The MBA and the fishermen

I would like to say that this is a real-life encounter, but I must confess, and I believe, that this is purely some story conjured up to bring us to our senses when we're already forgetting that the best things in life are simple, and should be enjoyed as simple as possible - no complications.

Enjoy!
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A boat docked in a tiny Mexican fishing village.

A tourist complimented the local fishermen on the quality of their fish and asked how long it took him to catch them.

"Not very long," they answered in unison.

"Why didn't you stay out longer and catch more?"

The fishermen explained that their small catches were sufficient to meet their needs and those of their families.

"But what do you do with the rest of your time?"

"We sleep late, fish a little, play with our children, and take siestas with our wives. In the evenings, we go into the village to see our friends, have a few drinks, play the guitar, and sing a few songs. We have a full life."

The tourist interrupted, "I have an MBA from Harvard and I can help you!"

"You should start by fishing longer every day. You can then sell the extra fish you catch.
With the extra revenue, you can buy a bigger boat."

"And after that?"

"With the extra money the larger boat will bring, you can buy a second one and a third one and so on until you have an entire fleet of trawlers. Instead of selling your fish to a middle man, you can then negotiate directly with the processing plants and maybe even open your own plant."

"You can then leave this little village and move to Mexico City, Los Angeles, or even New York City! From there you can direct your huge new enterprise."

"How long would that take?"

"Twenty, perhaps twenty-five years," replied the tourist.

"And after that?"

"Afterward? Well, my friend, that's when it gets really interesting," answered the tourist, laughing.

"When your business gets really big, you can start buying and selling stocks and make millions!"

"Millions? Really? And after that?" asked the fishermen.

"After that you'll be able to retire, live in a tiny village near the coast, sleep late, play with your children, catch a few fish, take a siesta with your wife and spend your evenings drinking and enjoying your friends."

"With all due respect sir, but that's exactly what we are doing now."

"So what's the point wasting twenty-five years?" asked the Mexicans.



And the moral of the story is:

Know where you're going in life… you may already be there.

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Key moments, decisions still to come in swine flu

By LAURAN NEERGAARD,AP Medical Writer AP - Sunday, May 10

WASHINGTON - The most pivotal moments in the swine flu saga are yet to come. Will it sweep through impoverished Southern Hemisphere countries in the next few months? Will it roar back in the rest of the world in the fall? And who will be vaccinated if it does?

In the weeks since swine flu grabbed international attention, and even years before that, some important actions have helped shape the course of this outbreak and the ways the world will handle future epidemics.

It's not clear if this new swine flu strain is a brush fire, sparking up around the globe only to fizzle, or if it will worsen when the regular influenza season hits.

No matter how this story ends, at the very least it has offered a real-world drill to find gaps in the playbook.

"We've been given an opportunity to take a look at this before it really got bad, and we need to," said Dr. Michael Osterholm of the University of Minnesota, a prominent pandemic flu specialist. "We better damn well do it now because one day we are going to really be in it for more than a week. If it's not this virus, there will still be another one."

For this virus, the coming months will bring a series of big decisions: Do manufacturers start brewing millions of swine flu vaccine doses? Will they be stockpiled unless the new flu returns or given along with or soon after regular flu shots? Will rich countries share enough with the developing world? Who gets in line first _ the younger people that this strain so far seems to target or the elderly who usually are flu's most vulnerable?

"You may only have one chance to get out ahead of it," Dr. Richard Besser, acting chief of the Centers for Disease Control and Prevention, told The Associated Press. "It's important for people to understand that all of these decisions will need to be made with incomplete science."

THE FIRST TURNING POINT

A different virus was the world's wake-up call. SARS (severe acute respiratory syndrome) started in China, and once it broke out of the mainland in early 2003, it took just weeks to infect more than 8,000 people from 37 countries. The virus killed more than 770 people before it disappeared.

Governments started scrambling to put together plans to handle the next global disease threat. Soon after, bird flu hit Asia, reinforcing the need.

Had the new swine flu hit sooner, before all that pandemic planning, it almost certainly would have spread faster. Even if it proves no more dangerous than garden-variety flu, that's deadly enough; a pandemic is more about geography than super-lethality. By the World Health Organization's tally, between 250,000 and 500,000 people worldwide die each year because of regular winter flu.

UNCOVERING THIS THREAT

As early as February, people in the Mexican hamlet of La Gloria were suffering unusually strong flu symptoms. When officials arrived to investigate in mid-March, nearly half the 3,000 villagers came out seeking medical help. About 450 were diagnosed with acute respiratory infections and given antibiotics. Mexico was investigating, but not until April 12 would the outside world _ the CDC and Pan American Health Organization _ start getting official word of the unexplained illness that eventually would be blamed for dozens of deaths throughout Mexico.

By then CDC already was on the trail of swine flu in California. The virus had spread before anyone knew it existed.

Preparation had paid off. In its pandemic planning, the U.S. starting in 2005 put money into researching better influenza detection. Studies of new methods found two unrelated children in San Diego with a strain of Type A influenza that turned out to be a never-before-seen type of swine flu. Puzzled, CDC announced the cases and started hunting more. On April 23, the agency confirmed five more illnesses in California and Texas and put all states on alert.

"At what point does unusual become concerning and at what point does concern lead to action?" Besser said. "We had to make that call."

That same day, CDC and a Canadian lab that Mexico had consulted delivered the bad news: The new flu was in Mexico, too.

Could Mexico have signaled a problem sooner? The Pan American Health Organization dismisses the question as one for historians.

"We would have done everything the same if we had it to do over again," said Hugo Lopez-Gatell Ramirez, deputy director of Mexico's Intelligence Unit for Health Emergencies.

AGGRESSIVE ACTION

With the diagnosis, Mexico's government immediately ordered the closure of all schools, museums, libraries and theaters in Mexico City. The following days brought increasingly drastic actions. Schools nationwide and other businesses shut down, streets mostly emptied and soldiers handed out millions of face masks.

With a handful of known illnesses at first, the U.S. raced antiflu drugs from a government stockpile _ enough for 11 million people _ out to every state. After a large outbreak at a New York City school, apparently spread by students who vacationed in Mexico, U.S. schools started closing. Ultimately about 468,000 students around the country were affected before the CDC decided that schools should reopen because the virus was mild.

Overall, "what happened was not overreaction. It was a prudent response," said Michael Leavitt, the Bush administration health secretary who led development of the U.S. pandemic flu plan and advised other governments on theirs. "If imminent information about terrorism is known to authorities, they need to react. A pandemic is sort of nature's terrorist."

Young children tend to be initial spreaders of regular winter flu, taking it home to family and friends, which is one reason that school closings are included in pandemic plans. But in this case, travelers were early spreaders.

"I'm not saying that was the right approach or the wrong approach, but what we've learned is we need to be proportionate in our response with what the risk is in our community," said flu specialist Osterholm.

PANDEMIC OR NOT

The World Health Organization, following its post-SARS guidelines, declared an international emergency the day after Mexico's outbreak made headlines, to spur countries to check where else the new flu had spread _ eventually to two dozen countries and counting.

Days later, the WHO issued an unprecedented warning: The world was close to a full-fledged pandemic. Sustained spread in regions beyond North America, rather than smallish outbreaks, would tip the scale.

For years, the U.S. had run drills. What would it do if bird flu started rapidly spreading in Asia? Close the borders to buy a little time. Reality brought a surprise.

The new swine flu started in North America, too late to close any borders. While the U.S. joined other countries in discouraging travel to hardest-hit Mexico, and some nations discouraged travel to the U.S. and Canada, too, once flu starts spreading in numerous places, such actions have little effect.

Asia remained largely untouched. China, no doubt recalling the harrowing days of SARS, tried to keep it that way by quarantining dozens of Mexicans for days.

STILL TO COME

What happens to all those antiflu medicines that were shipped to U.S. states but not used? They're waiting, under guard, in case they're needed come fall. Leavitt, the former health secretary, said that's the next weakness. Flying in drugs is easy; getting them to the sick is hard.

"The further into a pandemic you get, the more spontaneity that's required and the more lack of preparation reveals itself," he said.

Then there's the vaccine dilemma.

Makers could be told to start brewing doses in a few weeks. But that will take months and require testing, led by the U.S., of initial shots to see if they induce immunity, with one dose or two, and seem safe. The last mass vaccination against a different swine flu, in the U.S. in 1976, was marred by reports of a paralyzing side effect _ and that time the flu didn't return.

"One of the lessons of the '76 experience is to take account of the uncertainty," said Institute of Medicine President Harvey Fineberg. "Be able to take account of new information to modify your course."

If vaccine is ordered, would developing countries get a fair share? The WHO is calling vaccine makers together in late May to push for fair access. Regardless, any shots will come too late for the Southern Hemisphere, where influenza season is about to start.

World authorities will closely track the new swine flu there, for help deciding whether to order vaccinations for the rest of the world starting in the fall. The big worry is that the virus will mutate, becoming more severe.

"The thing that's keeping me up at night right now is that feeling of dodging the bullet, in the sense that people are taking a sigh of relief too soon," the CDC's Besser told the AP.

 

On the Net:

CDC: http://www.cdc.gov/h1n1flu/

WHO: http://www.who.int/en/

From Yahoo! News; see the source article here.

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With swine flu, we're all in this together

By MICHAEL WARREN,Associated Press Writer AP - Monday, May 11

MEXICO CITY - On the western edge of Mexico's capital, 10 new luxury apartment towers promise an antiseptically modern lifestyle with spas, private playgrounds and an exclusive shopping center. Blocks away, a world-class private hospital has opened.

But there's no escaping the view from these $1.5 million apartments: Just across a ravine is a slum where maids and construction workers make do in crowded, humid homes of raw concrete and spotty drinking water. For them, getting sick means medicating themselves at a discount pharmacy, or waiting for hours in an overcrowded public hospital.

Wealthy Mexicans aren't alone in trying _ and failing _ to distance themselves from deprivation and disease. People all over the world want to protect their families from the problems of the less fortunate.

But if there's anything we've learned from the swine flu epidemic, it is this: the virus doesn't discriminate.

"We're all in this together," President Barack Obama said as he urged public health agencies to reach all corners of America. "When one person gets sick, it has the potential of making us all sick."

The outbreak might not have become an epidemic if Mexico's first swine flu victims had been identified and treated quickly. We now know that for most, the virus causes only mild symptoms, and that nearly all of those who become quite sick can recover if they get proper treatment within 48 hours.

We also know that most of Mexico's dead didn't get that treatment in time.

But it feels awfully late to be pointing fingers over initial delays. And by ordering a nationwide shutdown last week of public gathering places where flu can spread, Mexico saved many more lives, experts say.

Now the world must face what Mexicans learned as they stayed home from schools and restaurants, venturing outside fearfully in face masks only to replenish their refrigerators: Rich and poor breathe the same air. The 53 people killed around the world so far range from poor day laborers to the grandson of one of the richest men in Mexico.

It's a moral challenge, as clear now as the view from those luxury living room windows: When vast numbers of poor people lack decent health care, no one is immune from disease.

A rural bricklayer with a bad cough, a kindergartner in a remote mountain village, a maintenance worker in a vast urban slum _ these swine flu cases might have seemed a world away from the United States and Europe.

But it takes just four hours by bus for workers to reach the capital from the pig-farming community of La Gloria, where hundreds of villagers were suffering from acute respiratory infections for weeks before one of their kindergartners became Mexico's earliest confirmed swine flu case.

It takes even less time to fly from Mexico City to the U.S., where this strange new strain of swine flu was first identified in a 10-year-old San Diego boy.

No one knows yet where this outbreak began. Despite calls to close the U.S. border, scientists say the deadly chimera _ a blend of bird, human and pig flu genes for which humans have limited natural immunity _ may have jumped from pigs to humans in North Carolina, about 10 years and 10,000 generations of virus ago.

Millions of dollars have been spent on pandemic preparedness since scientists realized flu could jump between species. Top flu experts even developed a detailed containment plan _ with an extremely limited window of opportunity.

World Health Organization experts determined that a virus with pandemic potential would have to be identified, the epicenter quarantined and 80 percent of the initially affected population blanketed with antiviral drugs within three weeks of the first symptoms.

Oh, and the outbreak would have to be limited to a small geographic area _ like a remote village of about 1,000 people.

This H1N1 virus was likely spreading all over Mexico and parts of the United States long before anyone got sick enough to be tested. By the time the wheezing, sneezing villagers of La Gloria complained enough for their samples to be taken, dozens had been commuting to Mexico City for weeks.

Before anyone knew this flu's name, cases were popping up all over the megalopolis of 20 million.

A Canadian lab quickly confirmed that swine flu had reached Mexico, and a global alarm was raised. But only hours later, the WHO said it was useless to close borders and ban flights. Travelers had already carried the virus from Mexico to New York and New Zealand. It has since spread to at least 29 countries around the world.

So now Mexico's challenge has become a truly global problem. Experts say even normal seasonal flu infects millions and kills about 500,000 people worldwide every year. With the WHO warning that a possible swine flu pandemic could infect 2 billion people, how on earth can we protect the whole world?

The drug makers say they can "most likely" produce 917 million doses in 10 months, a number considered overly ambitious by some experts.

Even the first vaccines won't be ready for months _ too late for the Southern Hemisphere, where flu season is about to start. And if the virus evolves into something more contagious or deadly _ possibly by mixing with regular flu or even H5N1 bird flu, which is endemic in parts of Asia and Africa _ these vaccines may not provide much protection in the end.

Antiviral drugs will be critical if it comes to that, but they are expensive, and there aren't enough to go around. The largest stockpiles are kept by the wealthiest nations, for their own citizens' protection.

But hoarding antivirals could backfire. A 2007 study modeled what would happen in a flu pandemic if wealthy nations hoard or share these drugs.

They concluded that the hardest-hit populations should be blanketed with antivirals, even if they are too poor to pay for them, and even if it means people with reliable health care in wealthier nations would go untreated.

Doing so would save many millions of lives, they found _ including in the wealthy countries that share.

Nobody knows where this current outbreak is headed as the swine flu virus evolves. It may lose its potency.

Or it may become a real killer. And if that happens, there will be some hard decisions to make.

From Yahoo! News; see the source article here.