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While most countries will not be affected at this stage, the declaration of phase 5 represents "a strong signal that a pandemic is imminent and that the time to finalize the organization, communication and implementation of the planned mitigation measures is short." In making the announcement, WHO Director-General Margaret Chan urged countries to activate their pandemic flu response plans. "This change to a higher phase of alert is a signal to governments, to ministries of health and other ministries, to the pharmaceutical industry and the business community that certain actions now should be undertaken with increased urgency and at an accelerated pace," she told a news conference in Geneva. There are now 91 confirmed swine flu cases in 10 states. New York has 51 confirmed cases; Texas 16; California 14; Massachusetts, Michigan and Kansas two each; and Arizona, Nevada, Indiana and Ohio one each. The reality is that these numbers are almost out of date by the time I say them. The virus is spreading, and there is no evidence of it slowing down at this point. What should Southeast Texans do: Avoid crowds where possible. Don't have casual physical contact with others such as shaking hands or hugging. Wash, don't rinse, wash your hands after any physical contact. Keep your hands away from your mouth, nose or eyes. Stay rested, drink plenty of fluids, eat healthily. If you have a cough, sore throat or body aches, WITH fever, see your healthcare provider. Pray for the families who have lost loved ones and particularly children. Don't panic, we will get through this together. You can't get swine flu from food even pork, mosquitoes, or people with common colds or allergies. Remember; be cautious but everything that coughs or sneezes is not swine flu. For daily updates see the CDC website or Southeast Texas Medical Associates' website www.setma.com. Appointment of SETMA's Chief Medical Officer, Office of Evidence-Based Medicine 03/17/2009 The partners of SETMA have appointed Major (Ret) W Bryan Sims, MSN, APRN-BC, FNP to assume the position of Chief Medical Officer, Office of Evidence-Based Medicine. Major (Ret) Sims is pursuing a doctorate in Advance Practice at the University of Texas Health Science Center at Houston. The 28-page DNP Essentials Summary outlines the scope and the expertise expected for those who successfully complete the program at which time Major (Ret) Sims will conferred the degree of Doctor of Nursing Practice (DNP). Major (Ret) Sims' past and present interests in evidence-based medicine, along with his extensive knowledge of the medical literature, make him an ideal candidate for this position. SETMA welcomes his to this new roll and as SETMA pursues NCQA recognition as a Patient-Centered Medical Home, he will play and invaluable roll. James L. Holly, MD CEO, SETMA, LLP

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