Nov 4, 2009 (CIDRAP News) – The head of the Centers for Disease Control and Prevention (CDC) predicted today that the current wave of H1N1 influenza is likely to begin to wane before the shortage of vaccine for it eases.Dr. Thomas Frieden made the comment at a wide-ranging US House subcommittee session that aired the reasons for and impact of the vaccine delays and the prospects for avoiding a repeat of the problem. The session was streamed over the Web.”It’s likely that the current wave of infection will peak, crest, and begin to decline before there are ample supplies,” Frieden told the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies. “Whether there’ll be another wave of H1N1 between now and May and whether we’ll get a different strain, only time will tell.”In a similar vein, an Alabama health official said there may not be enough vaccine doses to immunize people outside the priority groups until late December. He and other officials said the vaccine shortage has hurt the credibility of public health at all levels.In other comments, federal health officials described the slow growth of the vaccine virus as the fundamental reason for the current vaccine shortage and suggested that vaccine production difficulties are likely to continue as long as the process relies on growing actual flu viruses, as opposed to producing specific viral proteins.’Virus seems to be winning’Rep. David Obey, D-Wis., chair of the subcommittee, voiced frustration over the vaccine shortage and said the same kinds of problems in flu vaccine production were discussed back in 2004 and 2005. In opening the session, he said the nation has made significant strides since the pandemic virus emerged, “but despite some successes, the virus seems to be winning.”In a brief update on the H1N1 situation, Frieden said the nation has now had “many, many millions of cases” of the illness, well over 20,000 hospitalizations, and more than 1,000 deaths, including 114 children.He asserted that the illness “is no more severe than seasonal flu” but affects a different pattern of age-groups, as more than 90% of deaths are in people younger than 65—a sharp contrast to the seasonal virus.As for the vaccine supply, Frieden said, “With 20-20 hindsight it’s clear we should have been more skeptical” about projections of production timing.Dr. Nicole Lurie, Department of Health and Human Services (HHS) assistant secretary for preparedness and response, said the cumulative vaccine production today reached 32.4 million doses. Despite repeated questions by the committee, she and Frieden firmly refused to make any new predictions about the flow of vaccine.”To be quite honest, flu is really unpredictable, and we’re very hesitant about projecting forward more than week to week, largely because anything could happen,” said Lurie.Shortage’s impact on states and localitiesDr. Donald Williamson, Alabama’s state health officer, said the vaccine shortage has forced Alabama to change its H1N1 vaccination strategy.In September Alabama officials were told they could expect to get about 800,000 doses of vaccine by the end of October, but by Oct 23 the estimated amount was cut to about 400,000 doses, Williamson reported.”Current projections show that 62% of the vaccine coming to Alabama won’t be available until after December 1,” he said. Further, it may not be possible to expand the vaccine to all Alabamans who want it until late December or January.Because of the shortfall, the state decided to focus its vaccination efforts on the subpriority groups identified by the CDC and the providers most likely to serve them, rather than the broader priority groups. (The subpriority groups are pregnant women, healthcare workers, children 6 months through 4 years old, caregivers of babies under 6 months, and children between 5 and 18 with health conditions that put them at risk.)In line with the strategy switch, school-based vaccination clinics have been postponed until late November or early December, Williamson said.Rob Fulton, director of the St. Paul–Ramsey County Public Health Department in Minnesota, told the committee, “We know that the credibility of the entire public health system is in question because of the slow arrival of vaccine.”Like Williamson, he said the slow flow of doses is disrupting vaccination plans. For example, he said the county is anticipating getting 7,800 doses for school children age 9 and under, but the actual population in this age-group is 20,000. (Two doses of vaccine are recommended for children under age 10.)Fulton also commented that 135 of his department’s 320 employees are involved in the H1N1 response at least part-time, which means they have less time to spend on their regular work.Williamson said the vaccine shortage not only undermines public health’s credibility, but also leads people to question the vaccine’s safety. He also voiced concern about the public’s willingness to get the immunization later in the season when supplies finally improve.Root of the problemIn discussion about the cause of the vaccine delays, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), said the basic problem was the slow growth of the vaccine virus in eggs, in combination with the timing of the epidemic.The virus emerged in April, about 3 months later than planning for seasonal flu vaccine normally begins, he said. Then the virus never went away in the summer and was waiting when children went back to school, sparking an epidemic much earlier in the fall than usual, he added.”You have flu waiting for you when the kids go back to school and you have a slow grower, that’s the answer,” Fauci said.Obey asked if the need to provide some vaccine free of thimerosal, a mercury-containing preservative, contributed to the vaccine delays. Thimerosal-free vaccine is produced in individual syringes; putting vaccine in multidose vials is faster but requires thimerosal.Fauci said production of thimerosal-free vaccine probably contributed “a bit” to delays, but was not the major issue. “The fundamental basic problem is the virus not growing well,” he said.Lurie said one of the steps HHS has taken to speed production was to ask the manufacturers to shift production to multidose vials as much as possible.She acknowledged that HHS so far has ordered the filling and finishing of only 117 million of the total 250 million doses of bulk vaccine it has contracted for. “This week we’ve issued orders for more vaccine [to be filled and finished] so we don’t have a gap,” she said. “That 117 million has taken us further into the year than we thought it would.”Lurie said the agency is using a staged approach to filling and finishing because it doesn’t want to have a lot of leftover finished vaccine. “It’s better to keep it in bulk form so it could be used in the seasonal campaign next year or could be used potentially in the developing world.”Fauci asserted that the vaccine makers are not to blame for the vaccine delays. “I don’t want anyone to get the impression that it’s the drug companies’ fault this has happened,” he said. “It’s just the nature of the biology of the virus that it created an expectation that there’d be a certain amount.”The ‘end game’ for vaccine technologyFederal officials were questioned about the use of cell-based methods to make flu vaccines, as is now done to some extent in Europe. Cell-based production is considered more flexible and reliable and somewhat faster than the 1950s method of growing the vaccine virus in chicken eggs.Lurie noted that a cell-based vaccine plant is being built by Novartis in North Carolina and is expected to be ready to start making vaccine in 2011. But how soon a cell-based flu vaccine will win Food and Drug Administration approval is uncertain, she added.The Novartis plant “will get us a little shy of halfway to what our pandemic goal will be,” to make enough vaccine for the entire population, she said.Fauci said cell-based technology will be an improvement but is not the final answer to flu vaccine production problems. “We want to take vaccinology into the 21st century by not requiring the virus to grow. . . . The end game is to get away from requiring the virus to grow.”He said a number of newer approaches involve making particular viral proteins instead of growing the whole virus. One example is using baculovirus, an insect virus, to make the gene for hemagglutinin. He said one company is conducting phase 3 trials of a vaccine using that technique.”What we’re going to see over the next years is a gradual transition from egg-based [vaccine] to egg-based with cell-based to advanced molecular technology,” Fauci predicted.But the ultimate goal, he said, is to make a universal flu vaccine—one that targets a component of the flu virus that doesn’t change from season to season. Such a vaccine could be made and stored in large quantities, and people wouldn’t have to be vaccinated every year.”That’s the plan. That’s going to take years,” he said.
“The data consists of workers, informal workers and laid-off workers in tourism, as well as workers from the creative economy, such as artists, performers and members or employees of various television and film associations,” he said.According to the Office of the Coordinating Economic Minister, which spearheads the national committee for job creation, the preemployment program had garnered 1.4 million applicants just a day after registration opened on Saturday.The government has doubled its budget for the program to about Rp 20 trillion (US$1.27 billion) to upskill about 5.6 million workers who have lost their jobs because of the COVID-19 pandemic.Participants of the preemployment card program will undergo training for four months and each will receive Rp 3.5 million; Rp 1 million for training costs, monthly pocket money worth Rp 600,000 for four months and Rp 150,000 for survey expenses. The money will be transferred to their bank accounts or to their digital wallets, such as GoPay and LinkAja. The COVID-19 pandemic has left tourist destinations across the county empty of visitors. Many hotels have been temporarily closed due to a lack of guests.As of Wednesday, 1,266 hotels have temporarily halted operations, according to Indonesian Hotel and Restaurant Association (PHR) chairman Hariyadi Sukamdani.Of those, 844 hotels have registered 74,100 of their former employees for the preemployment card program.“Many hotels have not provided data on their former employees. We’re worried that many hotels don’t really care about their former employees, who really needed help getting new jobs,” Hariyadi said.He added that collecting data on affected workers in the hotel and restaurant industry alone was challenging as many businesses were lagging in providing the PHRI the necessary information. Meanwhile, the association also needed time to review and verify the data before submitting it to the government. “So, the data collection process has been pretty slow,” he said on Wednesday.Association of Indonesian Tour and Travel Agencies (ASITA) chairman Nunung Rusmiati also said that ASITA’s 7,000 members had been trying not to lay off workers, even though the outbreak had crippled their business.Many association members have decided to keep their workers but carry out extra cost-efficiency measures, such as cutting salaries by 50 percent, in order to survive.“If we don’t cut their salaries, we would really struggle […] We are also offering employees unpaid leave,” Nunung said.According to Hariyadi, who is also chairman of the Indonesia Employers Association (Apindo), amusement parks and zoos have also been greatly affected by COVID-19. With almost no visitors, many have not been able to operate, which leaves their workers and animals at risk. “We hope that this sector will also receive attention from the government.” Nearly 190,000 former tourism workers will join the government’s preemployment card program, which was established to help terminated employees find new jobs, a minister has said.Indonesia’s tourism has been hit hard by the COVID-19 outbreak, which has shut down borders and put a halt to global travel.The data on people who previously worked in hotels and other tourism-related companies across Indonesia is taken from related business associations and organizations, Tourism and Creative Economy Minister Wishnutama Kusubandio said in Jakarta on Sunday. Topics :
With almost 1000sq m of living space, the Singaporean Federation-style house features soaring ceilings, two fireplaces, panelled walls and polished timber floors. It has multiple living areas and entertaining spaces including a fully-equipped theatre, a bar room and a home office with kitchenette on the lower level with a separate entry. Mr Gordon said his family had hosted many memorable events at Winbrook, including the inaugural Winbrook Invitational Tennis Tournament and his son’s 21st birthday that included 120 guests. Elegantly restored to its magnificent former glory by Mr Gordon’s interior designer partner Lisa Page, the five-bedroom five-bathroom house dates back to the early 1900s and sits on a sprawling 3383sq m block in Kalinga. 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This modal can be closed by pressing the Escape key or activating the close button.PlayMuteCurrent Time 0:00/Duration 0:00Loaded: 0%Stream Type LIVESeek to live, currently playing liveLIVERemaining Time -0:00 Playback Rate1xFullscreenHow to bid at auction for your dream home? 01:45During a summer inspection of the historical inner-city “Winbrook’ estate, the owners found it abandoned, as though a family had just suddenly gotten up and left leaving all their belongings behind.“We bought the house in January 2018 and it had been vacant for about five years before that and actually wasn’t even on the market at the time,” mining industry veteran Brad Gordon said.“When we saw the property, it was in such a state of disrepair, but we saw that it had potential and knew the history of the place.” MORE NEWS: Mayor sells waterfront property Entry to the historical property is through electronic gates and through a long landscaped circular driveway that once belonged to the adjoining heritage-listed Kedron Lodge, built in the late 1860s.“Although vacant for at least five years, it had been occupied for brief periods of time throughout. When we first walked through it, it appeared as if the family had just got up and left,” Mr Gordon said.“There were colouring-in books on tables and crayons strewn across them. Clothes and toys were simply left where they had been dropped.”Mr Gordon said none of the essential services worked so there was no running water, power or any telecommunication connections. Most of the heavy lifting in regards to the renovation was completed in 2018, but the last room, the master ensuite, was finished a few months ago.“Lisa is an accomplished interior designer and this incredible restoration is thanks to her efforts. Sure, I was behind the end of a shovel at times but it’s her vision and talents that have transformed this magnificent property,” he said. Meet Brisbane’s house detectives Brisbane’s best suburbs to invest in Arguably the most opulent room in the house, the master bedroom, boasts a parents’ retreat, walk-in wardrobe, an ensuite with a freestanding tub and bi-folding glass doors that open to a balcony that wraps around north-facing parts of the house.A decadent entertainer’s kitchen overlooking a living/dining area has a butler’s pantry, barista café station, a fridge drawer, two dishwaters, dual ovens, European appliances and sparkling water on tap. More from newsParks and wildlife the new lust-haves post coronavirus10 hours agoNoosa’s best beachfront penthouse is about to hit the market10 hours ago He said they were kept entertained by the property’s swimming pool, spa, two lounging cabanas and a floodlit championships size tennis court with elevated spectator’s rotunda.Additional executive features include a wine cellar, gym, 12 CCTV cameras, a four-car garage, a home automation and video intercoms system and an under-house water tank with pump and garden irrigation system. “I’ve lived in acreage before and we were living in an apartment in London before moving back to Australia in 2017, an experience that we won’t repeat,” Mr Gordon said.“But life at Winbrook has been fabulous, we don’t have any neighbours, it has an acreage feel and we’re just 5km from the city and back on to Kedron Brook. It genuinely it feels like you’re living in the county.” Winbrook is being marketed by Ray White New Farm agent Christine Rudolph and will go under the hammer at 2pm tomorrow (Saturday, November 30).