A few comments on pandemic influenza(fluidinfo.com)
fluidinfo.com
A few comments on pandemic influenza
http://www.fluidinfo.com/terry/2009/04/26/a-few-comments-on-pandemic-influenza/
11 comments
I always thought the W-shaped spike in deaths-by-age from the 1918 pandemic was due to it spreading rapidly in infirmaries and barracks full of already sick and/or stressed out soldiers.
Another possibility is cytokine storms:http://en.wikipedia.org/wiki/Cytokine_storm
"In conclusion, I’d say that the thing is largely out of our hands"
But remember your mother's best advice : wash your hands and don't touch your face.
http://www.cdc.gov/flu/protect/stopgerms.htm
But remember your mother's best advice : wash your hands and don't touch your face.
http://www.cdc.gov/flu/protect/stopgerms.htm
My mother's best advice was drink more water and get an early night. But yeah, both are good.
Quite literally a hacker talking about news. This was a good read.
Oh, great. A disease panic, now accelerated by online social media and Twitter. This could be worse than the bird flu (panic) of 2004-2005!
Despite the opening claim to being "fairly sober -- neither alarmist, nor dismissive", I thought the choice of emphasis here is somewhat in the alarmist direction, mostly making sure to mention how bad it could be. Examples:
I expect it will go global in the next couple of days, maximum.
The social breakdown in a pandemic is extraordinary.
No-one knows how bad another pandemic might be in terms of mortality... single digit millions... 100M might be possible.
...you should probably not believe anything any politician says about pandemic influenza.
So let me offer as a small counterweight the at-least-as-likely alternative scenario: flu deaths worldwide in 2009 will be about the same as previous years, around 40K in the US and up to 500K worldwide.
At this point: eat well, sleep well, and discourage sick people from coming to offices or socializing. Same as always.
Despite the opening claim to being "fairly sober -- neither alarmist, nor dismissive", I thought the choice of emphasis here is somewhat in the alarmist direction, mostly making sure to mention how bad it could be. Examples:
I expect it will go global in the next couple of days, maximum.
The social breakdown in a pandemic is extraordinary.
No-one knows how bad another pandemic might be in terms of mortality... single digit millions... 100M might be possible.
...you should probably not believe anything any politician says about pandemic influenza.
So let me offer as a small counterweight the at-least-as-likely alternative scenario: flu deaths worldwide in 2009 will be about the same as previous years, around 40K in the US and up to 500K worldwide.
At this point: eat well, sleep well, and discourage sick people from coming to offices or socializing. Same as always.
On top of that it suggested two similarities between the 1918 flu and the current swine flu, without explaining in much detail why it happened.
"There were 3 waves of the 1918/19 pandemic. The first was in summer of 1918 - very unusual, as influenza normally falls to extremely low rates during summer. Note that the current outbreak is also highly unseasonal.
The 1918 pandemic killed with a very unusual age pattern. Instead of peaks in just the very young and the very old, there was a W shape, with a huge number of young and healthy people who would not normally die from influenza. There are various conjectures as to the cause of this. The current virus is also killing young and healthy adults."
In the first argument it isn't even clear why and if it's dangerous. Did the 1918 flu kill so many people because of something related to it being a summer outbreak, or would deaths have been even worse if it were a winter outbreak?
Those were just similarities just mentioned to make people think "Oh no! It's 1918 all over again!" without actually having to prove that it is. Pretty low debating tactic.
"There were 3 waves of the 1918/19 pandemic. The first was in summer of 1918 - very unusual, as influenza normally falls to extremely low rates during summer. Note that the current outbreak is also highly unseasonal.
The 1918 pandemic killed with a very unusual age pattern. Instead of peaks in just the very young and the very old, there was a W shape, with a huge number of young and healthy people who would not normally die from influenza. There are various conjectures as to the cause of this. The current virus is also killing young and healthy adults."
In the first argument it isn't even clear why and if it's dangerous. Did the 1918 flu kill so many people because of something related to it being a summer outbreak, or would deaths have been even worse if it were a winter outbreak?
Those were just similarities just mentioned to make people think "Oh no! It's 1918 all over again!" without actually having to prove that it is. Pretty low debating tactic.
Frequently washing your hands, with soap and water, is better protection than eating and sleeping against such infections
And of course, try not to use "anti-bacterial" soap. It won't help against a virus, and if anything you are simply selecting for those strains of bacteria that have that extra edge.
the 1918 flu pandemic was worse than the black plague and it's not even airborne like this one.
http://www.puertorico-herald.org/issues/2003/vol7n30/KillerV...
http://www.puertorico-herald.org/issues/2003/vol7n30/KillerV...
Neither of your claims check out. The black plague killed a higher proportion of the world's population, and the 1918 Spanish Flu was airborne, like other flus.
There are properly more people living in Washington DC than in Europe during the time of the plague.
Not at all. According to Wikipedia, the population of Europe before the plague peaked at 70-100 million, while the plague killed 25-50 million, still leaving the population over 20 million, possibly over 50 million. The population of Washington DC is 592,000; if you include the metro area, 5.3 million.
"Don't eat pork from Mexico!!"
Sigh
Surely this sort totally false information and rumors has spread verbally before Twitter was around, now we just have a permanent record of stupid things people say.
Sigh
Surely this sort totally false information and rumors has spread verbally before Twitter was around, now we just have a permanent record of stupid things people say.
The virus is an influenza A virus, carrying the designation H1N1. It contains DNA from avian, swine and human viruses, including elements from European and Asian swine viruses, said the CDC, which is already working on a vaccine.
- http://www.reuters.com/article/domesticNews/idUSTRE53N228200...
- http://www.reuters.com/article/domesticNews/idUSTRE53N228200...
if the virus spreads as well in the real world as it does in the virtual one we're screwed
Population variability and imperfect interfaces make that unlikely.
As I said in the other thread, the only certainty in a pandemic is that the public will react in bizarre and strange ways.
The general feeling is that the reaction will almost certainly be an order of magnitude over the threat, given our knowledge and expertise with pandemics, and that most deaths will be from human response as opposed to the pandemic itself (as would be the case with a dirty nuclear bomb).
The general feeling is that the reaction will almost certainly be an order of magnitude over the threat, given our knowledge and expertise with pandemics, and that most deaths will be from human response as opposed to the pandemic itself (as would be the case with a dirty nuclear bomb).
How?
I'm not disagreeing, I just don't see any obvious ways that the human response would cause a lot of deaths - so I'm curious.
I'm not disagreeing, I just don't see any obvious ways that the human response would cause a lot of deaths - so I'm curious.
A crash nationwide vaccination program in response to a swine flu scare in 1976 appears to have triggered hundreds of cases of Guillain-Barré syndrome, and "at least 25 deaths":
http://www.semp.us/publications/biot_reader.php?BiotID=177
http://www.semp.us/publications/biot_reader.php?BiotID=177
Given that the geographically concentrated swine-flu related death toll is already over 81, this doesn't provide compelling evidence that 'most deaths will be from human response as opposed to the pandemic itself'.
TV news stations will of course hype this thing beyond all proportion, as they always do, but that doesn't mean the threat isn't real and that, as the article suggests, the death toll from Swine 'flu itself won't run into tens if not hundreds of millions.
TV news stations will of course hype this thing beyond all proportion, as they always do, but that doesn't mean the threat isn't real and that, as the article suggests, the death toll from Swine 'flu itself won't run into tens if not hundreds of millions.
I wouldn't suggest that overreaction necessarily kills more than the disease itself. (Your quote is from another poster.) But I did want to share one example where it clearly did, to show it's not impossible.
Your link said that they vaccinated 40 Million people, and accidentally caused 25 deaths. If that's the downside, I'm willing to risk it ...
To be ultra conservative, assume there's a 0.1% chance that this becomes 10% as bad as the 1918 flu. The 1918 flu killed ~3% of the world population - if swine flu is one tenth as bad it means ~300K deaths in America. Therefore the expected number of (American) deaths is 300. As long as the vaccine is expected to cause less than a 300 deaths, we should do it, right?
To be ultra conservative, assume there's a 0.1% chance that this becomes 10% as bad as the 1918 flu. The 1918 flu killed ~3% of the world population - if swine flu is one tenth as bad it means ~300K deaths in America. Therefore the expected number of (American) deaths is 300. As long as the vaccine is expected to cause less than a 300 deaths, we should do it, right?
Of course, if the net lives saved outnumber the net lives lost, and other costs are similarly weighed, you take the chance (or at least give people the option).
But in the 1976 case: there was only 1 death from the feared strain... and 25+ deaths from the vaccination program, which was halted early. Overreaction can be out of proportion to the danger.
And there are all sorts of other harder-to-measure costs, including excess deaths, from overreaction. If a collapse of commerce driven by fear retards economic growth, more people die of other causes. If funds are diverted from other health interventions, more people die of other causes. Even in trying to vaccinate the whole nation: some small but nonzero number of people will die in the extra road travel to the vaccination sites.
Your 'ultra conservative' numbers are still way on the alarmist side, as far as I'm concerned. We may never have another natural pandemic even 1/10th as bad as the Spanish Flu. People are healthier; medicine and public health is far more advanced; the same WW1 disease-breeding-overcrowding is unlikely to recur; we have antibiotics (and many of the Spanish Flu deaths may have actually been from coincident bacterial infections).
There was a good article at The New Republic during the bird flu mini-panic that emphasized how unique the Spanish Flu was to its time. It appears to have disappeared from their archives, but fortunately I quoted it in its entirety to another forum at the time. See here:
http://www.xent.com/pipermail/fork/Week-of-Mon-20051003/0380...
But in the 1976 case: there was only 1 death from the feared strain... and 25+ deaths from the vaccination program, which was halted early. Overreaction can be out of proportion to the danger.
And there are all sorts of other harder-to-measure costs, including excess deaths, from overreaction. If a collapse of commerce driven by fear retards economic growth, more people die of other causes. If funds are diverted from other health interventions, more people die of other causes. Even in trying to vaccinate the whole nation: some small but nonzero number of people will die in the extra road travel to the vaccination sites.
Your 'ultra conservative' numbers are still way on the alarmist side, as far as I'm concerned. We may never have another natural pandemic even 1/10th as bad as the Spanish Flu. People are healthier; medicine and public health is far more advanced; the same WW1 disease-breeding-overcrowding is unlikely to recur; we have antibiotics (and many of the Spanish Flu deaths may have actually been from coincident bacterial infections).
There was a good article at The New Republic during the bird flu mini-panic that emphasized how unique the Spanish Flu was to its time. It appears to have disappeared from their archives, but fortunately I quoted it in its entirety to another forum at the time. See here:
http://www.xent.com/pipermail/fork/Week-of-Mon-20051003/0380...
This is actually a pretty interesting case as the virus is such an odd mix. For those who aren't aware Influenza has a multipartite genome (separated segments), I think we're pretty lucky this didn't show up during flu season in which case there would have been a very high chance of it mixing with another strain that easily transferred among humans but still resistant to antivirals.
This is going to sound strange, but I love watching how people act on incomplete information.
Some will fall back to observe-hypothesize-test. Some will ignore/dismiss all observations unless someone in authority tells them to pay attention. Some will make the most outlandish claims. Some will make false statements, like the "don't eat swine" claim, just to add momentum to the story.
Of course there's no right answer in a situation that could be fast-moving yet requires immediate decisions based on incomplete information. It's just cool to watch all the different modes of thinking critically.
I hope this story turns out to be bogus -- I have a job where I deal with hundreds or thousands of people in small meeting rooms. But I've read up many years before today, and I understand that the pandemic IS coming. It's just a matter of time.
Just not this year, I hope.
Some will fall back to observe-hypothesize-test. Some will ignore/dismiss all observations unless someone in authority tells them to pay attention. Some will make the most outlandish claims. Some will make false statements, like the "don't eat swine" claim, just to add momentum to the story.
Of course there's no right answer in a situation that could be fast-moving yet requires immediate decisions based on incomplete information. It's just cool to watch all the different modes of thinking critically.
I hope this story turns out to be bogus -- I have a job where I deal with hundreds or thousands of people in small meeting rooms. But I've read up many years before today, and I understand that the pandemic IS coming. It's just a matter of time.
Just not this year, I hope.
Anyone know an online pharmacy stocking Tamiflu? The one I know only has Symmetrel.