Monthly Archives: January 2013

China bypasses US chokehold with new pipleine

original article:  here

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China-Myanmar pipeline to open in May

By Jamil Anderlini in Beijing and Gwen Robinson in Yangon

A pipeline connecting the Indian Ocean coast of Myanmar with southwest China will begin pumping gas at the end of May, according to the Chinese company that built it.

The new pipeline will help free China from its over-dependence on the Strait of Malacca as transit way for its energy imports, giving the country an alternate and shorter supply route.

CNPC, the parent of publicly listed PetroChina, published state media reports on its website on Monday saying that the 793km pipeline would be fully operational by May 30, less than three years after construction began.

 

A parallel pipeline that will transport crude oil imports from the Middle East and north Africa across the width of Myanmar and into China is expected to be finished by next year, the reports said.

At present, about 80 per cent of China’s crude oil imports are transported through the strategically important Strait of Malacca, but the new oil pipeline is expected to reduce China’s reliance on that route by about one-third.

The new pipeline should cut the transport distance for African and Arabian oil shipments by about 1,200km.

But far more important to Beijing than the shorter distance will be reducing the vulnerability that comes from so much of the country’s energy supply being transported through a geographical chokepoint that is effectively controlled by the US, which remains the strongest naval power in the region, despite China’sgrowing investment in its own military.

The new pipelines “provide China with an alternative supply route should the Strait of Malacca ever be blocked because of piracy, terrorism or conflict”, said Stephanie Kleine-Ahlbrandt, northeast Asia director at International Crisis Group. “Beijing also fears that the straits could be threatened or cut off by the US if there was ever a conflict between the countries in the Taiwan Strait or elsewhere.”

The new gas pipeline will have the capacity to carry 12bn cubic metres of gas a year to China, with most of that supply to come from Myanmar’s gasfields in the Indian Ocean.

As China tries to diversify away from a heavy reliance on coal, its natural gas demandis forecast to grow by an average of 20 per cent a year between 2010 and 2015, with the main constraint being a lack of supply.

The crude oil pipeline scheduled to go into operation next year will be able to carry 22m tonnes a year of imported crude to China. The country imported a total 271m tonnes of crude oil in 2012.

Myanmar will take no more than 2m tonnes of crude oil and 2bn cubic metres of gas a year from the pipeline for its domestic consumption.

Human rights and environmental groups have criticised the pipeline for safety concerns, environmental damage and inadequate compensation for residents affected by its construction.

Chinese state media reports laud the project for contributing to the economy of Myanmar and solidifying the “brotherly” bond between the two countries.

But Beijing has discreetly signalled growing anxiety about the future of various big infrastructure and natural resources projects in Myanmar – particularly the gas pipeline and its Kyaukpyu port and industrial zone development, as well as the controversial Monywa copper mine, a joint venture between Chinese weapons maker Norinco and the Myanmar military. The mine was the scene of a violent government crackdown on protesters late last year.

In recent weeks, clashes in Myanmar’s northern Kachin state, which borders China, have further complicated the traditionally close ties between the two countries. On Monday, China repeated warnings about the impact of the Kachin conflict, as the Chinese side of the border has been hit several times in the past month by artillery shells believed to have been fired at Kachin targets by Myanmar’s military.

The Kachin situation figured prominently in high level bilateral discussions at the weekend, attended by Qi Jianguo, the deputy chief of general staff of the Chinese People ‘s Liberation Army.

 

 

 

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Pilot arrested by FBI for entering a “secret” no fly zone

Original article: http://www.aopa.org/aircraft/articles/2013/130110secret-no-fly-zone.html

Pilots returned, one by one, to Bermuda High Soaring in Jefferson, S.C. By about 5 p.m. on July 26, 2012, the lift had died and everyone had returned to the gliderport—everyone except Robin Fleming. No one remembered hearing from Fleming since 1:30 or 2 p.m., and Jayne Ewing Reid, co-owner and chief tow pilot of the glider club and commercial operation, was worried.

She called pilots who lived in the region and asked them to try to contact Fleming on their handheld radios. She flew the club’s Piper Pawnee in the direction of Fleming’s last known radio call, but found no evidence of the missing glider or its pilot.

“This is when you get that feeling that something’s not right,” she said. Fleming always called if he landed out. Worried that something had happened to Fleming, an avid glider pilot and instructor at Bermuda High, Jayne Ewing Reid and business partner Frank Reid decided to file a missing airplane report. Neither suspected that Fleming was in trouble with the law.

Fleming, 70, had been arrested for breach of peace after flying his Rolladen-Schneider LS8-18 sailplane noiselessly over the H.B. Robinson Nuclear Generating Station at an altitude of 1,518 feet msl—by his estimates, about 1,000 feet over the power plant’s dome—on his way to search for lift at nearby Lake Robinson.

No airspace restrictions were printed on sectional charts; no notam marked the area off-limits. When a woman at Hartsville Regional Airport relayed over the Unicom that law enforcement wanted him to land, he had flown to that airport and landed, greeted by a swarm of law enforcement vehicles.

Nonetheless, Fleming spent the night awake in a cell with 11 other inmates. The next afternoon, still in custody, he discovered the details of the charges: “flying very close to the nuclear plant dome in a ‘no fly zone,’” “escalated a multi-jurisdictional call out to a homeland security situation,” “ordered several times to land,” “causing the disturbance throughout the community.”

He finally left the detention center 24 hours after his arrest, exhausted and eager to clear his name. The charges were dropped the next month, but now Fleming wants to make sure no other pilots are subjected to a similar ordeal.

robin flemingRobin Fleming regularly flies his glider out of Bermuda High Soaring and instructs there on the weekends. He never expected that flying the whisper-quiet craft would land him with a breach of peace charge.

The arrest

Fleming took off from Bermuda High Soaring in Jefferson, S.C., at 12:41 p.m. that day, towed to 2,000 feet agl by one of the private airfield’s Piper Pawnees. He had intended to fly to Asheboro, N.C.; Dillon, S.C..; and Winnsboro, S.C., to complete a 500-kilometer course, but in soaring one goes where the lift is. A flight recorder installed in the aircraft for record attempts and competitions shows Fleming’s circling course as he searched for thermals to the east. He had looped down to Bennettsville, S.C., he said, when he decided to head home. The path back to Jefferson, traveling from one small airport to the next in case the lift died down, would take him near Hartsville Regional Airport—and the H.B. Robinson Nuclear Generating Station, two nautical miles away.

He approached Hartsville from the north at 3,100 feet msl, flying southwest toward Lake Robinson to look for lift. He had been up to 5,000 feet earlier in the flight, and knew that it went up that high if he could find it. He just had to get high enough to glide back to Bermuda High.

robin flemingThe flight started out normally, with an aerotow like this. Jay Campbell, pictured, was among the pilots who searched for Fleming.

On the Charlotte sectional chart, the nuclear power plant is marked with nothing more than a group obstruction symbol. Fleming was familiar with the post-9/11 notam that advises pilots to avoid flying near facilities such as power plants “to the extent practicable,” but he thought nothing of a single pass over the Robinson facility on the west side of the lake as he headed toward where he thought there would be lift at the lake. If he couldn’t find a thermal there, he thought, he might have to land at Hartsville.

At Hartsville Regional Airport, Wendy Griffin was monitoring the Unicom. Griffin said the people at the power plant sometimes call her if they see an aircraft flying nearby to ask her who’s flying and why the aircraft is there. (One time, she said, she got a call about a helicopter lingering in the area and found out from the pilots that they were working for the power plant.) Sometimes she calls the pilots on the frequency to find out their intentions, but on July 26 she saw that it was a glider and didn’t think much of it, she said.

“I said, ‘Well, I really don’t think it’s a threat,’” she said. “’I wouldn’t worry about it.’”

Someone did worry about it. A little before 5 p.m., Griffin said, a couple of police cars rolled up. When the officers came in, she added, she said she’d try to reach the aircraft on the radio.

Looking for lift over Lake Robinson, Fleming was switching between the Bermuda High frequency and Hartsville Unicom to monitor local traffic. He later recalled that during one switch to Hartsville, he heard the end of a transmission mentioning a glider over the nuclear plant. He responded that he was circling and moving away from the plant, he said. He found a thermal, he said, and began climbing to return to Bermuda High.

Fleming recalls that at some point someone requested he land at Hartsville, but then he was told he could continue. He climbed to 3,100 feet msl, circling to the northeast away from the lake, and planned to head back to Bermuda High Soaring; but he lost lift and descended to 1,900 feet msl. He turned toward Hartsville again, but found a thermal and climbed to 2,740 feet. “All I needed was another few hundred feet” to return to Bermuda High, he said. But he received a radio transmission for Hartsville telling him to land.

At the airport, Griffin said the officers on the scene told her to demand the glider land at Hartsville, but that an FAA official on the phone said the FAA was not demanding he land. So, she said, she gave Fleming a choice: “Police officers here are asking you to land, but the FAA says you do not have to land. I’m leaving this up to you.” Fleming said to tell the officers he’d be there in a minute, she recalled.

These accounts seem consistent with the Darlington County Sheriff Department’s incident report. Capt. Joyce C. Everett wrote that the suspect was “advised” to land at Hartsville, and that he had advised he was going to land elsewhere because he didn’t want to have his airplane towed. When he was instructed again to land in Hartsville, Everett wrote, he did. In a supplementary report, Sgt. Christopher J. Pittman wrote, “It is unclear as to exactly how that radio conversation went, but the pilot initially stated that he intended to land at Bermuda High landing strip in Jefferson, SC. After it was made clear that law enforcement expected him to land in Hartsville the pilot stated that he would comply.”

The arrest report, however, paints a different picture, alleging that Fleming “had to be ordered several times to land” before he complied. Griffin strongly contests this version of events: “I was the only one on the unicom with him,” she said. “I never demanded him to land.”

As Fleming landed, Griffin said, about four police cars chased the nonpowered craft down the runway, lights flashing. The glider came to a full stop at 5:11 p.m.

hb robinson nuclear stationThe H.B. Robinson Nuclear Generating Station lies adjacent to Lake Robinson and a short distance from the Hartsville Regional Airport.

Officers approached the aircraft and requested Fleming’s identification and pilot certificate, searched his pockets, subjected him to a pat-down, and took his wallet, cellphone, glasses, and sunglasses, according to Fleming’s account. He asked to call the people waiting for him at Bermuda High to tell them where he was, he said, but was denied. He was told he should consider himself under arrest, he recalled.

“’Haven’t you heard about 9/11?’—that’s what they said to me.”

‘No I’m not kidding’

Later that evening, Jayne Ewing Reid emailed the pilots she had asked for help in the search for Fleming, with news from the FAA: “9:02 pm – Robins plane is reported to be at Hartsville Airport.” There was still no word of its pilot.

Frank Reid called Hartsville Regional Airport and got the surprising news. Jayne Ewing Reid said she was relieved to know Fleming wasn’t in a field somewhere, but still in disbelief.

“Robin is OK !!” she wrote at 9:17 p.m. in an email to the pilots she had updated earlier. “He is in jail. No I’m not kidding.”

Jayne Ewing Reid spoke with Fleming a little later when he was able to make a collect call from his cell, and Frank Reid looked for a lawyer. Fleming’s friends were baffled that the mild-mannered pilot could arrive at such a fate.

“That boy has never had a ticket,” Frank Reid said. “… He is the most laid back and gentle person I have ever seen in my life.”

Breach of peace

The arrest warrant referred to a “no fly zone.” The incident report said that “a glider or drone had infiltrated the restricted airspace over the H.B. Robinson Nuclear Power Plant.” But Fleming knew nothing on the FAA sectional charts prohibited him from flying there.

From flying competitions in the area, he knew that the Savannah River Site, a 310-square-mile Department of Energy industrial complex that handles nuclear materials in support of national defense, is marked on sectionals with a notice requesting—not requiring—that pilots avoid flight at and below 2,000 feet msl in the area. If a nuclear site as large as Savannah River didn’t prohibit overflight, how could the area around the Robinson plant be restricted—especially if nothing said so on the charts?

Facilities such as the Robinson plant are addressed in an FDC notam issued following 9/11: “In the interest of national security and to the extent practicable, pilots are strongly advised to avoid the airspace above, or in proximity to such sites as power plants … . Pilots should not circle as to loiter in the vicinity over these types of facilities.” Because gliders routinely circle to gain altitude in thermals, the Soaring Society of America sought a clarification from the FAA, posting on its website on March 7, 2002, that the FAA did not consider this behavior loitering. “The key is to spend only as much time as needed to gain lift and move on beyond the facility,” the association wrote.

Fleming had made a single pass over the plant, and his circling had been mostly on the opposite side of the lake. The FAA looked into the overflight and later confirmed to AOPA that it found no violation of the federal aviation regulations—but Fleming was transported to the Darlington County Detention Center. The Federal Bureau of Investigation and Department of Homeland Security would interview him the next day, and Fleming said an officer read the arrest warrant to him around 3:30 p.m. July 27.

It’s unclear exactly how the concept of a no-fly zone was introduced, and a spokesman for the Darlington County Sheriff’s Office did not return phone messages requesting comment. Charles Ellison, site communications specialist at the nuclear plant, said that as he understands it, there is no no-fly zone around the facility. He said security staff had estimated that the glider flew about 400 feet above the plant, and so they contacted local law enforcement. “Any time an aircraft is flying that close, we consider it a perceived threat to security.”

Fleming said he understands the nuclear site’s initial concern, but thinks the ordeal could have stopped right there when security personnel who came to question him at the airport saw him in the police car and it became evident he wasn’t a threat. Ellison said it’s the plant’s policy to turn the matter over to local law enforcement. “Once we’ve neutralized the threat, we step back and we remove ourselves from the issue,” Ellison said.

How close was Fleming to the plant? His flight recorder, which logged his position every four seconds, gave the glider’s altitude when it passed over the site as 1,518 feet msl; the highest charted obstruction there is 577 feet msl. The incident report cited security staff as estimating it “within only a few hundred yards of critical structures.” Griffin said she heard security people saying Fleming had flown 100 feet over the dome.

“That just wasn’t true,” she said. “There’s just no way he ever did that.”

Freedom to fly

Fleming estimated he had been awake for almost 30 hours when he entered a room where a special agent from the FBI, an aviation security inspector from DHS, and a woman whose affiliation he can’t remember waited to question him July 27. He recalled that someone told him there was no intention to charge him with any federal offenses related to the incident, and that he was asked to explain the intent of his flight. He explained how he navigated by VFR charts, and that no restrictions were charted or published by notam in the area of the plant.
About 5:30 p.m., Fleming collected his pilot certificate and other belongings. Pilots from Bermuda High met him at the detention center and drove him to Hartsville to retrieve his glider.

robin flemingFleming was unable to stow his aircraft safely in its trailer while he was in custody for 24 hours.

The attorney Frank Reid had found represented Fleming for the breach of peace charge, but Fleming sought additional assistance from an attorney familiar with aviation through AOPA’s Legal Services Plan/Pilot Protection Services. John Hodge, an attorney and 17,000-hour pilot who has flown gliders, provided aviation-related information under the plan’s 20 hours allotted for local law enforcement issues. From the FAA’s perspective, Fleming’s flight was legal and legitimate: No restricted or prohibited areas were charted. Plus, local law enforcement does not have the authority to order an aircraft to land, Hodge said. And any argument that Fleming delayed in complying with the request to land must take into account the nature of a sailplane: Just like a sailboat, it can’t simply go directly from Point A to Point B.

A better knowledge of aviation issues among law enforcement officials may have produced a better result for Fleming. Griffin said she had to tell the officers on the scene to clear out the runway, and one officer talked about commandeering the airport. “He was running around, the one guy that was commandeering everything, saying, ‘We were going to shoot him down,’” she said.

On the other hand, Griffin said that pilots from the Chesterfield County Sheriff flew the department’s helicopter to the airport, but left when they found out what was going on. “They pulled out a chart and they said, ‘Look here, … nothing in this chart says you cannot fly over the nuclear plant,’” she said. “’Nothing.’”

Protecting pilots

Fleming waited outside the courtroom Aug. 21 as his case went before the judge. When his attorney returned and said the case would be dismissed if he agreed not to take any legal action against Darlington County law enforcement, he said, he reluctantly agreed. But he wouldn’t be satisfied until he could be sure a pilot can rely on the sectional for direction and not go through a similar ordeal.

In a post-9/11 environment, pilots must be sensitive to security concerns, but that doesn’t mean they must give up their freedom to fly. In its communication to members about the rules for flying near power plants and other infrastructure, the Soaring Society of America called on glider pilots to reach out to on-site security at local power plants and laboratories: “Open a dialogue and tell them who you are and when you may be in their area.” In addition, airports often encourage pilots to “fly friendly” in sensitive areas; the Hartsville airport has a right traffic pattern for Runway 3, keeping pilots on the far side of the airport as much as possible and minimizing overflight of the nuclear plant. But no law prohibits pilots from flying over it, and AOPA is working to ensure that law enforcement agencies and security at critical infrastructure understand how to respond appropriately when they have a concern about an aircraft.

AOPA routinely works with federal agencies on security issues, and the association reached out to staff at the TSA and National Protection and Programs Directorate to inform them of the issue. The association requested action formally in a letter to DHS, the organizations’ parent agency.

“This incident raises several disturbing issues that demand the immediate attention of the Department of Homeland Security to prevent unnecessarily detaining United States Citizens, or even worse, needlessly causing injuries or fatalities that would have resulted from a ‘shoot down’ of the aircraft,” wrote AOPA Senior Vice President Melissa Rudinger in the letter. She urged the department to “immediately conduct a thorough review of all security programs for similar types of facilities to ensure that it is clear on what constitutes a violation and what is the appropriate action to be taken.” She also requested that DHS make it clear that no one may shoot down an aircraft outside of the existing command structure.

The TSA responded in a letter that it takes these matters seriously—“Both in context of aircraft loitering in airspace around critical infrastructure as well as appropriateness of responses by various organizations at the Federal, State, and Local levels.” The agency said it would continue to work with organizations at all levels “by providing them with education on airspace matters via the local TSA Federal Security Directors and headquarters engagement. This will allow them to make informed and effective decisions on when and how best to execute a response based on their specific statutory and/or legal authorities.” AOPA continues to press the agency, along with the National Protection and Programs Directorate which deals with infrastructure protection, to explain what these education efforts entail; the association also has offered to assist in developing guidance and resources on general aviation-related issues.

AOPA General Counsel Ken Mead emphasized the importance of continued advocacy, explaining that it is “outrageous under these circumstances to be confined in jail without charges being filed for this length of time.” He added, “We should be persistent in demanding corrective action as well as better educational efforts of law enforcement authorities. Although the breach of peace arrest warrant that was ultimately filed refers to a ‘No Fly Zone’ neither the federal nor local authorities could cite a federal violation because this was not a ‘No Fly Zone.’”

Swine Flu Vaccination causes narcolepsy. What a surprise.

 H1N1 vaccine narcolepsy: Emelie Olsson watches television in Stockholm, Saturday. IMAGE

 
4 hr ago  By Kate Kelland of Reuters
A vaccine developed by GlaxoSmithKline for the 2009 H1N1 swine flu, and distributed to 47 countries but not the U.S., is under scrutiny for possibly triggering narcolepsy in children.

STOCKHOLM — Emelie Olsson is plagued by hallucinations and nightmares. When she wakes up, she’s often paralyzed, unable to breathe properly or call for help. During the day she can barely stay awake, and often misses school or having fun with friends. She is only 14, but at times she has wondered if her life is worth living.

Emelie is one of around 800 children in Sweden and elsewhere in Europe who developed narcolepsy, an incurable sleep disorder, after being immunized with the Pandemrix H1N1 swine flu vaccine made by British drug maker GlaxoSmithKline (GSK) in 2009.

Finland, Norway, Ireland and France have seen spikes in narcolepsy cases, too, and people familiar with the results of a soon-to-be-published study in Britain have told Reuters it will show a similar pattern in children there.

Their fate, coping with an illness that all but destroys normal life, is developing into what the health official who coordinated Sweden’s vaccination campaign calls a “medical tragedy” that will demand rising scientific and medical attention.

Europe’s drugs regulator has ruled Pandemrix should no longer be used in people aged under 20. The chief medical officer at GSK’s vaccines division, Norman Begg, says his firm views the issue extremely seriously and is “absolutely committed to getting to the bottom of this,” but adds there is not yet enough data or evidence to suggest a causal link.

Others — including Emmanuel Mignot, one of the world’s leading experts on narcolepsy, who is being funded by GSK to investigate further — agree more research is needed but say the evidence is already clearly pointing in one direction.

“There’s no doubt in my mind whatsoever that Pandemrix increased the occurrence of narcolepsy onset in children in some countries — and probably in most countries,” says Mignot, a specialist in the sleep disorder at Stanford University in the United States.

30 MILLION RECEIVED PANDEMRIX

In total, the GSK shot was given to more than 30 million people in 47 countries during the 2009-2010 H1N1 swine flu pandemic. Because it contains an adjuvant, or booster, it was not used in the United States because drug regulators there are wary of adjuvanted vaccines.

GSK says 795 people across Europe have reported developing narcolepsy since the vaccine’s use began in 2009.

Questions about how the narcolepsy cases are linked to Pandemrix, what the triggers and biological mechanisms might have been, and whether there might be a genetic susceptibility are currently the subject of deep scientific investigation.

But experts on all sides are wary. Rare adverse reactions can swiftly develop into “vaccine scares” that spiral out of proportion and cast what one of Europe’s top flu experts calls a “long shadow” over public confidence in vaccines that control potential killers like measles and polio.

“Noone wants to be the next Wakefield,” said Mignot, referring to the now discredited British doctor Andrew Wakefield who sparked a decades-long backlash against the measles, mumps and rubella (MMR) shot with false claims of links to autism.

With the narcolepsy studies, there is no suggestion that the findings are the work of one rogue doctor.

Independent teams of scientists have published peer-reviewed studies from Sweden, Finland and Ireland showing the risk of developing narcolepsy after the 2009-2010 immunization campaign was between seven and 13 times higher for children who had Pandemrix than for their unvaccinated peers.

“We really do want to get to the bottom of this. It’s not in anyone’s interests if there is a safety issue that needs to be addressed,” said GSK’s Begg.

LIFE CHANGED

Emelie’s parents, Charles and Marie Olsson, say she was a top student who loved playing the piano, taking tennis lessons, creating art and having fun with friends. But her life started to change in early 2010, a few months after she had Pandemrix. In the spring of 2010, they noticed she was often tired, needing to sleep when she came home from school.

But it wasn’t until May, when she began collapsing at school, that it became clear something serious was happening.

As well as the life-limiting bouts of daytime sleepiness, narcolepsy brings nightmares, hallucinations, sleep paralysis and episodes of cataplexy — when strong emotions trigger a sudden and dramatic loss of muscle strength.

In Emelie’s case, having fun is the emotional trigger. “I can’t laugh or joke about with my friends anymore, because when I do I get cataplexies and collapse,” she said in an interview at her home in the Swedish capital.

Narcolepsy is estimated to affect between 200 and 500 people per million and is a lifelong condition. It has no known cure and scientists don’t really know what causes it. But they do know patients have a deficit of a brain neurotransmitter called orexin, also known as hypocretin, which regulates wakefulness.

Research has found that some people are born with a variant in a gene known as HLA that means they have low hypocretin, making them more susceptible to narcolepsy. Around 25 percent of Europeans are thought to have this genetic vulnerability.

When results of Emelie’s hypocretin test came back in November last year, it showed she had 15 percent of the normal amount, typical of heavy narcolepsy with cataplexy.

The seriousness of her strange new illness has forced her to contemplate life far more than many other young teens: “In the beginning I didn’t really want to live anymore, but now I have learned to handle things better,” she said.

H1N1 vaccine narcolepsy: Emelie Olsson falls asleep whle watching television in Stockholm, Saturday. IMAGE

TRIGGERS?

Scientists investigating these cases are looking in detail at Pandemrix’s adjuvant, called AS03, for clues.

Some suggest AS03, or maybe its boosting effect, or even the H1N1 flu itself, may have triggered the onset of narcolepsy in those who have the susceptible HLA gene variant.

Angus Nicoll, a flu expert at the European Centre for Disease Prevention and Control (ECDC), says genes may well play a part, but don’t tell the whole story.

“Yes, there’s a genetic predisposition to this condition, but that alone cannot explain these cases,” he said. “There was also something to do with receiving this specific vaccination. Whether it was the vaccine plus the genetic disposition alone or a third factor as well — like another infection — we simply do not know yet.”

GSK is funding a study in Canada, where its adjuvanted vaccine Arepanrix, similar to Pandemrix, was used during the 2009-2010 pandemic. The study won’t be completed until 2014, and some experts fear it may not shed much light since the vaccines were similar but not precisely the same.

It all leaves this investigation with far more questions than answers, and a lot more research ahead.

WAS IT WORTH IT?

In his glass-topped office building overlooking the Maria Magdalena church in Stockholm, Goran Stiernstedt, a doctor turned public health official, has spent many difficult hours going over what happened in his country during the swine flu pandemic, wondering if things should have been different.

“The big question is, Was it worth it? And retrospectively I have to say it was not,” he told Reuters in an interview.

Being a wealthy country, Sweden was at the front of the queue for pandemic vaccines. It got Pandemrix from GSK almost as soon as it was available, and a nationwide campaign got uptake of the vaccine to 59 percent, meaning around 5 million people got the shot.

Stiernstedt, director for health and social care at the Swedish Association of Local Authorities and Regions, helped coordinate the vaccination campaign across Sweden’s 21 regions.

The World Health Organization (WHO) says the 2009-2010 pandemic killed 18,500 people, although a study last year said that total might be up to 15 times higher.

While estimates vary, Stiernstedt says Sweden’s mass vaccination saved between 30 and 60 people from swine flu death. Yet since the pandemic ended, more than 200 cases of narcolepsy have been reported in Sweden.
With hindsight, this risk-benefit balance is unacceptable. “This is a medical tragedy,” he said. “Hundreds of young people have had their lives almost destroyed.”

PANDEMICS ARE EMERGENCIES

Yet the problem with risk-benefit analyses is that they often look much more different when the world is facing a pandemic with the potential to wipe out millions than they do when it has emerged relatively unscathed from one, like H1N1, which turned out to be much milder than first feared.

David Salisbury, the British government’s director of immunization, says “therein lies the risk, and the difficulty, of working in public health” when a viral emergency hits.

“In the event of a severe pandemic, the risk of death is far higher than the risk of narcolepsy,” he told Reuters. “If we spent longer developing and testing the vaccine on very large numbers of people and waited to see whether any of them developed narcolepsy, much of the population might be dead.”

Pandemrix was authorized by European drug regulators using a so-called “mock-up procedure” that allows a vaccine to be authorized ahead of a possible pandemic using another flu strain. In Pandemrix’s case, the substitute was H5N1 bird flu.

When the WHO declared a pandemic, GSK replaced the mock-up’s strain with the pandemic-causing H1N1 strain to form Pandemrix. GSK says the final H1N1 version was tested in trials involving around 3,600 patients, including children, adolescents, adults and the elderly, before it was rolled out.

The ECDC’s Nicoll says early warning systems that give a more accurate analysis of a flu strain’s threat are the best way to minimize risks of this kind of tragedy happening in future.

Salisbury agrees, and says progress towards a universal flu vaccine — one that wouldn’t need last-minute changes made when a new strain emerged — would cuts risks further.

“Ideally, we would have a better vaccine that would work against all strains of influenza and we wouldn’t need to worry about this ever again,” he said. “But that’s a long way off.”

With scientists facing years of investigation and research, Emelie just wants to make the best of her life.

She reluctantly accepts that to do so, she needs a cocktail of drugs to try to control the narcolepsy symptoms. The stimulant Ritalin and the sleeping pill Sobril are prescribed for Emelie’s daytime sleepiness and night terrors. Then there’s Prozac to try to stabilize her and limit her cataplexies.

“That’s one of the things that makes me feel most uncomfortable,” she explains. “Before I got this condition I didn’t take any pills, and now I have to take lots — maybe for the rest of my life. It’s not good to take so many medicines, especially when you know they have side effects.”