WOW! US Gov Contract DOUBLED for Presidential Emergency Declaration

FEMA just DOUBLED a contract for 4 Billion Dollars in case of a Presidential Emergency Declaration. The contract was just let at the 1st of January and 15 days later something happened to make FEMA double the budget. The primary unplanned for situation that pops to mind during this time frame is the SARS-like outbreak coming from CHINA. Note this is just top of the Pyramid type spending; Billions and Billions more will have to be thrown at a major outbreak, fortunately most of that planning was already done in contracts tied the H7N9 influenza outbreak the fizzled several years back. Unfortunately the media is not reliable enough to accurately characterize the risk associated with this Coronavirus outbreak. Typically if the media and CDC is fomenting panic it is for clicks/views and budget increases. But if the media and CDC publicly underplay a disease risk it is because they fear a public panic will interfere with their planned actions. It is recognizing this latter situation that allows the astute observer to react prior to the herd of humanity stampeding. Often the best risk assessment can be garnered by looking at what the Government is contracting in reference to any particular situation. The fact that FEMA just had to DOUBLE its spending limit, just days after the settling a contract, for top level Presidential level disaster response is telling. Our initial assessment is that People will NOT be dropping like flies; that said, it takes very little to disturb the normalcy of a 1st World medical system. The SARS-like outbreak has the potential to shut down hospitals, dialysis clinics, and make normal medical treatment difficult to find. More people would be likely to die from being shut out of treatment for normally treatable chronic diseases than would from the SARS-like virus itself. More to follow: Sources:

https://beta.sam.gov/opp/844a15b48a8546b3affd9c0e146dde63/view?keywords=fema&sort=-modifiedDate&index=opp&is_active=true&page=1 https://washingtontechnology.com/articles/2018/01/02/fema-response-contract.aspx?m=1

National Institutes of Health Orders a One Year Stockpile of "EMERGENCY DISASTER EVENT PREPARATION FOR PERSONAL PROTECTIVE EQUIPMENT"

The National Institutes of Health [NIH] just placed a solicitation  to stockpile an entire year's worth of Personal Protective Equipment [PPE] to support eight agencies inside of NIH. They are placing the massive order in case there is a disruption in supply of medical goods like goggles, gloves, gowns, masks, spacesuits.

The NIH's rationale is that the animal testing they are doing is so vitally important that no disruption in supplies can be risked. Apparently the disruption in PPE supply is expect to last at least one full year, and they have an option to carry it on for four more years.

"This Sources Sought Notice has been posted to establish, provide, and maintain a laboratory animal personnel protective equipment (PPE) resource to ensure the accessibility and availability of essential supplies throughout an emergency/disaster, government shutdown, or any other interruption of regular deliveries. These supplies support irreplaceable multidisciplinary animal research, which is critical to the mission of eight institutes at the National Institutes of Health."

 "During emergency/disaster events, the normal supply and distribution channels will most likely be unavailable/or protracted due to the impact of the emergency and the rush of immediate orders. Our program's disaster plan takes these factors into account; it is therefore our intention is to establish an offsite source of critical supplies with an established, laboratory animal PPE vendor with a proven track record of providing quality products and services. As outlined in our emergency plan it is the intention of our program to be able to house up to a one year's supply of PPE products with a local vendor within a 90 mile radius of NIH in Bethesda, Maryland."

A few near term risks that potential could make PPE unavailable for an entire year are:

1) EBOLA
2) H7N9 BirdFlu
3) MERS-CoV

The POTRBLOG team believes that this contract clearly indicates that the Government expects a protracted shortage of medical PPE, and that the window of opportunity for individuals to purchase needed PPE at reasonable prices is now at a close.

Sources:

Solicitation Number: HHS-NIH-OD-OLAO-SBSS-15-001

Aerosolizing ONE DROP of Ebola Infected Blood Can Kill 500,000 People

US ARMY Says EBOLA = FLU in Airborne Stability, Needs Winter Weather To Go Airborne

Ebola Bodily Fluids Readily Weaponizable Using An Ultrasonic Humidifier

Ebola Emergency ZMAPP Production Rates & Costs

CDC's "Lesser Of Evils" Double Standard On Health Care Worker Protection Indicates They Expect a Large Ebola Outbreak In USA

CDC Warns Hospitals On EBOLA "CONTAMINATED AIR" and Directs use of "Airborne Infection Isolation Room"s

Inhalation Ebola: Governments Ready For World War Ebola

CDC Sees AIRBORNE EBOLA Transmission, Issues Guidance For Aircraft Flight Crews, Cleaning & Cargo Crews

 CDC is already evacuating DOUBLE the number of expected Ebola infected personnel at a rate of 7 doctors per month

US Government on H7N9 MERS EBOLA Pandemic Purchasing Spree: Millions for Adjuvanted Vaccine; Ventilators; Doxycycline Injections; Mobile Killing Chambers; Air MEDEVAC

Fall 2014 is starting to look much like Fall 2013 in terms of the Federal Government Pandemic Spending

In the last week:

(1) HHS gave Sanofi Pasteur $105 million to produce an adjuvanted H7N9 influenza vaccine; Last year they purchased the syringes needed to give EVERY American two of these vaccinations. Even more troubling the CDC had ALWAYS previously banned the use of adjuvanted flu vaccines in the USA because they were considered dangerous.


(2) HHS also gave PHILIPS RESPIRONICS  a $46 million dollar sweet heart deal funding the entire R&D development to production cycle of 10,000 Advanced All Hazard Stockpile Ventilators (AAHSV)


(3) The US Army ordered a stockpile of test reagents for H7N9 and MERS-CoV specifically

"in preparation for potential pandemic outbreak of H7N9 and/or novel Middle East Coronavirus".

(4) The Department of Defense has also placed a large order for Doxycycline Hyclate Injections to fill their Pandemic Influenza Stockpile. Interestingly, there is also a US Patent on the use of Doxycycline to spur blood serum treatments for Ebola, as has been recommended by WHO to treat Ebola infections. The supply has been directed to USNORTHCOM, meaning the outbreak is expected to occur in North America. It also just happens that this drug is currently in critically short supply in the US.


(5) The USDA has awarded a contract to build multiple Mobile Modified Atmosphere Killing Trailers

"for the depopulation of poultry in response to an animal health emergency such as a catastrophic infectious poultry disease" aka H7N9 Bird Flu

(6) And not to feel left out, The US State Department expects its going to have to do A LOT of Ultra high infectious containment Aeromedical Evacuations after February 2015. As such, they have put out an RFI seeking additional EBOLA type air ambulance medical flight airlift capability.



Of course all of these expenditures just scratch the surface of the pandemic preparations the US Government undertook in 2013. If the population had just an inkling of what was actively being prepared for, they'd be in Church as if it were Christmas and Easter combined.

Our Analysis:

H7N9 is low risk with medium impact. Its had every chance to go Global and has not. If it appears NATURALLY in the USA, hot points for infection are river deltas like San Francisco, Houston, and New Orleans

MERS is a low to medium risk with medium impact. MERS has had several chances to breakout at HAJJ and has not. But since MERS outbreaks have previously occurred 6 months out of phase with HAJJ, mostly in Spring camel birthing season, a human infection carry over into October might allow HAJJ to be fuel to the fire. That said, the spread of MERS seems to be tied to behaviors related to Eastern toilet habits and Islamic palliative care,

EBOLA is High Risk with High Impact. The experts at the ARMY's Aerobiological Science center report that Ebola has an airborne stability like Flu, and that Winter type weather may allow for airborne spread to occur. One must also consider the Airborne implications of Ebola victims have co-infections with Cold, Flu, Tuberculosis, or even seasonal allergies. All these factors make for the potential of an EXPLOSIVE number of Ebola cases in cold weather climates.

Source and background info:

Award is for the development of an adjuvanted pandemic influenza vaccine.

Advanced All-Hazards Stockpile Ventilator

preparation for potential pandemic outbreak of H7N9 and/or novel Middle East Coronavirus.

Doxycycline Injection

Doxycycline Hyclate Injection Shortage

Compositions and methods for treating hemorrhagic virus infections and other disorders

Mobile Modified Atmosphere Killing Trailers

Emergency Aero-Medical Services

US ARMY Says EBOLA = FLU in Airborne Stability, Needs Winter Weather To Go Airborne

[H7N9 Vaccine] New Information, Its MORE Dangerous Than Previously Thought

[ALERT!] ALL 300 Million American Citizens WILL Be Given TWO Experimental Adjuvant Laced H7N9 Vaccinations!

BIRD FLU: US Government quietly orders 600 Million syringes stockpiled in 10 Cities

CDC Contracting With Poison Control Centers and 2-1-1 to Create Public 'Phone-In' Bird Flu Triage Centers

Systems & Intrinsic Disorder: MERS-CoV's "Hard Shell" Is Key To Understanding Its Epidemiology

The Best High Throughput "No Touch" Ebola Fever Thermometer

The latest and greatest "no touch" fever thermometer with the potential highest victim through-put rate is the the VisioFocus made by Tecnimed in Italy. The thermometer directly displays a person's temperature on their forehead as the temperature is being taken.

The beauty of this display feature is that medical personnel do not have to touch or take their eyes off the person being measured. This lack of handling and fumbling with the thermometer means that any group of people being scanned can be more rapidly moved through the queue.

The draw backs to these types of no touch thermometers is that they measure skin temperature and an offset is automatically applied to determine core body temperature (oral, anal, or axial). Environmental conditions can alter heat transfer rates off of the skin, thereby making measurements less accurate.

The thermometer is also able to measure the temperature of household objects, such as baby milk bottles. This capability also allows the device to be rapidly calibrated if the thermometer has undergone a rapid temperature swing, such as from a cold winter day to a warm inside room. The unit displays in both degrees Fahrenheit and Celsius.

Another obvious drawback to the unit is that one can not take one's own temperature without the aide of a mirror to make sure the thermometer is at the right focal distance away from the forehead or eyelid.

For greater insight watch the video.

SURVEILLANCE ALERT! CDC Immigration Unit Using Wisconsin School System As a Petri Dish For Pandemic Early Warning

There something unethical about using a school system as vertebral Petri dish to run infectious disease epidemiological experiments.

CDC and HHS are dumping  illegal immigrants (and legitimate refugees) into Wisconsin's school system with seemingly little to no effective  preventative medical care, and as such the CDC sees this as an opportunity to use an undisclosed school system in Wisconsin  as a Pandemic Canary in a Coal Mine for advanced warning of a Pandemic outbreak.

"The Centers for Disease Control and Prevention (CDC),
National Center for Emerging and Zoonotic Infectious Diseases
(NCEZID), Division of Global Migration and Quarantine (DGMQ),
requests approval of a new information collection to better
understand the triggers, timing and duration of the use of
school related measures for preventing and controlling the
spread of influenza during the next pandemic. 

The information collection for which approval is sought is
in accordance with DGMQ/CDC’s mission to reduce morbidity and mortality in mobile populations, and to prevent the introduction, transmission, or spread of communicable diseases within the United States. Insights gained from this information collection will assist in the planning and implementation of CDC
Pre-Pandemic Guidance on the use of school related measures,
including school closures, to slow transmission during an
influenza pandemic."

Odds are that the same thing is happening in other states, but CDC apparently thinks Wisconsin has the most suitable "mobile" population. In that regard, news media has been reporting that thousands of children of Central America are being sent to Wisconsin. The CDC plans to monitor approximately 1500 of these kids.

"Milwaukee, WI (WTAQ) - Wisconsin might end up housing some of the thousands of children who are now flooding into the country from Guatemala, El Salvador, and Honduras. The Federal Emergency Management Agency has asked the Catholic Charities organization to look for places that can handle the unaccompanied children. Father David Bergner of Catholic Charities in Milwaukee says he's been asked to find potential sites that could hold 100-to-300 kids."

In short,  what this public health debacle means is that you really really don't won't your kids in that school system; the CDC is eying it for a reason. A reason that might not exist if CDC and HHS took better preventative action before dumping these kids into a school system like they were swabbing bacteria into a petri dish. Even in the 1900's they at least knew enough to run new comers through a quarantine-able Ellis ISLAND before sending them on their merry way.

Heck, maybe its possible the CDC is just nostalgic for all those diseases public health wiped out of the United States in the 1900's. Maybe its all just part of some sort of EPA mandate to reintroduce endangered bacterial and viral fauna back into their old stomping ground. After all, whats the worse that could happen except increased job security for the CDC.

Sources:

http://www.ofr.gov/(S(ceta5szhejoorj53ewpyzdhu))/OFRUpload/OFRData/2014-17051_PI.pdf

Central American immigrants could be coming to Wisconsin

Looks Like Arizona Had/Has A Probable MERS Case and DIDN"T REPORT IT TO THE CDC

CDC recently altered its MERS case definitions and they have also loosened up who can be tested for MERS. As we posted yesterday these actions seem to stem from asymptomatic discoveries made during the 500+ people they tested after the two recent confirmed cases (all of which the CDC has been very secretive about).

But there was an additional suspected MERS case in Arizona that according to the Arizona Health Director's blog was not reported up to the CDC. Based on the CDC's recent changes to how they define what a MERS case is, it appears ARIZONA HAD/HAS A PROBABLE MERS and that it did not get reported to the CDC.

"The person had a travel history to Saudi Arabia and was exposed to sick people.  The person had MERS-compatible signs, symptoms, and incubation period- so alert healthcare providers collected specimens for us to test at our State Lab. We received specimens on Monday night and tested them on Tuesday- and by mid-afternoon Tuesday we knew that the samples were negative.  If it had been positive, we would have sent it to the CDC for confirmation"

Given the recent changes by the CDC, it appears quarantine stations at US points of entry are going to go into MERS testing overdrive

Sources:

http://www.cdc.gov/coronavirus/mers/case-def.html

http://directorsblog.health.azdhs.gov/mers-cov-x-2/

ALERT: CDC Alters Emergency MERS Testing To Target Asymptomatic Individuals

ALERT: CDC Alters Emergency MERS Testing To Target Asymptomatic Individuals

The CDC has had the Emergency Use Authorization for the experimental MERS-Cov test changed so that they may now test individuals without any direct probable cause that they are infected.

"The amendments authorize the expanded use of the CDC assay to include testing persons who may not be exhibiting signs and symptoms associated with MERS-CoV infection, but who meet certain epidemiological risk factors (e.g., contact with a probable or confirmed MERS-CoV case, history of travel to geographic locations where MERS-CoV cases were detected, or other epidemiologic links for which MERS-CoV testing may be indicated as part of a public health investigation)" 

The obvious rationale for this Emergency Use change is to support a broad scope MERS testing campaign of all individuals returning from Saudi Arabia after the 2014 Hajj. CDC has been upgrading its capabilities at Quarantine Stations across the country for just such an eventuality. However, there are other indications that this Emergency Use alteration has to do with un-released test results from people exposed to the most recent USA MERS cases. In that regard, we have been expecting some sort of MERS shift out of the CDC.

The first clue something was afoot was when the CDC recently went against its own MERS case definition to declare an individual who had met with a known MERS case and who had tested positive for MERS-CoV as not really having a MERS-CoV infection. The CDC followed that action by withholding MERS test results from exposed persons in Missouri and Virginia; and probably more locations we don't yet know about.

Our suspicion is that out of the recent USA MERS cases there were multiple exposed asymptomatic individuals who have tested positive for MERS, and that these people may be capable of spreading MERS. Given the CDC's timing of the Emergency Use change, relative to the CDC's suppression of MERS test results, it is difficult to discount that the CDC's new found interest in asymptomatic MERS cases confirms our suspicions of unusual test results.

While we still hold to the opinion that MERS has a low risk of ongoing chain transmissions outside of the Muslim and Eastern World, CDC's activities regarding MERS testing may indicate otherwise. Moreover, given Saint Louis's bookending of MERS cases in Chicago and testing in Springfield Missouri, we have to admit that the spread of a Zoonotic Bronchitis in our family after a trip to Six Flags did bring thoughts of a readily spread but low impact MERS back to the forefront. Had the CDC acted a few weeks earlier in expanding the Emergency Use Authorization for MERS testing, we could have been tested.

Obviously the CDC can't find what it is not looking for, but with their new expanded Emergency Use criteria it is possible the reports of wide spread Bronchitis in locations common to known USA MERS infections may just lead to further MERS positive test results.

Sources;

http://www.fda.gov/medicaldevices/safety/emergencysituations/ucm161496.htm

http://www.fda.gov/downloads/MedicalDevices/Safety/EmergencySituations/UCM400989.pdf

www.sickweather.com

US Government Showing Major Concern For A Devastating ZERO DAY Pandemic Exploit

Systems & Intrinsic Disorder: MERS-CoV's "Hard Shell" Is Key To Understanding Its Epidemiology

CDC Threatening Pilots With Legal Action For Not Reporting Sick Travelers On Interstate Or International Flights

MERS Testing & Massive Hepatitis Alert in Springfield Missouri, CONNECTED?

Coughing fest @#6Flags 5 days later we've got it too, plus a cat with severe rales. May be #zoonotic coincidence but #MERS did come to mind.
— Potrblog.com (@Potrblog) June 1, 2014

Our cases of #CamelCough close 2 over; the cat recovered 2 Though its still spreading in #STL ; & no #CDC updates on #Mo #MERS test results.
— Potrblog.com (@Potrblog) June 17, 2014

Systems & Intrinsic Disorder: MERS-CoV's "Hard Shell" Is Key To Understanding Its Epidemiology

Since 2012 our take on MERS is that it is either wide spread (via Hajj) and of little risk, or that its not very contagious and again of little risk. Since that time, enough epidemiological information has come forth for us to deduce from a systems analysis that MERS-CoV has adapted itself to thrive in a very specific anthropogenic environment and outside of that (or similar) environment MERS-CoV won't sustain deadly pandemic reproduction.

Our hypothesis is that MERS-CoV's specific adaptation is the development of a "Hard Shell". That hardened shell allows MERS-CoV to survive in desert fecal aerosols, while also allowing it to survive as a wet fecal fomite or aerosol, even after Islamic cleansing rituals have taken place.

Based on our analysis, a search of relevant literature showed that others have come to a similar conclusion but a via a completely different path. (see sources below) Their path was based on determining the amount of 'flexibility' in MERS-CoV's inner and outer shells via Protein Intrinsic Disorder Prediction. The conclusion was that of all the Corona viruses modeled, MERS-CoV showed the lowest disorder /  hardest shell, and thusly was likely fecally transmitted .

Frankly, this finding should not be surprising since other animal Coronaviruses like SARS and Feline-CoV have been documented to spread via aerosolized wet feces and aerosol dry fomite dissemination. Where as, Human cold causing Cornoaviruses are believed to be spread via sneezing and coughing.

What it means in the Desert:

The dry environmental spread of MERS-CoV is likely from a desert dwelling animal that produces very dry dung. The Camel is a prime example, its fresh dung is immediately ready for burning, and is often collected for that purpose. Its safe to assume that people down wind of Camel (or Human) desert deposited excretia are at risk if Human disease producing MERS-CoV is present . For MERS to survive this kind of dust blown dehydrated environment it likely must have a hard shell.

What it means in the Hospital:

The other unusual aspect of MERS infection is that chain transmission has occurred only in hospitals in the Kingdom of Saudi Arabia [KSA]. Given the wealth, and Islamic piousness observed in KSA, this means that MERS-CoV must transmit in a western medical environment which strictly follows Islamic cleansing / palliative care requirements.

In short, KSA's wealth allows more health care workers per patient; a lot more health care worker exposure to fecal matter via close physical patient contact/care; and significant health care worker inter-exposure via common restrooms in which no toilet paper is used to block fecal hand contact, but instead soapy hands are relied for posterior cleanliness. For MERS to survive in this environment, it must have some resistance to soapy water aerosolization or fomite deposition degradation; again this points to a hard shell.

What it means outside of Saudi Arabia:

Given the lack of deadly MERS chain transmission outside of KSA, and our previous stated conclusions; it appears that lethal MERS transmission requires a minimum exposure dose, one which MERS has adapted to allow KSA hospital care to deliver. Outside of a wealthy discrete healthcare environment, similar dose exposures in a distributed environment might be expected to occur in poor, high population density areas with similar cultural / religious practices. This epidemiological analytical transformation is analogous to a MERS smart bomb on discrete target vs a cluster bomb on an area target. One might also expect chain transmission to occur in western nursing homes.

What it means for HAJJ:

HAJJ has not yet supported deadly MERS chain transmission, but that does not rule out that it will.

Quick Conjectures:

#1 One possibility is that Camel Coronavirus in Humans is to MERS, as Feline Coronavirus[FCoV] in Cats is to Feline Infectious Peritonitis [FIP]. CATS living in high density populations often have FCoV, but only in a small percentage of cats does that infection internally mutate into the disease manifesting version which causes FIP. The disease causing version is not believed to be transmittable to other cats. Since MERS is transmissible, a worst case reinforcing scenario would be a human MERS patient infecting a Camel with "human MERS".

#2 Camel herders are immune to MERS akin to the way in which Milk Maids were immune to SmallPox.

#3 If the in country dwell time for HAJJ pilgrims remains below the median time for symptom onset from exposure, the odds are an outbreak inside of Saudi Arabia is self limiting.

#4 The risk of a massive MERS outbreak at Hajj increases as a function of KSA's gross domestic product per (transient population) capita decreases.

Sources:

Prediction of Intrinsic Disorder in MERS-CoV/HCoV-EMC Supports a High Oral-Fecal Transmission

Bedouin Camel Coprophagia Dysentery Cure A Pathway For MERS Infection

MERS Likely Spread Via Islamic Palliative Healthcare

MERS-CoV Infection Via Diarrhea & Eastern Toilet Habits

Feline Infectious Peritonitis

How cats become infected with feline coronavirus, the virus which causes FIP

.

Bedouin Camel Coprophagia Dysentery Cure A Pathway For MERS Infection

Its abundantly clear that MERS-CoV transmission is fecal based (more on that in a follow on post). In that regard, one important but embarrassingly overlooked source for Camel to Human MERS-CoV transmission is the Bedouin practice of eating fresh steaming camel dung to treat dysentery.

Based on this connection, one might expect that most camel turds are consumed by people during the flood season when dysentery may be at its highest. Of course one might also assume that this treatment is most used when one is out in the desert and away from the cities. Tracking the epidemiological correlations may be telling in regards to MERS first appearance and subsequent peaks.

Now as nasty as Camel Coprophagia may seem, if you're dying in the middle of the desert and the obviously healthy native people tell you that you better chomp down of a fresh steaming camel turd if you want to stay alive, what do you do? Reportedly this is the exact situation the Nazi army in North Africa faced in WW2. The Nazis ended up placing fresh hot camel turd on the menu, and a few medical innovations followed.

Sources:

More on Merde

Ralph A. Lewin

From: Perspectives in Biology and Medicine
Volume 44, Number 4, Autumn 2001
pp. 594-607 | 10.1353/pbm.2001.0067

MERS Likely Spread Via Islamic Palliative Healthcare

MERS-CoV Infection Via Diarrhea & Eastern Toilet Habits

US Navy And Genetically Engineered Human-Cow Hybrid's Polyclonal Antibodies Coming To MERS Rescue

A senior 'vaccine' scientist at US Navy's Naval Medical Research Unit (NAMRU) placed an order for a large amount of anti-MERS Polyclonal Antibodies produced by Sanford Applied Biosciences (SAB). This order no doubt will help SAB's bottom line with its hyper MERS infected trans-human cows, which produce such Polyclonal antibodies.

Given the cows are being infected with MERS-CoV, and given that its transmitted in feces, one hopes that these cows-human hybrids only poop in a bio-level 3 containment facility that doesn't compost its waste. We would not want to be down wind of those farmers fields. 

If NAMRU's research on the Polyclonal treatments for MERS infections is successful, SAB may be in for a large windfall. Of course, it still remains to be seen if serum derived from trans-human cows will be considered  halal or harram by MERS primary victims.

Sources:

Anti-MERS COV Polyclonal Antibodys

Solicitation Number: N3239814RCVB001

Agency: Department of the Navy
Office: Bureau of Medicine and Surgery
Location: Naval Medical Research Center

MERS-CoV Infection Via Diarrhea & Eastern Toilet Habits

Triple Immunoglobulin Gene Knockout Transchromosomic Cattle: Bovine Lambda Cluster Deletion and Its Effect on Fully Human Polyclonal Antibody Production

Cows offer hope against human illness

MERS Likely Spread Via Islamic Palliative Healthcare

ALERT! CDC Threatening Pilots With Legal Action For Not Reporting Sick Travelers On Interstate Or International Flights

The Centers For Disease Control has released a flyer which threatens Airline pilots with legal action if they do not report ill travelers. The document specifies that both International and Interstate passengers must be reported if they are ill.  Obviously this action is an indication that either a pandemic is underway or one is expected, and that air travel will be how the pandemic spreads. (STAY OUT OF AIRCRAFT RESTROOMS)

As we have previously reported, The US government is showing major concern for a devastating 'zero day' pandemic exploit and is significantly increasing Federal Quarantine Station capacity/ capability. The CDC has also ordered its employees to prepare for a National / International disaster.

The obvious candidates for CDC's actions are MERS, EBOLA, H7N9 Bird Flu and H1N1 Swine Flu. Of these only EBOLA seems to be of any immediate (albeit fleeting) threat, and as such the Department of Defense has deployed EBOLA detection kits to National Guard units in all 50 states and to military units in South Korea.

Of  the other threats, MERS and H7N9 are primarily adapted to their locations/cultures of origin/mass detection, and as such the threat of ongoing chain infection-transmission outside those locales/cultures seems low. Albeit, current MERS protocol involves quarantining all health care personnel who had initial contact with the infected person, meaning even a few cases could shut down the health care system.  In regards to H1N1, the possibility of a more severe 2nd wave in the Fall should not be discounted.

UPDATE 5/27/14: CDC just created a job openings for a
"Public Health Advisor (Quarrantine Program)" sic

Job Title:Public Health Advisor (Quarrantine Program)

Department:Department Of Health And Human Services

Agency:Centers for Disease Control and Prevention

Job Announcement Number:HHS-CDC-D3-14-1125484

 https://www.usajobs.gov/GetJob/ViewDetails/370536200

Sources:

MERS-CoV Infection Via Diarrhea & Eastern Toilet Habits, What You Need To Know

MERS Likely Spread Via Islamic Palliative Healthcare

US Government Showing Major Concern For A Devastating ZERO DAY Pandemic Exploit

DoD Has Deployed EBOLA Detection Kits to National Guard Units In All 50 States

CDC Orders Its Personnel to Prepare Their Families For National / International Disaster

US Licensing LIVE Rabies Based EBOLA Vaccine, Preps Pandemic Quarantine Stations & Injury Fund

MERS Testing & Massive Hepatitis Alert in Springfield Missouri, CONNECTED?

Updated: 5/22/14
The local department of health says these are "two completely separate incidents" (see sources below), however a prudent risk posture would indicate exercising caution as if they were related.
--------------------------------------------------------------------------------------------------------

A confluence of two public health situations in Springfield Missouri involving MERS and Hepatitis-A have caught our attention.

This morning Missouri Public health authorities have reported at least two people in Springfield are being tested for MERS;  This evening Missouri Public health authorities are asking around 5,000 people to come in for medical evaluation related to a Hepatitis exposure at a Springfield Red Robin Restaurant.

The question of course is: are these two events related; and if they are, is such subterfuge permissible from a public health perspective? The safe course of action is to prepare as if they are related.

When we look at the MERS data we perceive a virus that is primarily transmitted through feces (as is Hepatitis-A). We also suspect that there is a minimum contamination level below which one might test positive for MERS-CoV via blood testing, but not develop the syndrome. Over all we perceive a low risk from MERS (with some cultural/religious based transmission exceptions); however we don't discount that our analysis might be incorrect (or that mutation could alter the risk).

The number one preventative is to avoid fecal contact. In that regard, we have a conjecture that MERS may be somewhat resistant to soap; through hand washing is important.  The number one proactive measure is to wash with Hibiclens surgical scrub as it continues to kill enveloped virus for hours after having washed with it.

So, the question for Missouri Public Health is: Is the Hepatitis incident at Red Robin even remotely connected in ANY WAY to the possible MERS cases in Missouri? It would be wise to be prepared as if it does.

Sources:

http://www.news-leader.com/story/news/local/ozarks/2014/05/20/two-healthy-greene-county-residents-tested-mers/2275032/

http://www.usatoday.com/story/news/nation/2014/05/21/hepatitis-a-exposure/9392415/

MERS Likely Spread Via Islamic Palliative Healthcare

MERS-CoV Infection Via Diarrhea & Eastern Toilet Habits, What You Need To Know

@Potrblog two completely separate incidents.
— S-GC Health Dept. (@SGCHD) May 22, 2014

MERS Likely Spread Via Islamic Palliative Healthcare

There seem to be two risk factors for catching MERS-CoV
#1 Contact with Camels
#2 Being a healthcare worker in a Saudi Arabian hospital treating MERS patients

The risks from #1 are obvious, but why does #2 put people at risk? Well as we have discussed previously, Eastern countries handle bodily function "Number 2" differently than Western countries, see MERS-CoV Infection Via Diarrhea &; Eastern Toilet Habits, What You Need To Know.

In that regard, healthcare workers helping their palliative MERS patients fulfill Quranic religious requirements would be at greater risk of MERS transmission. This risk would especially be the case in the Kingdom of Saudi Arabia where one would expect the utmost dedication to these practices; in the same regard Western healthcare workers with less physical contact would have less opportunity for transmission.


Of course given the religious aspects, it's not the type of  infection vector which will be readily admitted too as some might consider it embarrassing. With that in mind, it is certainly much less embarrassing to blame transmission on an airborne route. However such a misdirection does nothing to solve the problem, even worse it serves to misdirect preventative resources. Rather than take embarrassment, the obvious solution is to increase infection control precautions for increased physical contact with patients.

For a thoughtful explanation of  what Palliative Care for Muslim Patients entails see this PDF
http://www.oncologypractice.com/jso/journal/articles/0306432.pdf
and this link which goes into great detail
http://www.salaam.co.uk/knowledge/hygiene.php

To sum it up:  avoid bathrooms in both Aircraft and Hospital Emergency rooms; and wash your hands with Hibiclens.

MERS-CoV Infection Via Diarrhea & Eastern Toilet Habits, What You Need To Know

The best translatability guide we have for the MERS-CoV  outbreak is likely the SARS-CoV outbreak in China. In that regard, it has been "found that SARS case-patients may have high concentrations of virus in stools during the 2nd week of illness and continue to shed the virus in feces until at least 26 days after onset of symptoms."

Its important to note that feces and bathrooms were noted as a being a source for SARS-CoV spread, and that the CDC lists diarrhea as one of MERS-CoV's key symptoms.  It is also important to note that in the Eastern world, where MERS is most prevalent, toilet hygiene is very different from the Western world. One key difference (as explained in the video below) which is likely to cause the spread of MERS-CoV is the Eastern method of  using water and a bare hand to remove feces from the posterior.

The Eastern method of cleaning one's posterior of feces is prone to aerosolize CoV, and it also leads to direct contamination of the hand, which leads to CoV spread to surfaces via fomites. This vector may explain why CoV is seemingly readily being spread among health care workers in Saudi Arabia.

In that regard its plausible to assume that as MERS spreads from the Eastern world to the Western world, one is most likely to become infected in restrooms and food handling facilities. The obvious most dangerous common places for MERS-CoV infection would be Aircraft and Hospital restrooms. 

Overall we see the deadly pandemic risk from MERS as being low, especially given that MERS has had at least two HAJJ cycles to spread across the world. HOWEVER when one combines poor hospital infection control and MERS tendency to infect and kill health care workers, it is possible that MERS-CoV could end up shutting down hospitals. The worst case scenario is an overlapping H7N9 and MERS-CoV outbreak. Edited to add that MERS is most likely to be spread Globally during the HAJJ cycle starting in October, which in turn means that Hospitals could be shutting down from MERS-CoV infections right as the Flu season starts to kick off.

If you are concerned about MERS-CoV (and we're not yet concerned) one of the best countermeasures is to wash with a CHG containing surgical wash/scrub such as Hibiclens. CHG will protect your hands from contagion for at least 6 hours after use.

Sources:

http://www.cdc.gov/coronavirus/mers/interim-guidance.html

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3322913/

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