Apr 11, 2006 (CIDRAP News) – A mathematical modeling study suggests that a modestly effective vaccine could keep an influenza pandemic from striking more than 10% of the US population, but only if large amounts of vaccine were distributed quickly and the virus was not too highly contagious. The modeling study seems to lend some support to the US strategy of stockpiling a vaccine based on recent strains of H5N1 avian flu, which won’t precisely match an emerging pandemic strain. But the model incorporates many assumptions that may or may not prove accurate in the event of a pandemic, and experts note that very little H5N1 vaccine would be available if a pandemic occurred anytime soon. Germann TC, Kadau K, Longini IM, et al. Mitigation strategies for pandemic influenza in the United States. Proc Nat Acad Sci 2006 Apr 11;103(15):5935-40 [Abstract] Germann and two associates, Kai Kadau and Catherine A. Macken, all of Los Alamos National Laboratory, worked on the study with Ira M. Longini Jr., a biostatistician from the Fred Hutchinson Cancer Research Center and the University of Washington in Seattle. See also: “Aggressive” production and distribution of vaccine could control a pandemic with an R of less than 1.9, the model predicted. “We believe that a large stockpile of avian-based vaccine with potential pandemic influenza antigens, coupled with the capacity to rapidly make a better-matched vaccine based on human strains, would be the best strategy to mitigate pandemic influenza,” the authors write. “This effort needs to be coupled with a rapid vaccine distribution system capable of distributing at least 10 million doses per week to affected regions of the U.S.” Other experts who were asked to comment on the study had different reactions. Travel restrictions alone would accomplish little, according to the simulations. A 90% reduction in travel would slow the virus’s spread by only a few days to a few weeks, depending on transmissibility, and would not dent the ultimate size of the pandemic. Other control strategies used alone could limit a pandemic only if the virus had relatively low transmissibility (R of 1.6), the model predicted. For example, targeted use of antiviral drugs could succeed in that case, provided the supply was adequate and close contacts of patients could be quickly identified. But if R were 1.8, the nation would need a “prohibitively large” 51 million treatment courses of antivirals. Dr. Gregory Poland, a vaccine expert at the Mayo Clinic in Rochester, Minn., said the situation with the H5N1 vaccine being made for the US government points up the problems with the predictions. As was reported recently, the vaccine seems effective in about half of recipients, but it takes 12 times the dose used in seasonal flu vaccines, he noted. The study was supported by the National Institutes of Health (NIH). Its goals, the NIH said in a news release, were to determine how to slow the spread of a pandemic virus long enough to permit development and distribution of a well-matched vaccine and also how to limit the number of cases to less than 10% of the population, the percentage in an average flu season. The model projected that without any control effort and an R of 1.9, the virus would spread across the nation within 30 days of its first arrivals, that 122 million people would ultimately fall ill, and that the pandemic would peak in 85 days. With an R number of 2.4 and no control effort, as many as 151 million would get sick, according to the model. William Schaffner, MD, a hospital epidemiologist and professor in the infectious disease division at Vanderbilt University in Nashville, said he found the study reassuring, though he had not examined it closely. “The ultimate take-home line was that even a partially effective vaccine is an important part of the strategy,” he said. For a highly transmissible virus (R greater than 1.9), it would take a combination of measures to limit the pandemic, the model predicted. For example, the combined use of vaccination, targeted antiviral use (3 million courses), school closures, social distancing, and travel restrictions could work at an R level as high as 2.4, the authors predict. With a moderately transmissible virus (meaning each case leads to fewer than 1.9 additional cases), “Our model suggests that the rapid production and distribution of vaccines, even if poorly matched to the circulating strains, could significantly slow disease spread and limit the number ill to less than 10% of the population, particularly if children are preferentially vaccinated,” says the report by Timothy C. Germann and colleagues. With a more contagious virus, additional measures such as school closings, travel bans, and antiviral drugs would have to be used in combination with vaccination, says the report published online last week by the Proceedings of the National Academy of Sciences. Michael T. Osterholm, PhD, MPH, a leading pandemic preparedness advocate, had a sharply different view of the study. “I think it’s based on a number of assumptions which in the real world won’t happen,” he said. “The idea that we’ll even have vaccine to consider in terms of dealing with the pandemic is at this point not likely for the vast majority of the world.” Osterholm, director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of the CIDRAP Web site, said “any number” of assumptions used in the model could be questioned. “I continue to worry that far too much credence is being put into theoretical models that lack reality testing in the likely world of a pandemic,” he said. “A moderately effective vaccine would work if you could get it into enough people,” said Poland, who directs the Mayo Vaccine Research Group and Program in Translational Immunovirology. “This current vaccine, if we used the whole world manufacturing capacity, offers enough doses for somewhere around 37.5 million people. So that’s not an answer.” He added that it may be necessary to make more than one vaccine, given the different clades (families) of H5N1 virus that have emerged. With a very limited supply of a vaccine for which two doses are recommended, the model showed it would be less helpful to vaccinate a given number of people with the two doses than to give just one dose to twice as many people. The model simulated the unfolding of pandemic flu in a US population of 281 million over 180 days. It factored in US census data about population distribution and commuting patterns and assumptions about the frequency of interpersonal contacts. It assumed that a few infected people would arrive from abroad each day at 14 airports in the United States. The researchers ran the simulations with four different reproductive (R) numbers (the number of additional people infected by each infected person), ranging from 1.6 to 2.4. He added that building up the capacity to treat the sick is important, but the main emphasis in pandemic preparedness should be on vaccination and other preventive measures. “The results [of the study] were so affirming of the general thoughts of the public health community that it’s really very reassuring, and I hope it stimulates further what I think is already a strong effort by HHS [the Department of Health and Human Services] to stimulate vaccine production and research on new ways to produce the flu vaccine and make better flu vaccines.” Poland also said no one knows how contagious the next pandemic virus will be. “My understanding is that the estimated R number for the 1918 pandemic was right around 3,” higher than the maximum of 2.4 used in the study, he said. “You wonder now if we truly have a novel subtype that’s easily transmissible, given the travel we have, if we wouldn’t have higher numbers. The average family is bigger than two people.” NIH news releasehttp://www.nigms.nih.gov/News/Results/FluModel040306
The International Financial Reporting Interpretations Committee (FRIC) has confirmed it will not seek to amend discounting rules under International Accounting Standard 19, Employee Benefits (IAS 19).The decision relates to uncertainty regarding the discounting of liabilities when using more than one currency.According the latest IFRIC update, “the committee concluded that the requirements in IAS 19 provide an adequate basis for an entity to determine the discount rate when the entity operates in a country that has adopted another currency as its official or legal currency”.In March the IFRIC proposed rejecting the call for it to start work on a project to develop interpretive guidance on the issue. The IFRS IC launched its probe of the topic after a company in Ecuador sought guidance on discounting its defined benefit liability, as this was denominated in US dollars.IAS 19 requires sponsors to use a high quality corporate bond rate to discount liabilities, or failing that a government bond rate.In the March edition of IFRIC Update, the committee confirmed current discounting practice in those terms.It also added that the discount rate was not meant to reflect the return on assets.Environmental lawyer highlights BoE climate change concernsSeparately, lawyers from environmental campaign group ClientEarth have warned that the Bank of England’s (BoE) policy focus on climate-change risk should serve as wake-up call for companies.ClientEarth corporate lawyer Alice Garton said: “The Bank of England continues its leadership on the financial risks and impacts of climate change. This latest statement reiterates that climate-related loss, mispriced assets and potential disruptions to financial markets must be taken seriously by all market actors, now.”In a quarterly update written by bank staff with responsibility for insurance and cross-border issues, the BoE said that climate change presented financial risks “which impact upon the bank’s objectives”.The bank identified these risks as manifesting through both the physical effects of climate change and the transition to a lower-carbon economy.The update said: “As banks and insurers realign their portfolios and adjust their underwriting practices, this will have consequences across the economy. Businesses and investors not considering these issues will be left behind.”Through its policy response, the bank was working with the sectors affected by climate change, such as insurers, it said.It was also aiming to enhance the resilience of the UK financial system through an orderly market transition to a lower-carbon economy.Recently, environmental NGOs such as ClientEarth, as well as investors, have shown a growing willingness to use the courts where companies fail to match their green commitments with deeds.FTSE 350 firms improve auditsMeanwhile, the UK Financial Reporting Council (FRC) has announced that its reviews of the audit environment among FTSE 350 companies during 2016/17 revealed an improvement in audit quality.Melanie McLaren, executive director at the FRC, said in a statement: “High-quality audit underpins public trust and confidence in business. While the progress made by individual firms differs, all firms are investing in audit quality and have set out further action to improve.”The FRC’s latest update revealed that 81% of the FTSE 350 audits it reviewed in the past year required no more than limited improvements.The FRC wants this figure to reach 90% by 2018-19.Among the areas singled out for improvement were revenue recognition and processes for complying with ethical or independence requirements.The review also noted that auditors must do more to challenge management in areas where significant judgement is exercised, such as impairment, asset valuation and provisions.
Total pay for employees in the UK, including bonuses, increased by 1.2% in real terms between the periods of February 2018 to April 2018 and February 2019 to April 2019, according to research by the Office for National Statistics (ONS).The Average weekly earnings in Great Britain: June 2019 report also found that regular pay, excluding bonus payments, increased by 1.5% in real terms, namely adjusted for consumer price inflation, between February 2018 to April 2018 and February 2019 to April 2019.In nominal terms, having not been adjusted for consumer price inflation, total pay increased by 3.1% and regular pay rose by 3.4% during the same reporting period.Lee Biggins, founder and chief executive officer at CV Library, said: “Pay is up year-on-year and while this is good news for working professionals, the picture is less rosy for businesses. After all, we cannot ignore the fact that businesses are struggling to entice potential candidates out of their roles, in turn having no choice but to offer higher pay in order to remain competitive.”Average regular pay excluding bonus payments for employees in Great Britain was £502 a week in nominal terms, before tax and other deductions from pay, in April 2019. This equates to £468 a week in real terms.The construction sector has seen the greatest average total pay growth, including bonuses, between February to April 2018 and February to April 2019, with a rate of 4.4%; this compares to 3.1% total pay growth across the economy as a whole. The lowest average total pay growth was recorded in the wholesaling, retailing, hotels and restaurants industry, at 1%.In some sectors, average weekly bonus pay outpaced the growth in regular pay. For example, in the construction sector, average weekly bonus pay grew by 17.1% during the reporting period, compared to a 4.1% increase in regular pay. In the finance and business services industry, which is the highest sector for bonus payments, they increased by 1.4% between February to April 2018 and February to April 2019, versus an increase in regular pay of 3.9%.The manufacturing industry and the wholesaling, retailing, hotels and restaurants sector both experienced a fall in bonus payments of 6.2% and 12.8% respectively, while regular pay growth, excluding bonus payments, for these sectors was 2.2% and 2.4% in turn.Jon Boys, labour market economist at the Chartered Institute for Personnel and Development (CIPD), added: “Wage growth continues to outstrip inflation delivering more money to [employees’] pockets. However, real pay, excluding bonuses, is still £5.70 a week lower than the pre-recession high. Some have benefited more than others.”