Sunday, February 17, 2008

Chapter Twenty-Three

On the news last night there was yet another report on a rumored flu vaccine. Everything Sissy heard prepandemic from reading the various postings of scientists and people familiar with medical science, either by profession or a studied interest, indicates that a vaccine is extremely unlikely for at least six months into a pandemic. That is just coming up with a trial version. It will take many months beyond that to manufacture enough vaccine to make it widely available to the general public.

Sissy isn’t even sure if that hypothesis includes lowered manufacturing capabilities due to infrastructure collapse. Certainly the partial destruction and abandonment of the vaccine plant in Egypt is a blow to some plans.

The WHO (World Health Organization) is still operating, but at the same diminished capacity as the rest of the global community. Their ability to mitigate the initial outbreaks of the panflu strain was severely compromised because countries were not releasing their data very quickly, if at all. And when the human outbreaks become too many to ignore or hide, the WHO lost several of their frontline people who were struck down by the virus after being sent into the suspect areas.

Many of the WHO’s facilities have been compromised during outbreaks as well, including their SE Asia headquarters in Malaysia. Their regional offices in Copenhagen, Denmark and Washington DC, USA however were secured in time and have become two of the more important locations utilized by the WHO to filter information through. They’ve also lost several regional offices like the ones in Brazzaville, Republic of Congo and in New Delhi, India. Its been reported that the WHO is still trying to guide the production of an effective vaccine by providing a clearinghouse for information exchange and by giving scientists a safe and sterile environment to work in. On the other hand, rumors in some third world countries are making it impossible for the WHO to operate there, as people are afraid that the WHO caused the pandemic to begin with.

The vaccine plants in both Austria and the Czech Republic, both owned by a company called Baxter, have been secured and they have staff working around the clock. The vaccine manufacturing facilities in the US have also been secured, though they did have a few instances of attempted attacks by misguided members of the public that blame the facilities for not coming up with a vaccine quickly enough. The angry actions were illogical, but people are scared and uninformed; results of the lack in transparency by governments.

Other manufacturing facilities around the world are in various stages of production capability. The vaccine plant in Egypt has all but been written off, with the UN confiscating any salvageable equipment and shifting it to other WHO facilities around the world.

Journalists reporting on vaccine rumors are always careful to remind listeners and viewers that no official statements have been released. They also state that no verifiable vaccine trials have been announced. But that’s the way rumors are, a lot of noise but no verifiable information.

"Guess what rumor I heard at the market today?"

"Oh let me guess. Its either about a vaccine or about the poor woman three streets over."

"How ever did you guess?" Scott asks in a sarcastic voice.

"What did Mrs. Linden say she had heard this time?"

"Well it seems those families in that enclave had actually gotten a supply of an experimental pandemic vaccine. The problem was the ‘experimental’ part. It backfired on them. Instead of preventing the virus, that’s house they became infected. Not form the commodities or deliveries, but from the vaccine."

"Oh for Pete sake. Who makes this stuff up?! No one honestly believes that tale do they?"

"Of course everyone says its just a rumor and pooh-poohs it; but some people have that look on their face. You know the one; they say they don’t believe it but their eyes say that may it might be true."

"That’s just great. If and when they do come up with a vaccine I can see people refusing it because they think they’ll catch the virus from the vaccine."

"Human nature sweetheart. I just thought you’d get a kick out of it."

"I just wish people would stop gossiping and rumor mongering. It isn’t healthy when that’s all you do. What happens if our family becomes the target of malicious rumors like that?"

"I’ve got news for you, they haven’t exactly spared us. You saw what it was like on Christmas Day. Why do you think I keep going to market days or to the burn barrel? Its not ‘cause we need anything. I just don’t want us to appear too different; to stand out too much."

Its not that people aren’t eagerly awaiting news, it is just the fact that there isn’t going to be an instant magic bullet of protection has finally sunk in. Most people now are so focused on the day-to-day issues of survival, and so wary of mass gatherings, that unlike in the early days of the pandemic the cry of "where is the vaccine?" is rarely heard during a riot.

Gone too are the days when the WHO could simply call for a "Tamiflu blanket" to try and calm a panflu outbreak. It turns out that the world’s nations had less than half the number of doses they thought they did. This was primarily caused by the fact it took a minimum of twice the dosage that was originally expected to treat a panflu infection. There is also the issue that the strain of influenza that eventually made it to pandemic status has a strong component of anti-viral resistance. And, if the prophylactic benefit was to be truly taken advantage of, the infected person needs to begin taking the course of anti-viral medication immediately upon developing symptoms or even earlier.

Many countries, particularly those in SE Asia and the Middle East, had used up most of their anti-viral inventory even before the pandemic began. This was in response to the early and widespread bird die-offs, but probably contributed somewhat to anti-viral resistance. In Indonesia, where Tamiflu was handed out at even the suspicion avian influenza in a human being, the prepandemic CFR was 80% in reported cases.

One of the most worrying rumors that has recently cropped up is that they suspect there are multiple strains of the pandemic virus going around. Areas that have already suffered through an initial wave of infections are beginning to see a second spike . . . possibly the beginning of the hypothetical "second wave." The problem is that people who have already had the pandemic flu should theoretically be immune to getting it again due to antibodies in their system; however, some of these people are getting sick again. If the theory is correct, then these people could only get sick again from a strain of panflu that is different enough from the first to require different antibodies. If these rumors prove out, then manufacturing an effective vaccine is going to be even more difficult. And more people are likely to die.

As quiet as things are in Scott and Sissy’s neighborhood, it becomes even more so after February 1st when most Florida schools attempt to re-open. There has been a great deal of shuffling around, trying to make sure that all children can access a classroom.

One of the biggest changes this shuffling brings about is the decentralization of the school district bureaucracies. While the school board still reigns as the final supervisory body, it is necessary to give schools and teachers more autonomy to deal with unique situations and student needs. Nontraditional classroom settings are becoming the norm – home education, virtual classrooms and schools, non-accredited private schools, "storefront" classrooms, schooling via public television and radio, etc.

For those students whose parents have chosen to return them to a traditional classroom setting, there is a whole slew of new hygiene rules:

  • Students are required to wear PPE at all times, from bus stop pick up to bus stop drop-off and all times in between.
  • Students eat at their desks rather than in a cafeteria; and, all utensils are disposable (primarily the much maligned "spork").
  • Mandatory hand-washing breaks have been instituted and basic rules of hygiene are reviewed periodically through out the day, every day that students are on campus.
  • There are monitors at all of the bus stops and on the buses themselves. A child exhibiting any of a list of symptoms is not allowed to even stay at the bus stop. The monitors also enforce the PPE rules. And, once students arrive at the school they go through a third checkpoint before entering school grounds.
  • No touching! Students are not to touch other students or school staff, even if they are wearing gloves.
Peer pressure – in the form of reward and punishment systems – is utilized to create a tightly controlled social environment. Infractions of the rules are grounds for immediate expulsion. The appeal process is very difficult as teachers and staff have been given a great deal of latitude with which to accomplish their responsibilities. Discipline rules are also more strictly enforced. People who were expecting the old public school baby-sitting service receive a very rude awakening very quickly.

One educational area that cannot be worked out to the satisfaction of anyone is classroom access for special needs students. There are too few special education teachers to continue most of the classes. Many students who were on behavioral altering medications no long have access to these medications and cannot function in a classroom setting without them. There are fewer special transportation options for students who need them. There are other problems as well, such as hygiene and PPE enforcement with some of this population. Many of these students are told they will have to use the non-traditional options. For parents and caregivers of special needs children already weary from enforced SIPs, losing the option to get services through the school system is a tremendous blow.

The Chapman family continues to school as they always have. The intermittent power outages have caused some disruptions, but nothing that can’t be addressed by having flexible schedules. The curriculum and school supplies are holding up. They will have to address Rose’s highschool graduation as best they can. Luckily she is already dual-enrolled at the local community college and that institution is allowing most students to re-register each semester without having to go through the whole application process each time which is usually the case for dual enrollment. At least some concessions are being made for students..

And, now that February is here, the family also begins to harvest more of what they have planted in their agricultural experiments. Some of the burdock and the celeriac are ready to use from the edible landscaping. The best thus far though is that the garlic is ready to harvest. Sissy still has plenty of dried garlic in the minced and powdered form, but fresh garlic will be a real treat. It tastes great in salads and pasta dishes; but science has also shown garlic to be a type of broad-spectrum antibiotic. It’s a good thing that they planted so many bulbs, between the family’s own use and the high demand of it at the neighborhood market, Scott feels that he could have doubled the crop and still not had enough. They carefully set aside as many cloves as possible to plant next season.

February is also a busy time for planting. Luckily the owner of the orange grove next door doesn’t mind if they take some soil to mix with their compost to fill more containers so long as they don’t disrupt his tree roots. But they have to put most of this month’s plantings into the landscape. Several simply do not lend themselves to container gardening. Sunflowers, jicama, cantaloupe, and chayote need to be able to climb or spread. The amaranth, salsify, cardoon, celeriac, and Jerusalem artichoke are unusual enough that hiding them in the landscape makes sense as long as they can keep the animals out of them. The black-eyed peas are planted in the hottest, sunniest part of the yard as they are a distinctly southern plant well suited to Florida’s weather. They have to set up a trellis for the pole beans to grow on since the pecan saplings will soon be leafing out. Everything else – potatoes, peas, and shelling beans – they plant in containers.

Later this month Sissy will start harvesting their garbanzo beans, parsnips, potatoes (from an earlier planting), salsify, and shallots. What everyone is really waiting on though are the ten hanging baskets of strawberries. They are an extremely prolific variety that Sissy has experimented with before. If you keep them picked, they seem to produce more. The berries aren’t as large as the ones that are planted in the ground, but the baskets are pretty and the hanging varieties are easier to take care of. They can be moved so they don't scorch or freeze; and, moving them means that they can be brought inside to prevent berry rustling.

Sissy is getting a little worried though. It might be that things have started to "look up" so quickly that she is imagining the worst for no reason. It just feels like things might be going too well. Scott now has reliable help going to the rental units, which takes a load off Sissy’s mind, and he is doing a lot of sideline repair work and is even talking about hiring a couple of more men from the neighborhood. But this means greater exposure to people who might be sick. The neighborhood market is really thriving and people are beginning to bring their own garden produce to barter; but again, this means that more people are congregating. The schools have finally re-opened, but that is yet another way people are starting to get side tracked from the mitigation measures that helped the area avoid some of the troubles that have been visited upon other states.

Prosperity and a return to normalcy is a good thing, but for Sissy, it just feels like the other shoe is just waiting to drop.

"Don’t look a give horse in the mouth. Things are finally looking up. Why are you so anxious?"

"Look Scott, I don’t know. OK? I guess I’m just paranoid."

"Look Babe, as bad as times have been, we knew things would eventually turn around. So maybe things won’t be completely better for a while. But it looks like they aren’t getting any worse either. Try and relax will you? When you get like this, you may me nervous."

"I’ll try. And I really hope you’re right. I really do."

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