to four weeks during which a major clean-up operation would be conducted," he said.

"After that, the schools can resume classes and arrange make-up sessions later."

Sanan chairs the committee dealing with the disease. He also thought about promoting the use of facemasks.

"The Public Health Ministry plans to allocate Bt10 million for purchasing face masks," he said.

"All Cabinet members will wear face masks at their meeting to lead by example."

Sanan plans to seek Bt70 million from the Cabinet |today for public campaigns on how to guard against the pandemic.

Former public health minister Suchai Charoenratana-|kul also advised the govern-ment to close all schools for one week.

"All entertainment events should be withheld during the same period, too," he said.

The new flu is a real threat because its death toll here is the highest in Asia and the sixth highest in the world.

The government should also be cautious about the use of antiviral vaccine for the H1N1 flu, he said.

"Any rush may bring unwanted deaths and paralysis," he said.

-- The Nation 2009-07-14

Update at 14:05:

435 Bangkok Schools To Close July 15-19

435 schools, 200 nurseries and 13 occupational training centres to close

Full story:

http://www.thaivisa.com/forum/435-Bangkok-...15-t280294.html

[george]

Swine flu pandemic now 'unstoppable': WHO official

The swine flu pandemic has grown "unstoppable" and all nations will need access to vaccines, a WHO official has said, as 12 new deaths were reported and a study raised fresh concerns.

Britain, Brazil, Colombia, Mexico, the Philippines and Thailand all reported deaths on Monday, while Saudi Arabia shut an international school after 20 students were diagnosed with the A(H1N1) virus.

As the death toll increased, the World Health Organisation official said a swine flu vaccine should be available as early as September and all countries would need to be able to protect themselves.

A group of vaccination experts concluded after a recent meeting that "the H1N1 pandemic is unstoppable and therefore all countries would need to have access to vaccines," said Marie-Paul Kieny, WHO director on vaccine research.

Health workers should be at the top of the list for vaccination since they will be in high demand as people continue to fall sick, she added.

Countries would be free to decide on their national priorities, but other groups should include pregnant women and anyone over six months old who has chronic health problems, the WHO official said.

Particular attention would have to be paid to children since they are considered "amplifiers" of the spread of the virus, especially when gathered in schools, Kieny added.

More than 90,000 swine flu cases have been reported worldwide, including 429 deaths, the most recent WHO numbers from last week show.

While most cases have been considered mild, a study released on Monday said the virus causes more lung damage than ordinary seasonal flu strains but still responds to antiviral drugs.

Virologists tested samples of the virus taken from patients in the United States as well as several seasonal flu viruses on mice, ferrets, macaque monkeys and specially-bred miniature pigs.

They found that A(H1N1) caused more severe lung lesions among mice, ferrets and macaques than the seasonal flu viruses.

But it did not cause any symptoms among the mini-pigs, which could explain why there has been no evidence that pigs in Mexico fell sick with the disease before the outbreak began among humans.

The team also found that the virus was highly sensitive to two approved and two experimental antiviral drugs, including Tamiflu, now being hurriedly stockpiled around the world.

This confirms the drugs' role as a "first line of defence" against the flu pandemic, they said.

The worry about the present strain of A(H1N1) is that it could pick up genes from other flu strains that would enable it to be both highly virulent and contagious, and these warnings are spelt out in the new study.

"Sustained person-to-person transmission might result in the emergence of more pathogenic variants, as observed in the 1918 pandemic virus," it says.

Another concern is that the virus could acquire mutations enabling it to be resistant to Tamiflu.

"Collectively, our findings are a reminder that (strains of swine flu) have not yet garnered a place in history, but may still do so."

Most of the deaths reported on Monday were in Asia, with Thailand reporting three fatalities and the Philippines two.

Thailand's death toll has now reached 21, while the Philippines has three deaths.

Authorities in Britain announced the deaths of a six-year-old girl and a doctor who had contracted swine flu, bringing the number of fatalities there linked to the virus to 17.

Brazil on Monday reported the death of a nine-year-old boy, taking the number of fatalities in the country to three. A young woman died in Colombia and three new deaths were reported in Mexico, taking the toll to 124.

In Europe, Italy's health ministry reported 38 new cases over the course of the last four days, taking its total well over the 200 mark.

The school closure in Riyadh came with officials there especially concerned over swine flu with upwards of two million people expected over the next five months on pilgrimages to the Muslim holy cities of Mecca and Medina.

-- AFP 2009-07-14

[richsilver]

It has been widely reported that face masks do nothing to stop the virus. There was also a story several weeks back in the NY Times that public health officials felt that closing the schools had no impact on the spread of the virus.

[sonalex00]

Hi all, I am a new member of forum

[chatette]

utterly absurd mask mania. i wonder who is making all the money from the useless masks, which are more likely to be a vector with all the face touching involved. Washing hands would be more effective.

[paulandmaneerat]

This situation is beginning to get very scary. I think the closing of places of entertainment should be seriously considered, also any other places where a large number of people gather in one confined space. Of course it begs the question, what about supermarkets, bars, restaurants, airports etc. I would not want to be the minister who activated closure of these places too, but if a two week closure would see the dramatic reduction of infections we are told would occur, and possibility a swifter end to this 36 month plague, we should bite the bullet and do it.

Of course there is the question of compensation for lost revenue. But should money speak louder than human lives? Again I would not want to be the minister making that decision either.

P&M

[Thai at Heart]

Finally a professional opinion about what can be done.

The schools should have all been shut ages ago. Are there public service advertisements out there explaining what people should be doing? We have just had a "longish" holiday and half of Bangkok migrated home which I am sure will contribute greatly to the spread.

What has been done so far has been typically piecemeal i.e. close the tutorial schools and internet cafe's but kids are still going to school and normal life is continuing. As they say, do something properly, or do nothing at all.

[BEENTHEREDONETHAT]

The following makes you wonder how they came up with the name Swine Flu?

"Virologists tested samples of the virus taken from patients in the United States as well as several seasonal flu viruses on mice, ferrets, macaque monkeys and specially-bred miniature pigs.

They found that A(H1N1) caused more severe lung lesions among mice, ferrets and macaques than the seasonal flu viruses.

But it did not cause any symptoms among the mini-pigs, which could explain why there has been no evidence that pigs in Mexico fell sick with the disease before the outbreak began among humans."

[MHM]

Is it safe to stay at home? What if someone visits? This is a rather silly attempt to demonstrate action in the face of criticism. A 'public space' without the public is a nonsense that simply isn't going to happen. Life goes on.

[londonthai]

"if people across the country, including patients with flu-like symptoms, stay home and do not participate in any social gathering for two weeks,"

the society is about interactions - excluding any social meetings of healthy is just impractical and stupid. All ill should stay home and, in a worse condition, be hospitalised and on tamiflu.

closing infected schools for a few days is reasonable, but closing all schools for that long (up to four weeks) is just panicking.

as to morbidity of this flu, it's not higher than any other seasonal flu - at least not at this stage. Might be, if it mutates to become more harmful and spreads sometimes winter time.

Edited July 14, 2009 by londonthai

[Scott]

The spread of the flu is considered unstoppable and as such the gov't needs to come up with a strategy to combat the flu. They may need to slow the spread to make sure the medical community can cope. That may mean closing certain places where people congregate and it may mean identifying 'clusters' where the outbreak is particularly prevalent. They may need to identify particularly vulnerable groups and seek to minimize their exposure both at schools and work places.

But first there needs to be a strategy of what they want to accomplish.

[webfact]

"The transmission rate of the new flu virus from humans to humans will be drastically decreased if people across the country, including patients with flu-like symptoms, stay home and do not participate in any social gathering for two weeks," said Dr Tippawan Nagchinta, a health expert from the United States Centres for Disease Control and Prevention (CDC).

Everything seems to be under control within 2 weeks time!

They always mention 2 weeks. Is that only a number or proven as reliable due to medical research?

[Lopburi99]

Surely they've considered the widespread ramifications of this?

This is a mind boggling announcement!

Edited July 14, 2009 by Lopburi99

[alant]

question..... do muslim women catch less flu or other airborne diseases than those that do not coverr their face? all this face mask stuff made me wonder.

if the red and or yellow shirts threatened to hit the airports again the government could shut the country down for a couple of weeks and blame them.

[z21rhd]

It is almost unbelievable that these so-called experts are totally divorced from reality : one does not have to be a epidemiologist (which I am) to understand that the request for Government "to tell people to avoid crowded places in order to slow down the increase in the H1N1 virus' fatality and infection rates" is patently rubbish , when one wonders how people will get to work, how children will get to school, how people will go to their markets??

What? close all factories, businesses, schools, transport systems. Switch all air conditioners. Close the Health centres and hospitals. Just in my little town with big schools the Sorng Theos arrive and leave with as many as 20 on a pickup, on the light truck as many as 40 children CRAMMED together.

Where do these idiots come from??? They might have read of Canute.

[george]

Sanan to propose that all schools close

BANGKOK: -- Deputy Prime Minister Sanan Kachornprasart said on Tuesday morning he will propose to the cabinet meeting the closure of all schools nationwide for two to four weeks to help curb the flu outbreak.

Maj-Gen Sanan said it was not necessary to shut down entertainment venues for the time being.

State authorities would ask for cooperation from the owners in implementing measures to prevent the A(H1N1) influenza virus from spreadingm but it would be better if they voluntarily shut their doors for a while for a thorough clean up of the premises.

He would also ask the cabinet for a 70 million baht budget for a publicity campaign to educate people on the best ways of avoiding infection by the swine flu virus.

-- Bangkok Post 2009-07-14

[minxwhale]

Finally a professional opinion about what can be done.

The schools should have all been shut ages ago. Are there public service advertisements out there explaining what people should be doing? We have just had a "longish" holiday and half of Bangkok migrated home which I am sure will contribute greatly to the spread.

What has been done so far has been typically piecemeal i.e. close the tutorial schools and internet cafe's but kids are still going to school and normal life is continuing. As they say, do something properly, or do nothing at all.

Funny how Thailand is taking such extreme measures and scaring the public when this flu is being treated like a seasonal flu in the West.

The hysteria created by the Thai media and government is unprecedented and I've never seen Thais so concerned about safety and health ever. It's truly laughable when you see a family riding with children on a motorcycle all of them sans helmet, yet dutifully wearing their useless facemasks.

The death rate in this flu has proven to be much lower than that of the garden variety seasonal flu, yet the BKK Post saw the need last weekend to write a screaming headline that 1,200 people in Thailand would die from the flu. No context as to how many people die every year from normal flu. Many more than 1,200 I can assure you.

Yeah let's shut EVERYTHING down, grind the national economy to a halt for a flu that will continue spreading and won't kill very many.

[Igor]

Two things:

1) close the theaters? Here in Chiang Mai they may be the safest place! You seldom see the cinemas approach 20% capacity.

2) While the schools are closed "a major clean-up operation" will occur? What are they planning to do? Wash the blackboards?

Okay, three things. It is my educated opinion the cheap face masks being worn are of absolutely no protective value and may, in fact, increase your chances of becoming infected. HOWEVER, since YOU wearing a mask DOES protect ME from your sneezing, I encourage people to wear them. I do not wear one. But, then, I'm not sneezing and know how to use a handkerchief when I do.

[Dkalasz]

One word SOAP

as i took a bus trip a couple days ago from lom sak to chaing mai for a small holiday and a border cross it accured to me I have never seen soap in a public bathroom here.. \

forget the face masks buy some soap

Just my opinion

[Lopburi99]

Jeezus, are things that serious back there? Do I postpone my trip back to LOS in two weeks?

I'm not one to be easily alarmed, but what is going on there?

Edited July 14, 2009 by Lopburi99

[webfact]

Sanan to propose that all schools close

<snip>

he will propose to the cabinet meeting the closure of all schools nationwide for two to four weeks to help curb the flu outbreak.

it was not necessary to shut down entertainment venues for the time being.

would like to know why one must close the other can stay open?! Just wondering

Edited July 14, 2009 by webfact

[londonthai]

"to halt all forms of public life seems to be growing more strident."

"Any rush may bring unwanted deaths and paralysis"

somehow can't see flu influencing in a bad way much of public life, but all these proposed measures will - closing for example all airports for 2 weeks is shutting the whole export economy as well as the aviation and foreign tourists industries, in effect will be much more serious, than the devastating closures last year

[Bangyai]

What has been done so far has been typically piecemeal i.e. close the tutorial schools and internet cafe's but kids are still going to school and normal life is continuing. As they say, do something properly, or do nothing at all.

Very true. Unfortunately doing things half cock is a bit of a Thai weakness. The situation now is that its going to be very difficult to bring this thing under control without taking some pretty drastic measures, On a personal level the best you can do is avoid crowds

[Thai at Heart]

Two things:

1) close the theaters? Here in Chiang Mai they may be the safest place! You seldom see the cinemas approach 20% capacity.

2) While the schools are closed "a major clean-up operation" will occur? What are they planning to do? Wash the blackboards?

Okay, three things. It is my educated opinion the cheap face masks being worn are of absolutely no protective value and may, in fact, increase your chances of becoming infected. HOWEVER, since YOU wearing a mask DOES protect ME from your sneezing, I encourage people to wear them. I do not wear one. But, then, I'm not sneezing and know how to use a handkerchief when I do.

As far as I know, masks don't really protect you from catching it, it may help people from spreading it. But if you are so sick you need a mask, STAY AT HOME or if you're really sick go to the hospital.

Does disinfecting a school once it's closed really help? What is the life of this virus in a normal environment? As far as I know it can be up to 48 hours, but all this scrubbing and cleaning appears to be more for the benefit of the cameras than of any real practical use. It would be interesting to know if they are even bothering to wipe down anything on the BTS or Subway. Lets forget about the buses, most haven't been cleaned in years.

Wash your hands regularly is the best advice I have heard.

I can see consumption of Dettol going through the roof.

[Jingthing]

Jeezus, are things that serious back there? Do I postpone my trip back to LOS in two weeks?

I wouldn't say it is that serious yet, but the virus is spreading rapidly. Be prepared for the possibility that you could get the flu here and have to stay inside for a week. That can happen anywhere in the world now, nothing special about Thailand. At least 40 percent of the world population is expected to get this virus (or potentially if not vaccinated). Like someone else said, wash your hands.

Edited July 14, 2009 by Jingthing

[Lopburi99]

Just checked the U.S. Embassy website. No new warden messages, the last H1N1 update being on June 19. I would expect to hear more soon. It will be very interesting what is said.

Edited July 14, 2009 by Lopburi99

[grantbkk]

The only thing that is 100% certain is that whatever the various ministries do in Thailand it will be only in their self-interest and it will be wrong. Like most numbers produced by the government the figures are suspect. Foreigners visiting or living in Thailand are virtually on our own, as usual, not that there is anything wrong with that.

While it is laughable to close the tutorial schools and not all schools in an attempt to control the spread of H1N1 it doesn't come as a surprise to anyone familiar with the government here. Overcrowded public transportation conveyances are clearly more dangerous. Not to mention the go-go girls coughing on stage, spattering the bar patrons just trying to watch the show.

Now we have the anti-mask zealots to contend with. To them I ask, What is the downside of using a mask?"

Thai and Bangkok Airways have called on the government to "play down" the H1N1 death toll because it is bad for their business. Exactly the same request came from the last elected prime minister asking the news outlets to stop reporting so may foreign deaths by suicide as it was bad for tourism. Some of still remember the "Pattaya Plunge" as a common term used for high-rise jumpers.

Please remember that normal western hygienic practices will reduce the chance of contracting H1N1 when combined with common sense when mixing with crowds in Thailand. Visitors here have no idea that most kitchens here have no hot water. Hand washing is almost always optional and parents have never taught their children to blow their nose. That is why it is common practice to jam a finger up their noses to the second knuckle to remove obstructions.

[Padrino]

more people are still dying from the standard flu every day in the majority of countries. I would rather be here than in the UK who have the 3rd highest number of infected people next to Mexico and the US !

Back home 2 of my brothers friends have caught the virus and are fine with symptoms nowhere near as bad as normal flu. Stop worrying too much - stay healthy -not too much drinking or smoking - plenty of sleep - vitamins /minerals etc , then if you do get it your body should fight it well. It seems to be affecting people differently but for the most part its the standard very young and elderly who are most at risk. I think only one man of so called normal health has died in the UK, just make sure if you do get it you go to a decent Thai hospital.

[thailandpeter2]

This situation is beginning to get very scary. I think the closing of places of entertainment should be seriously considered, also any other places where a large number of people gather in one confined space. Of course it begs the question, what about supermarkets, bars, restaurants, airports etc. I would not want to be the minister who activated closure of these places too, but if a two week closure would see the dramatic reduction of infections we are told would occur, and possibility a swifter end to this 36 month plague, we should bite the bullet and do it.

Of course there is the question of compensation for lost revenue. But should money speak louder than human lives? Again I would not want to be the minister making that decision either.

P&M

While i agree with you that some public places should be closed, closing all would be risky and not only a matter of lost revenue. i would say, close:

- schools and universities (this should really have been done last week or so already)

- entertainments places (bars, theatres, massage parlors, internet cafes, concerts, etc.)

- possibly restaurants

- demonstrations (red shirts, yellow shirts, etc.), as they are also mass gathering of people which could 'help' the flu in spreading

of course, the people working there or the owners would have to be supported financially by the government - it's not just a matter of lost revenue, but some people - epsecially the workers in these restaurants, and small foodstall or small restaurant owners, are dependent on their daily income to survive)...

to close down other public places which - i agree - could be transmission points is very risky, and NOT only regarding lost revenue:

- supermarkets and maybe also food markets: where will people get their food then, especially in cities?

- airports, railway stations, public transport: there ARE definitely situations in which people need to travel, and which are not 'only' for business or holiday reasons...

- bank's branches counter services outlets like bank branches counter services, utilities services outlets, etc.: quite impossible to do that...

so, while surely something HAS to be done (while working on a vaccine/prevention AND also of course on effective cures for a possibly mutating virus which can get resistant to current treatments too), methods applied have to be selected carefully. while of course a spread of the flu should be minimized, on the other side you surely would not like to see a total breakdown of the country and it's society... because following this health care services could also break down and that would be counterproductive...

also, of course free treatment and free vaccines would have to be provided at least to people who would financially suffer from the temporary shutdown of their work and income place/sources...

[AsiaCheese]

... Now we have the anti-mask zealots to contend with. To them I ask, What is the downside of using a mask?" ...

What's the upside of using something that's of absolutely no use?? It's been clearly stated that the only masks that will filter out airborne H1N1 viruses are the N95-spec ones. That is NOT what is being distributed; N95 are very expensive and make breathing rather hard...

But yes: asking people to wear face masks goes well with the rest of the recommendations/plans -- it's the completely useless "we're doing something" show...