WHO updates critical medicines list for radiological and nuclear emergencies | Hacker News Reader

WHO updates critical medicines list for radiological and nuclear emergencies

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78 pointssaguntum71 comments

I don't have much faith of any country doing a good job at this.

Canada built up federal and provincial stockpiles of N95s after SARS1 (2003), and destroyed those N95s without replenishing them once they expired...

(and if it's not obvious, didn't rotate stock to avoid expiration entirely)

https://www.cbc.ca/news/canada/saskatchewan/heath-minister-e...

https://www.reuters.com/article/us-health-coronavirus-canada...

I live close enough to a nuclear plant to have government-provided iodine tablets on-hand, but nobody's given me free N95s to... you know, not breathe in radioactive dust.

Hold the phone, how do N95 masks even expire if stored properly? What causes their fibers to decay?

>destroyed those N95s without replenishing them once they expired

Whenever I'll do something stupid, I'll remind myself of this action of the Canadian government to comfort myself.

Did they at least learn the lesson after COVID to keep their stocks up for the next once in a lifetime pandemic?

I think the French did the same or close.

Fist scandal was having piles and piles of vaccines and masks for the H5N1 flue.

Second waves was discovering that said piles ( of masks ) were gone.

Part of the French social contract is based on having a strong state, that is somewhat competent at providing basic shit. ( in exchange for all the ailes of a strong state )

That was not a glorious moment

It was the same all over Europe (possibly elsewhere as well) IIRC. At least also in Germany.

It made me feel better if you guys screw it up too.

( it’s a joke, I actually wish for our respectives government to get their shit together )

In hindsight things are obvious but most countries did the same mistake and so would you if you were in charge.

This is a defeatist attitude that will not help improve our society.

Sure, there are some reasons for the mistakes (my assumption is that since Europe survive almost unscathed SARS, the importance of having usable stockpiles wasn't as clear as it is now), but this doesn't mean that it was physically impossible to avoid these mistakes.

I’m also praising a predecessor of that same health ministry.

And, is it defeatism or a factual observation of our leaders action?

Demanding more clarity and accountability is good enough for the stakeholders of private society.

Why not our democratic leader? Specially the accountability bit.

More than poor handling or stocks, I have difficulty to digest the lies.

Example : In France, once it became evident that the stocks were gone, the official language element became « mask are useless » ( for real )

Then a few weeks later « mask are too complex for the general public to handle, we need to keep them for health professionals »

And finally, « please wear a masks »

The best practices and science did not change in those mere 3 months. They were just telling us bullshit. I don’t like that.

A sane and open post mortem of the situation would be helpful.

And that’s not défaitismes, it’s a hope that we can do better if we have a hard look at ourselves and our leaders actions.

If I were in charge of the Center for Disease Control, I would use some of its $8 bn budget to prepare adequate countermeasures for a respiratory pandemic.

I would not be in charge because I’m a moron.

The event I was referring to was that our health minister at the time of the H1N1 pandemic got ridiculed because she ordered masks and vaccines en masse early on in the outbreak.

In insight, she did really well. So, not every body is fucking it up every time. At least that woman did not.

The fibers in an N95 are electrostatically charged, which is how they are able to capture small particles.

I don't know for sure, but it's possible this charge may decay over time perhaps?

(Or, more likely, the manufacturer may have only tested/verified up to a certain time after manufacture, and that's what they are certified for)

Seemingly they can be recharged, one hour between two plates at 1000 V appears to be the soft spot:

https://aip.scitation.org/doi/10.1063/5.0023940

just imagine the cost of either re-processing the existing masks or having 1000 V "re-chargers" at home ...

A bit like the old quartz-fiber radiation dosimeters, I suppose - those actually were a consumer product [1], along with the high-voltage DC charger required to "zero" them for reuse, back some 60 or so years ago and a fair bit before safety was invented.

[1] https://www.orau.org/health-physics-museum/collection/civil-...

>a fair bit before safety was invented.

i still remember the oscillating fan at my grandparents' house from the 50s. It was a 12" fan made out of solid metal. Not one piece of plastic to be found any where on this thing. The blades looked like something from the back of a Naval ship. The interesting thing to me was the grate covering the fan. To this day, I'm really not sure of the purpose. I could easily stick my hand through the grate today as an adult. Yes, this fan still works today as well as it did when I was a kid and the fan was already 30 years old. Something like this: https://i.etsystatic.com/15784874/r/il/432676/2183412824/il_...

Clearly, safety was not invented at that time.

Oh, I know the type very well! As a kid I often put ours on a chair by my bed. Even then I didn't really feel great about that, but when you don't have AC, it doesn't take much trying to sleep through a Mississippi summer night before you decide it's worth the risk for enough breeze not to feel like you're drowning. Ours was especially delightful too in having the speed control on the front of the base, so you couldn't even turn it off without having to think about what life might be like with everyone calling you "Stumpy".

As far as I could ever tell, the grate's only there to keep it from sucking up curtains, and to keep you from getting caught up between the fan blades and the pedestal; with the torque out of those old motors, it'd certainly take off a finger and probably break an arm. For everything else you're on your own, which is why I don't really mind the scar I still have on my right middle knuckle from the only time I ever tried to turn it up to "high" without turning a light on first - if I'd missed the lever by a quarter inch more, that old cast-iron widowmaker would've given me a whole lot worse.

> The interesting thing to me was the grate covering the fan. To this day, I'm really not sure of the purpose. I could easily stick my hand through the grate today as an adult.

The cage probably maybe protects the blades from hitting the ground if tipped over? No need to protect them from fleshy objects though, those will move one way or another.

Perhaps it doesn't matter whether N95 still function well. Once pass the expire date printed on the package, warehouse has to remove them from inventory.

>"Did they at least learn the lesson"

The only thing politicians learn is how to win elections. The rest is just a change for trade.

If only they just threw away masks...

The Trudeau administration funneled 44 million dollars [0] and months [1] of taxpayer funded research work to CCP controlled CanSino in order to get cheaper doses than the American backed vaccine candidates [3]. It, unsurprisingly, failed spectacularly.

[0] https://globalnews.ca/news/7302194/canada-coronavirus-vaccin...

[1] https://ipolitics.ca/2021/03/12/a-waste-of-a-lot-of-time-res...

[3] https://en.wikipedia.org/wiki/Operation_Warp_Speed#Companies...

Some manufactured versions can last over a decade if stored properly in low humidity to prevent water from discharging the fiber charge.

If we had a smart government, we would start stockpiling now for the next pandemic and have a FIFO replacement system. The cost of such a ‘respirator battery’ would be about 1-2 Abrahams tanks

Don't even need to be aggressive about FIFO. Buy with 5y shelf life, sell off and rotate when there's 1y left.

The average construction site/whatever will happily buy N95s that will expire in 6 months for a 20% discount because when they go through a pile every week.

Heck, I buy nearly expired allergy pills for a discount because I know that the API is super stable in solid form at standard conditions.

How on earth do they expect typical governments to distribute hundreds of thousands of doses of things which are recommended to be administered within <24h? This document seems... aspirational.

Also, how do you reconcile "shelter in place" with "seek prophylactic medical care"? They're pure contradictions. If you're exposed to unknown fallout, do you run outdoors again right away to find chelators, or do you delay that and risk irreversible damage?

Maybe the most reasonable thing would be to distribute most of these things to households in advance. Like the way they distribute KI near nuclear power plants, except to everyone.

I'm assuming this is not in case of nuclear war, because there's no way any doses of anything would get deployed to ordinary civilians in the first few weeks at least.

you also probably can't distribute cytokines and colony stimulators ahead of time.

probably the thing to do is make sure everyone has good basic PPE, bottled water, and maybe a basic rad badge, and only seek medical care if you know you've been exposed to high levels of radiation.

I'm looking particularly at KI and the chelating agents, which are ordinary shelf-stable things. The point of these is to prevent biological absorption of particular elements in fallout, so either you have them available right away, or it's a lost opportunity.

- "Time of treatment initiation: DTPA should be administered as soon as possible after exposure, ideally within the first 24h. If early administration is not possible, therapy can be initiated at any time; however, the efficacy decreases substantially when radionuclides are deposited in the bone and other organs (47, 48)."

- "The optimal period of administration of stable iodine is < 24 h before and ≤ 2 h after the expected onset of exposure."

K iodide (KI) is not completely shelf stable, it oxidizes slowly in air (into elemental iodine, which is unsuitable to be ingested as a iodine source for humans).

K iodate (KIO3) is completely shelf stable, but it can be unpleasant when taken in very large doses.

Elemental iodine in solution with iodide forms tri-iodide, which is perfectly fine to consume. This is what Lugol's solution is and it has an unlimited shelf life.

It is fine to consume, but the part of the iodide that has been converted into iodine can no longer be transformed into a useful form inside the human body.

Therefore any reserve of iodide will provide a smaller dose than expected when it is too old, unless it was stored in special conditions, e.g. in nitrogen without contact with air.

> you also probably can't distribute cytokines and colony stimulators ahead of time.

Everybody would be fine to keep a pack of iodine pills flying around their home.

I rather delay a day of colony stimulator than popping iodine when there is fallout outside.

Components of a pharmaceutical stockpile for radiation emergencies This publication focuses on pharmaceuticals for treating radiation exposure and addresses the governance and management of such a stockpile. A typical radiation emergency stockpile will include the following medicines:

Stable iodine, administered to prevent or reduce the exposure of the thyroid to radioactive iodine;

Chelating sand decorporating agents (Prussian blue, applied to remove radioactive caesium from the body and calcium- / zinc-DTPA used to treat internal contamination with transuranium radionuclides);

Cytokines used for mitigation of damage to the bone marrow, in case of acute radiation syndrome (ARS); and

Other medicines used to treat vomiting, diarrhoea and infections.

I keep some random amazon iodine on hand since the cost/potential benefit seems favourable on that. Outside of that it doesn't seem like there is much the average person can do without going full prepper

There's not huge downside to taking once, but for adults the benefit isn't huge either. Especially as you get older (like older than 40 they only recommend it for highly exposed people).

There is a huge protective effect in young children, especially young infants.

https://www.cdc.gov/nceh/radiation/emergencies/ki.htm#How_to...

They skipped right over Deathclaws. What's the best medicine against those?

Patrolling the Mojave almost makes you wish for a nuclear winter.

Avenger minigun with a whole whack of ammo.

Plasma rifle aimed at the eyes

I see one benefit from more people finally realizing that nuclear war might affect them, and be bad.

I ain't no hippie, but I really hope this translates into global nuclear disarmament once Russian imperialism is vanquished.

Nuclear weapons are as sane a problem solving tool as a suicide pact.

Without nuclear weapons, direct conventional war is far more likely.

Thanks for replying. While I agree, direct conventional war has a much lower likelihood of ending civilization. To be very cold about it, sure lots of people will die in direct conventional war, but they would be measured in the hundreds of thousands, not tens or hundreds of millions.

Conventional war is also localized. Imagine the global economic effects (not just $, but say food and fertilizer distribution) of having clouds of fallout circling the planet. COVID lock-down ^10? ^100? ^1000?

> not tens or hundreds of millions

https://en.wikipedia.org/wiki/World_War_I_casualties

https://en.wikipedia.org/wiki/World_War_II_casualties#:~:tex....

https://en.wikipedia.org/wiki/Korean_War

https://en.wikipedia.org/wiki/Vietnam_War_casualties

I wonder if there's an analogous metric to wtfpm that applies to historical ignorance because it sure as hell seems to be increasing lately.

I personally just don't see conventional war going to those numbers today, unless we completely unravel economic interdependence.

*ding* that would do it

If there's one good thing about global capitalism, it's that it has replaced outright violence as the best way to gain power!

I've posted about this too many times to repeat so your wrong WW1 yada yada

That's the same line of thinking that most people had prior to WW1 so I wouldn't be so sure. s/Germany/China/g and things will unravel pretty fast.

Syrian civil war is above 1m military and civilian casualties. War in Yemen and US invasion in Iraq are close.

26 millions of Soviet citizens died in the World War 2. Unless you think that Untermensch aren't people.

It even constrains what is done in conventional war too. Firebombing on the level of Dresden or Tokoyo would also lead to nuclear war now so those brutal tactics can't really be used anymore either.

We also can't underestimate with disarmament the dangerous equilibrium of a country lying about disarmament while believing most other countries have disarmed.

We might be forming a new dangerous equilibrium now though anyway with fighting a proxy war against a conventionally far weaker nuclear power.

Not the first time a proxy war was fought with them. The Cold War was basically four decades of proxy wars between the US and Russia.

Doesn't make this not dangerous, of course. It was a dangerous game back then, too.

> The Cold War was basically four decades of proxy wars between the US and Russia.

Including direct conflict that both sides pretended to be proxy conflict to manage public demands for escalation abd political fallout in the event of defeat.

There is a certain self-contradiction in your post - there is no question that without nukes Putin would end up in the same place as Saddam Hussein. And indeed that the Ukraine invasion couldn't have happened if they had had nukes (although what happens through the Ukrainian revolution is unclear - maybe the Russians would just have invaded then). The way war and peace have worked out over the last 70 years has making it quite clear that nuclear disarmament is unilateral suicide.

Strategists across Asia are identifying that they need nukes to hold off, in no particular order, India, China and the US.

> There is a certain self-contradiction in your post

I agree, there is. I am well aware of the Budapest memorandum, and in another comment I may have said something like "If Ukraine teaches us anything, it's to never give up your nukes."

This still does not resolve the issue from the POV which an alien observer might experience. From that POV, you have a species which sits on the edge of self-annihilation. The replies here seem to indicate that this will be an unsolvable problem, forever. I still hope otherwise. So maybe I am a actually "hippie" in this regard.

In any case, I should have qualified my OP much more.

>"The replies here seem to indicate that this will be an unsolvable problem, forever."

I can imagine that in a very long term people might evolve to the point of not needing to kill each other. But as it stands now every country is more than willing to commit murders at scale to achieve their goals assuming they're reasonably safe from "proper payback" or big economic losses.

What drives me nuts about the current situation is that the power over nuclear annihilation currently rests in the hands of a number of people who could be fit into a small hotel.

This is one of the few benefits of the centralization of power which we currently experience. You really just need a few hundred people to reach this consensus.

We may never be in a better place in history to solve this problem as we are in today.

That is decidedly not the case. Even dictator is backed by a decent numbers of allies within his country, and he will need to get their agreement to actually do the disarmament, even if he already agreed to outside parties. And in country like China (authoritarian but not quite dictator yet), the top guy is backed by a huge power pyramid, there are tens of thousands of politicians and strategists funnel their plans and ideas upward for discussions.

The good news is that it goes both way too: even dictator can’t unilaterally decide to go ham and nukes everywhere. Sure, nuke your direct enemy is still an option, but anything more than that, or risks escalation more than that will probably be hard to be decided by just one or few guys. If you want to be optimistic, just realize that any time in the past where things might go wrong, actual human beings had stepped up to prevent fullscale nuclear war to happen. From Bayesian point of view, the odd is still on our side.

I know that tactical nuke could be unfortunately escalated to larger scale, but then again, this needs people to agree to escalate in some sense. And there is still the obvious Murphy’s law of anything that can go wrong will go wrong. But we are trying to be optimistic, aren’t we?

> sits on the edge of self-annihilation.

Nuclear war does not result in self-annihilation.

Russia would not unleash all their nukes on the US, unless they want to be "pacified" by China afterwards. It would not bomb China and the US at the same time, unless they want to be the target of both of them, and maybe the UK and France too.

The US answer to a Russian or Chinese attack would not be an all-out nukefest, because nukes will continue to be needed for deterrence.

The far more likely nuclear war scenario is one where there is a limited initial engagement. After which, people from major metropolitan areas will move away, or prepare for rapid evacuation if the need comes.

I'd venture to say that a nuclear war (including strategic nukes exchanges) would result in fewer deaths worldwide than Covid-19.

  > there is no question that without nukes Putin would end up in the same place as Saddam Hussein.

Speaking of Saddam, was our invasion of Iraq any more justified than Putin's invasion of Ukraine?

Because the moralizing propaganda being shoveled down our throat every day is nauseating. I guess I understand why it would work on people under 25, but I see too many adults who should know better swallowing the party line completely.

I feel like the same questions have been asked since Oppenheimer, and we're no closer to actual resolution.

The Ukraine war makes disarmament much less likely, since Ukraine did actually surrender their nukes (Budapest memorandum https://treaties.un.org/doc/Publication/UNTS/Volume%203007/P... ), and as a result they got invaded. How can we provide security guarantees that are better than that?

So give Ukraine a few nukes-on-missiles and they'll be on a more equal footing with Russia and the entire nature of the war will change? It obviously is an escalation, but an escalation that seems likely to de-escalate the entire war. Russia would not be so sanguine if Moscow and St. Petersberg were at risk. Of course the downside is Putin may not care and use nukes anyway and just hope their anti-missile systems protect them. However, Russia broke the pact so it only makes sense to give Ukraine their nukes back.

From what I see nukes are the only thing that can protect less equipped countries from the invasion should they refuse to dance to the prescribed tune. One can argue that they needed the invasion by being bad girl but it is beyond the point. Everyone wants to live however they understand it.

I’ve always viewed nuclear power as the path to nuclear disarmament, since you can turn weapons into fuel.

But it seems the storage problem and the renewable clean energy and environmental activists won’t view nuclear disarmament as part of the power revolution.

FWIW, the Kremlin's current social media campaign has been recently focusing on encouraging fear of nuclear warfare in the West in response to supplying tanks to Ukraine. I've seen a number of posts across several platforms since Tuesday with leading topics that inevitably devolve in threads laundering FUD.

Why are people so cavalier about the prospects of nuclear war these days?

Why are discussions about the Ukraine conflict so dishonest?

I can list the ways if anybody wants.

It truly boggles the mind how easily led people are on false premises.

As Goebbles would call it the "Big Lie..."

How much should we trust or care about the WHO critical medicine lists, given that ivermectin is on there too? Seems like a bunch of anti-vaxx nonsense to me.

In Belgium Iodine tablets are freely and for free available in all pharmacies. All you need is show up with an ID (this is to prevent hoarding) They will give you a box with enough doses for 2 adults and 3 children for free.

Now if only this system existed for all WHO essential medicines... The covid pandemic would have played out differently...

Who knows where to get these in the SF bay area? The clock is ticking close.

Your doctor's office will be able to help you find a specialist in case of acute radiation poisoning.

Probably best to book ahead, there's likely to be a rush on.

Also, the doctor's office or pharmacy may not exist.

We'll just ask the neutrons to wait for the next available new patient appointment.

In a mass casualty incident I think specialists will be working under the direction of FEMA.

Just buy lots of redwine. It's enough.

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