“These purchases have been for large enough quantities that we’re concerned about hoarding of the drug in general, whether for seasonal flu or a possible pandemic,” said Darien Wilson, a spokeswoman for Switzerland-based Roche’s U.S. offices in Nutley, N.J.

Wilson said the large purchases have been by private companies, which Roche has not named. Doctors said there also has been an increase in demand for the drug among patients.

And, by the way, Flu Wiki has never advocated stockpiling tamiflu. Individual opinions vary on and off the wiki; personally I advise against it. The point is to educate oneself about the issues, so that you become aware, e.g., that your state health department may advise against stockpiling (unless you live in VA) while WHO has advised its employees to do the opposite (stockpile for themselves and their families), and on the third hand your own MD may not have even considered the issue – and won’t until advised to do so by the CDC, whose draft plan remains unreleased. All the preceding is accurate.

Do be careful to avoid Argumentum Ad Verecundiam. When authoritative sources vary in their advice, becoming educated on the issues (with references) can only be a plus. That’s not fear-mongering, that’s prudence.

“No doubt there is a duty to draw attention even to hypothetical scenarios. But when officials use worst-case language as an attention-getting device, they undermine their own cause. Already pharmacists have warned that customers are buying up the drug Tamiflu, one of the few antivirals believed capable of combating avian flu. If there is an outbreak, the last thing we need is people randomly experimenting with medication that must be employed in controlled circumstances to be effective. Public health is in part a management science, yet what’s going on is not management, but fear-mongering. … What’s needed now is quet, behind-the-scenes preparation and public calm.”

Your publisher was the one who brought up the link between the Flu Wiki and “consulting to the American Red Cross” and other organizations. I assumed, perhaps mistakenly and if this is not the case I apologize, that she “and my partners” are getting paid for this work. It’s a red herring as far as I’m concerned and completely beside the points and questions I’ve raised.

“But beyond all that [vaccines and antiviral stockpiles], the federal government can’t provide much tactical help. “It’s every community for itself,” says Gary Oxman, the health officer for Multnomah County, Ore., which includes Portland. This comes as no surprise to local officials.”

You have a blog. If you knew that in advance, what would you do?

Let me direct you to an article in the National Journal last week so you get the flavor of how local public health experts are going to be (and planning to be) overwhelmed by this:

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“By definition, a pandemic affects a vast geographic area and a huge number of people. Avian flu would spread fast and easily from person to person (especially in buses and other confined public spaces), since it is contagious before symptoms develop. By the time the first victims appeared, epidemiologists would have to presume that the flu had already spread far and wide.

“Every community in America would go on red alert. At that point, the federal government “can’t come in and take over,” Libbey said. “The math alone just doesn’t work.”

“The federal role in such a pandemic would be largely policy-oriented and advisory, Libbey and local health officials explain. The Centers for Disease Control and Prevention would issue technical advice to health care workers, such as what symptoms to watch for in the population, how to administer a vaccine or an antiviral, and which groups of patients should receive treatment first.”

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In a true pandemic we’re not counting on the feds, because the feds aren’t counting on the feds. The medical rx pages on the wiki are its least important aspect, though you focus on it. What will be more important are pages on how water and sewage and public utilities and small businesses plan to keep going when 20% of the workforce is sick, or whether CT (not yet published) can study NY and MA’s plans. With plan-o-rrhea (hundereds of them) it’s not such a simple proposition to find and look at the best state plans and crib if you’re a town or county official. And, btw, Canada’s and the UK’s plans are in some respects more robust than ours. They, too, are available for study.

You are focusing on the probable, which is we’re not going to all die tomorrow. As Cel suggests, we are focusing on the possible, which is to look at worst case and help public health authorities hep us. That’s why you buy life insurance.

It’s not that I don’t appreciate and admire your efforts. I do. I just don’t think conveying medical or even emergency services information via an open wiki, especially since there’s at present no official government or private sector endorsement at any jurisdictional level, is not an ideal situation. Again, the questions of legitimacy, accountability and authority all come to mind, and are concepts librarians and other information professionals stress when it comes to accepting information on the Internet.

So if anyone who’s truly informed about the subject has the judgment to accept or reject the information on the Flu Wiki, why would they bother visiting and contributing, rather than just clicking on through to the many excellent resources you’ve assembled? Or just, as I suggested in one comment, Googling “flu site:gov” and getting the official views.

Again, you said it yourself in your “Are you a professional page?”: “The Flu Wiki is not intended to substitute advice from public health authorities or health care professionals.”

I’m glad your work is getting you some consluting contracts, but that’s really beside the points and issues I’ve raised.

As far as PhD scientists and MDs making fools of themselves all over the blogosphere, a degree doesn’t confer sainthood and since you haven’t provided a specific example, perhaps they were talking outside their specialization. We all make mistakes. But for scientific information to be accepted it’s subjected to testing, retesting and publication, which gives it far more credibility in my eyes, than information contributed by anonymous, pseudonymous and unverifiable individuals. If someone printed and distributed a monthly magazine or even a newspaper filled with informaton by anonymous contributors, how many subscribers do you think they’d ever have? Why do we insist on lowering our standards of information authenticity when it comes to the Internet?

No one who is informed about the subject should be consulting a wiki for medical information ? the publisher advises everyone in a medical disclaimer that the medical information can?t be trusted ? and as for emergency services information, that?s why we have government and volunteer organizations that are more legitimate sources of information.

Anyone who is truly informed about the subject has the judgement to look at Flu Wiki and judge whether or not the information therein represents the consensus of the scientific community on the subject. I guess that’s why I and my partners are being invited to consult with scientists and political bodies all over the country. I guess that’s why I’ll be consulting to the American Red Cross on risk communication and disaster platforms.

Your unwarranted antagonism is both unattractive and unneccesary. We’ve established our credentials with the quality of the information. I spent the day watching PhD scientists and MDs making complete asses of themselves all over the blogosphere. The credential is the quality.

All the Flu Wiki has to offer that’s authoritative are links to existing sites or existing information on the impact of avian flu and human influenza that’s credited to epidemologists.

No one who is informed about the subject should be consulting a wiki for medical information — the publisher advises everyone in a medical disclaimer that the medical information can’t be trusted — and as for emergency services information, that’s why we have government and volunteer organizations that are more legitimate sources of information.

All the more reason then that the Flu Wiki team, given your own observations and forgiving attitude towards their anonymity (except for the publisher), should abandon their effort. Since the experts who are willing to stand up and be identified — they get paid to do that sort of thing — have already warned us what to expect, why should anyone pay heed to an anonymous group of editors?

Funny isn’t it how politics is often used as an excuse to avoid the sometimes negative consequences of public information. People who have the courage of their political and information convictions should not be afraid to be identified.

I presume you mean “everyone wants to minimise the risk of a pandemic.” The fact that your own post is significantly less polished and more error-prone than the Flu Wiki is a bit like your argument shooting itself in the foot, don’t you think?

As for the Flu Wiki, I believe it must be viewed with an informed eye. Much therein is largely supposition, however it appears to be intelligent and logical supposition. Such suppositions are made by all examining a particular issue, particularly including the highest in respective fields. Supposition, speculation and intelligent guesswork are the skeleton around which progress takes form.

The Wiki very much pays attention to worse-case scenarios. The likely course of events as I see it – and how the neccessity of the phrase ‘as I see it’ shows how in the dark we are as to the possible courses of events – is for the pandemic to be considerably less damaging than that of 1918. However, worse-case scenarios are those which most need attention paying to as the consequences of mismanagement, ignorance or unpreparedness are so much more dire.

I am of course wary of the fact the authors have not declared their credentials. However as the issue is a highly political one I would do the very same to preserve my own livelihood, as would any sensible person. Should no pandemic come to pass, any advocates of extreme preparation would be instant political targets. Perhaps they would be held liable for the high costs of preparation, in the political, media and career sense if not the legal one.

The possibility of a pandemic would become the stuff of jokes like the year 2000 bug. Any who publically supported sensible and moderate preparation for less likely, severe scenarios would be pilloried, due to the lowest common denominator hysterical feeding frenzy that is public life. Thus I cannot condemn the authors of the Flu Wiki.

If a severe epidemic does come to pass it may well change society significantly. It will most certainly make sweeping changes in the political arena. A severe pandemic would be a kind of political singularity past which no-one could predict. Again not disclosing one’s identity fully seems like a sensible precaution.