Swine Flu outbreak

The Atheist said:
Just one point here - a flu that killed 10% of the population would not just be a disaster, it would almost be the end of civilisation as we know it.

If 10%, the rest are going to be extremely sick and no infrastructure could cope, resulting in billions of deaths from disease and starvation afterwards. Never mind the banking crisis, commerce would cease.

A really disturbing pandemic would be one with a death rate over 1%.
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Many nations throughout human history have suffered 10% or higher death tolls from war or disease or natural disaster, and yet have continued to forge ahead.

The real issue is not so much the death toll as the total number of infections, and the severity in those that don't die, and finally how rapidly the spread occurs.

If conditions are severe for survivors, infection rate is 100%, and this all occurs in the space of a year, yup that would be catastrophic. However if infection rates were low, survivors had mild symptoms, and the pandemic was spread over, say, 5 years... not so much.
 
So my region is pretty much shutting down and rumor and speculation about massive numbers of cases are spreading. It's getting weird just going to the post office and the grocery store-- people are wearing those goofy ass masks... which I start to covet after a while because they are so hideous and dorky that eventually they look cool.

I thought you guys would find this morsel particularly interesting: I have a friend who is very religious and very involved with church activities (and I am compelled to add, "I like her a lot, though, and she's very kind and willing to listen and discuss just about anything." :) ) She cancelled some church event for tonight and there was an uproar.

It sounded thus:

"We have nothing to fear. The flu will not be visited upon us by God during worship."

The cool thing is that she came and told me about the uproar and I smiled. She said, "Yeah. I know. I just told everyone that God may be fine with us worshipping but the local authorities have suggested that we close up."

I think she lost the battle, though, because she came in later looking grim.

I said, "Well, isn't there a story about Jesus, or St. John or somebody and a bunch of swine that were filled up with demons? They were Legion or something?"

"Yep. And they were driven off a cliff."

"So maybe you guys just need to get together tonight and pray to drive the swine flu off a cliff?"

She said, "Right," and rolled her eyes.

"Just don't breathe," I added.

:)

What a strange take on it though! These are not fringe people, these are pretty progressive religious people. They take antibiotics and get medical treatment under normal circumstances.

But bring a plague upon their heads and suddenly they backslide a few hundred years...

Weird weird weird.
 
skeptigirl said:
Sorry, Ron Paul is full of it. I didn't have time to hear the other video of 9 minutes of news. Halfway through it sounded like the same news being heard elsewhere.

As for Paul, to claim the government shouldn't be involved... So is he saying we should disband the public health system? He needs to travel to a few countries where the government is not involved in public health.

The 1976 flu vaccine could have gone either way and the decision made at the time was made on the best information available. Paul's opinion is like saying science based medicine is a failure because 30 years ago they were still taking tonsils out.

Then he goes on to say TB is worse. Sure, because the annual death rate around the world is high every year. That is reason to fund more public health, not evidence we should only fund the worst of it.

The man should be ashamed to call himself a doctor.
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This time :shocked: I agree, that Ron Paul is off. His brand of libertarianism doesn't fly for me anymore.
 
The Atheist said:
If you're trying to find a pattern in seven deaths, I suggest you'll be wasting your time.

Read your own sentence at the start of your post - quality of evidence.

So far, the actual evidence is only startling for the lack of it.

I will, however, repeat that the tiny number of deaths from what was clearly an established outbreak, seems to indicate a very mild influenza. Which just happens to be occurring at the same time as an outbreak of.....

Influenza A, since at least a couple of people with A positive 'flu results here have come back negative for "swine" 'flu.
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For the sake of other readers here, and because I already wrote the same thing for another forum with the same misconceptions, I'll address this one more time. People who do not know what the significance of case definitions are have been using the WHO data wrongly to both accuse the WHO of a cover up, or to declare there is no real pandemic at all, depending on where the person with the misconception's preconceived beliefs take them.

Here is a link and some quotes from the "Interim WHO guidance for the surveillance of human infection with swine influenza A(H1N1) virus." Forgive all the bolding but I know lots of people only have time to skim posts.
At this early stage of the outbreak of swine influenza A(H1N1) virus, the main aims of surveillance are the early warning of virus spread and laboratory confirmation of virus circulating in new geographical areas and countries.

...Member States where cases of swine influenza A(H1N1) virus infection have already been reported Until further notice, the National IHR Focal Points or competent national public health authorities should report to WHO all probable and confirmed cases on a daily basis. Deaths should be reported for both probable and confirmed cases. WHO will present the cumulative number of cases for global reporting back to Member States and the public. This activity will only continue for the initial period of data collection. ...
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The purpose of reporting confirmed cases is not to tell the public or even the medical community how many total cases there are. The purpose is to identify confirmed spread to new areas of the world and for additional assessments of the severity and extent of the disease pandemic.

These indicators are used for implementation of various measures by the countries involved. An indicator does not have to mean total cases. It can indicate other factors. For example, you don't want to send your Tamiflu stocks to areas only identified by rumors. You may decide to quit treating exposed persons and only treat symptomatic cases for another example.

To make these decisions epidemiologists need data that is comparable from one source to another. That is why definitions are developed and used to collect and report data.

When the public misunderstands the purpose of certain reports, it leads to false conclusions somehow an outbreak is being covered up, or that it is really much less severe than the public is being told by the media hype. You have to understand what it is you are looking at if you want to draw the best conclusions about the evidence.

WHO just raised the pandemic alert level to 5. That suggests, 1) no cover up and 2) clearly there are more cases than the defined "confirmed cases".

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gumboot said:
No, I don't. I think they're the only ones that should be used to determine the severity of the virus.
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That can be true but it depends on who collects the data and whether or not their goal is to enumerate total case fatalities. You are assuming that is the goal of the confirmed case fatality numbers WHO is collecting and publishing. But that is not their goal with this report at this time. Do you have evidence that is specifically how WHO expects or intends to use their confirmed case count, to determine a complete, clear pattern of the fatalities?

Or might that not be feasible at this time and WHO is using the data to indicate other aspects of the pandemic?

gumboot said:
If the confirmed infections outside Mexico were severe in nature, or had comparable death rates to the Mexican infections, I would be very concerned. But they don't, so I'm not.
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As long as the virus responds to anti-virals, I am not overly concerned. As for the pattern of severity, there's no way there is yet enough data to draw a conclusion either way.

Except we can conclude two things from the data so far. It doesn't appear the population has much immunity to this strain. And AFAIK, all strains of influenza ever seen have killed thousands of people.

gumboot said:
It's simply illogical to assume that the probable, suspected, and unknown infections are more severe than the confirmed cases.
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Only if you don't understand the data you are looking at. Many probable and suspected cases can be presumed to be actual cases from what we are seeing. And that includes fatalities.
 
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BeAChooser said:
Not necessarily - http://www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/dec2206mortality.html
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Almo said:
Read the book and then say that.
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The reasons for the difference are covered earlier in the thread, but briefly:

Antivirals did not exist.
Antibiotics did not exist.
Vaccines did not exist.
Medicine has come an awful long way since 1918.

gumboot said:
Many nations throughout human history have suffered 10% or higher death tolls from war or disease or natural disaster, and yet have continued to forge ahead.
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Not usually in a very short, ~3 month time frame. Not since the Black Death, I would guess.

FSM said:
So my region is pretty much shutting down and rumor and speculation about massive numbers of cases are spreading. It's getting weird just going to the post office and the grocery store-- people are wearing those goofy ass masks... which I start to covet after a while because they are so hideous and dorky that eventually they look cool.
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I'm waiting for the first ones here - outside of the airport.

I have some sanding masks at home, so I'm pretty tempted to strap on to see what reaction I get.

skeptigirl said:
WHO just raised the pandemic alert level to 5. That suggests, 1) no cover up and 2) clearly there are more cases than the defined "confirmed cases".

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And more importantly, that sustained human-human transmission has occurred in two countries.

One more region and it's DEFCON 6!
 
The Atheist said:
This is terrible.

It won't stop the spread, and it's a negative impact on the economy, which will get doubled up, because as soon as class starts again, the 'flu will whip through the kids and give it to their families.

Whoever thought that up has lost touch with reality.
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Actually, I've been thinking about the benefit of trying to stop an unstoppable train. There is a benefit in slowing the progress of an influenza pandemic even if stopping it is futile.

You spread the cases out so as to not overwhelm the health care infrastructure.
 
JHawke said:
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But why is this necessary? Other states didn't do it.
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Yet. They will when the case numbers increase in their states.
JHawke said:
..Denmark had plenty of Tamiflu even before the outbreak started.
(And we never really used flu shots over here)
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Don't get out much, do you?
Influenza vaccinations in Denmark during the season 1999-2000
RESULTS: In Denmark, 47% of the older group and 8% of the younger group were vaccinated against influenza. In the municipality of Copenhagen the acceptance rate was 66% in the older group, compared to 46% in the rest of the country. General practitioners vaccinated 69% of the older group and 66% of the younger group, 24% were vaccinated at a vaccination clinic, and 7% were vaccinated elsewhere. Half the 18-64 year-olds were vaccinated by their own GP, 33% at their workplace, 11% at a vaccination clinic, and 6% elsewhere.
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We don't see much better coverage here yet either. The public underestimates the disease risk and vaccine benefit.


JHawke said:
...Is it because California has no stockpile of Tamiflu ready?
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No, and even if they didn't have any, they wouldn't need a declaration of emergency to get some from the federal public health stocks. These declarations are just formalities to set various control efforts in motion.
 
Steelmage said:
First, Ron said (or indiciated) that the vaccine was made quickly, therefore there could have been mistakes made.
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Nonsense. He's full of it. I'll be posting some stuff on the 1976 vaccine later.
Steelmage said:
The process to make vaccines must be done correctly or they do not work.
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Of course.
Steelmage said:
He never said anything about science based medicine being a failure.
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Analogy:"Similarity in some respects between things that are otherwise dissimilar."
Steelmage said:
He is talking about the government actions lead to something akin to overreacting and it is the government that failed.
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More nonsense but it fits with what Paul and his followers believe so they accept it without evidence.
Steelmage said:
Boy, you sure go for a knee jerk reaction.
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If by knee jerk you mean I know this stuff well enough to know BS the second I see it, then you're right.

Steelmage said:
What about the first video, as far as I know was informing people, the news I see here seems to be scare tatics more then anything. This is from the BBC. About 7 minutes in, they talk about all the cases in other parts of the world the flu is mild. Only in Mexico it is not mild, they also talk about that the people who are dieing is under the age of 45.
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All the mainstream news is reporting this about the same. With lots of factual errors and misinterpreted data.
 
skeptigirl said:
That can be true but it depends on who collects the data and whether or not their goal is to enumerate total case fatalities. You are assuming that is the goal of the confirmed case fatality numbers WHO is collecting and publishing. But that is not their goal with this report at this time. Do you have evidence that is specifically how WHO expects or intends to use their confirmed case count, to determine a complete, clear pattern of the fatalities?
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The above makes no sense whatsoever.

What the WHOs goal is in collecting data is irrelevant. It's an obvious fact that when assessing the severity of an illness you should only use confirmed cases of the illness and not speculative ones.

That's just basic statistical fact.
 
The Atheist said:
Just one point here - a flu that killed 10% of the population would not just be a disaster, it would almost be the end of civilisation as we know it.

If 10%, the rest are going to be extremely sick and no infrastructure could cope, resulting in billions of deaths from disease and starvation afterwards. Never mind the banking crisis, commerce would cease.

A really disturbing pandemic would be one with a death rate over 1%.
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While the initial death rate in some places hit with the 1918 pandemic was as high as 60%, the average when you looked across the broader population was closer to 2.5%.

But the death rate is only half the equation. Rabies has a fatality rate reaching close to 100%. You have to calculate the fatality rate using the attack rate. 2.5% of 40% of everyone on the planet is a whole lotta total deaths.
 
skeptigirl said:
Only if you don't understand the data you are looking at. Many probable and suspected cases can be presumed to be actual cases from what we are seeing. And that includes fatalities.
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And how many "probably and suspected" infections have proved fatal outside Mexico?
 
gumboot said:
The above makes no sense whatsoever.

What the WHOs goal is in collecting data is irrelevant. It's an obvious fact that when assessing the severity of an illness you should only use confirmed cases of the illness and not speculative ones.

That's just basic statistical fact.
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Gummy my friend, let's try another approach, because if you can discuss the finer nuances of the characters in Les Miserables, I know you must be a relatively intelligent person.

Why do you think the WHO would have raised the pandemic flu alert level to 5 based on only 7 confirmed fatalities?
 
skeptigirl said:
While the initial death rate in some places hit with the 1918 pandemic was as high as 60%, the average when you looked across the broader population was closer to 2.5%.
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I think Western Samoa, as a country, probably got hit the worst - 90% infection rate and 30% of adult men died (22% adult women and 10% children). All in the space of a few weeks. Western Samoa appears to still exist. :)

Europe and the Black Death is probably the more obvious example of how much of a toll you can absorb without retreating to the caves.

That or Noah's Ark. :D
 
gumboot said:
And how many "probably and suspected" infections have proved fatal outside Mexico?
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Did you miss my discussion of the fatalities outside of Mexico?

Key difference: the denominator. When we see as widespread of an outbreak outside of Mexico, only then will we have comparable numbers. Until then, the fact there are no fatalities outside of Mexico is meaningless.
 
gumboot said:
I think Western Samoa, as a country, probably got hit the worst - 90% infection rate and 30% of adult men died (22% adult women and 10% children). All in the space of a few weeks. Western Samoa appears to still exist. :)

Europe and the Black Death is probably the more obvious example of how much of a toll you can absorb without retreating to the caves.

That or Noah's Ark. :D
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The Pacific Islanders also still see an incredibly high rate of tuberculosis disease, and measles probably caused near extinction of Hawaiians when first introduced. Measles & small pox killed as many as 95% of the native Americans when first introduced into the population.

So yes, there is often very unusual severity seen when populations lack historical exposure to new infections. Fortunately in this case, even though the flu strain is new, influenza has already resulted in natural selection of a population likely to survive for the most part, any new flu strain. For isolated populations that isn't always the case.
 
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