Pandemic Flu

[jatx]

Originally Posted by JAGeorgia

4. Before Avian Flu could be a candidate as a cause for Pandemic Flu it would have to mutate to H2H transmission, be virulent, AND cause a global outbreak.
These last three occurring at the same time makes it very unlikely, but not impossible.

Dad,

Can you tell us a bit about what's involved in clearing each of these stage gates, including how the probabilities are modeled. I.e., what are the drivers, etc.?

BTW, mugwump, JAGeorgia has a tinfoil hat too, but he only wears it to water the lawn, not when hanging out with the lab nerds at CDC.

[The Reaper]

I have no issues with you posting this and discussing it professionally since it is of general interest and you seem to have a better handle on it that I do.

Since there is a scare of the year (Y2K, SARs, etc.), I just wanted you to clarify whether these were the same Chicken Littles making dire predictions as before, or people who exhibit professional conduct and do not panic over every potential crisis.

As I stated before, I think that it is only prudent for citizens to prepare themselves for as many natural disasters as is practicible. People should not demand that the US Government evacuate them, save them, feed them, water them, house them, rebuild their homes in a flood plain, give them money, etc. Between hurricanes, storms, tornados, eruptions, quakes, tsunamis, droughts, floods, fires, pandemics, and the metric ton of manmade disasters, intentional and otherwise, it is every American's responsibility to be prepared as much as possible, or accept the consequences stoically.

Are you taking 90 days as the planning figure because that will be the time for the disease to infect (and kill) everyone that it is going to, or because of some other factor?

TR

[mugwump]

TR

RE: the Chicken Little scenario. It is extremely difficult to assess risk in these situations. The technical issues are mind-boggling and the hard data subject to varying interpretations. It's not hard to infer how conflicted I am about this.

Your earlier question about SARS was a good one. I only knew one of my current crop of colleagues in the SARS days and he was extremely concerned, right up until what turned out to be the mid-point of the outbreak. Once they estimated the long case generation time -- the 27 cases in 30 days thing I referenced above -- he rapidly went from condition red to yellow even while the media were in full panic mode. He said it could be contained. In retrospect his yellow-red-yellow stance was consistent with the data available at the time. He is in full red mode now.

I've tried to articulate how cautious these guys are -- it sounds like JAGeorgia can probably chime in here. Being/appearing hysterical when the cold facts don't support it is professional suicide. The only thing worse is falsifying data. Robert Webster at St. Jude is one of the few talking to the media about his fears at this time. He's the guy in the ABC News segment I linked to. He's older and is at the point where he says what he thinks I've been told.

With all that said I truly think this is a crap shoot whether it hits or not. I pray it does not.

As far as 90 days...not totally arbitrary but close. I followed a guideline for a year's supply for one person and if I can gather all the chicks back to the nest there are four of us. The pallet I got from a client was the same: one year for one person (sixteen cases of Mountain House with six #10 cans per case -- the Blueberry Crumble is pretty good ). This was supposed to be for me alone -- morons. They sent Tamiflu for me alone too -- one course. I said "thanks, that's for my daughter." They caught the hint and sent 3 more courses.

I've been told and have read that "bad" pandemics (typically 3 pandemics per century with one being "bad") go through the population in three waves lasting 180 days each. I've been told to figure on up to 1.5 years until it burns completely out. I've also been told 6 - 12 months. In the 1918 pandemic the first wave was weak -- nearly indistinguishable from the background seasonal flu. The second wave was by far the worst and resulted in the lion's share of deaths.

[mugwump]

Originally Posted by jatx

Dad,

BTW, mugwump, JAGeorgia has a tinfoil hat too, but he only wears it to water the lawn, not when hanging out with the lab nerds at CDC.

JAG -- I use the Aluminum Foil Deflector Beanie, how about you?

http://zapatopi.net/afdb/

[mugwump]

A balanced, accessible newspaper article that addresses TR's question about Chicken Little:

http://cnews.canoe.ca/CNEWS/Canada/2...495802-cp.html

"When we initially started talking about this and to today, we were always saying: We don't know if H5 is going to be the virus, we don't know if it is going to be a bad pandemic, when it will strike, any of that stuff," Thompson says from Geneva.

"All of that seems to me now lost. It seems to me that in everything I'm reading, it's a lock."

[uboat509]

Something else that I think that some people are missing is the economic impact of this disease. Take Africa as an example. If (probably when) H5N1 gets going in Africa it will be devastating, not because of all the peole who die from the disease itself but when a huge percentage of the chickens die from the disease or are culled as a precaution it will remove a vital protein staple from their diet. Even if not another African ever becomes infected with H5N1, it will affect them deeply. Although we are a long way from that in this country there could certainly still be some serious consequences. We had ONE mad cow and how many countries placed embargoes on our beef? How many people decided to forego beef? Chicken is a staple in a lot of people's diets here in America as well and while no one is going to starve here simply because they can't get chicken I can certainly see it having a profound effect, econmicaly on the country.

SFC W

[mugwump]

TR - I asked someone I trust about amount of food. In true scientist fashion I didn't get a straight answer, but she did send this:

H5N1CompMAPS1.jpg
H5N1CompMap2.jpg

Scenario of Human Spread of H5N1: Los Alamos National Laboratory computer simulation based on air travel
in which H5N1 influenza virus is carried by airline passenger from an outbreak, say in Asia or Africa, to Los Angeles, California.
Map 1 shows the high infection rate in Los Angeles by Day 50 after virus began spreading human-to-human. Map 2 shows that in twenty days, by Day 70, the virus has spread across the United States. Map 3 shows that by Day 90, six weeks into the
pandemic, nearly all of the United States is enflamed red with high numbers of bird flu cases. Map 4 shows by
Day 110, the number of flu cases is beginning to decline. Map 5 shows that by Day 130, four and a half
months later, the virus is in decline. Computer map simulations in 2006 by Tim Germann,
Los Alamos National Laboratory EpiSims project.

Nice sim, but I was most excited by the fact she used the word "enflamed" (no such word) and the term bird flu (wrong in context).

She also sent this from the pandemic.gov site:

1.1.10. In an affected community, a pandemic outbreak will last about 6 to 8 weeks.

1.1.11. Multiple waves (periods during which community outbreaks occur across the country) of illness could occur with each wave lasting 2-3 months. Historically, the largest waves have occurred in the fall and winter, but the seasonality of a pandemic cannot be predicted with certainty.

So 12 weeks of food is probably not logically defensible if mult. waves are anticipated.

Edited to add: The explanation is apparently from Germann and not her. Her spelling and syntax remain annoyingly perfect.

Sir, if over 90% of the population is likely to be infected, wouldn't it be more beneficial to get sick early on, when your stock levels are high and you can help out more with keeping things running because you are either immune to the flu or dead?

Martin

[The Reaper]

Shocked to see the D+70 to D+90 change.

If you were going to need anything imported from Asia, you won't be seeing it for a while with all of the SoCal port and transport workers out of commission.

JIT construction will be over as well, but industries idling and workers staying home may help slow or ameliorate the spread of the disease while it wrecks the economy.

Martin:

My thoughts as well. If the hospital can save you, you better be there before D+90.

Wonder what percentage will never get sick from it by lack of exposure, immunity, or some other variable?

TR

[mugwump]

Ha, another "known unknown". It might be more virulent first or last. My preps revolve around my teenage kids. They are healthy as horses and therefore (pardoxically) most at risk, if 1918 patterns are followed.

I like the way you think, helping to keep thngs running.

[mugwump]

Originally Posted by The Reaper

Shocked to see the D+70 to D+90 change.

That's the short generation time -- all of those 1024 cases at 30 days, each creating another 1024 in 30 another days.

Originally Posted by The Reaper

Wonder what percentage will never get sick from it by lack of exposure, immunity, or some other variable?

In the last big one (1918-1919) about 70% didn't get sick. The current thinking is that 98% were exposed. Of the lucky 70% some unknown percentage were asymptomatic Typhoid Mary types.

Originally Posted by mugwump

Ha, another "known unknown". It might be more virulent first or last.

English comprehension issue on this end. Especially the last sentence, not sure I'm following you if you're talking about the waves (which would say the other way...).

Martin

[Warrior-Mentor]

Mugwump,
Have you read Tipping Point?
Just curious.
JM

[The Reaper]

Originally Posted by mugwump

That's the short generation time -- all of those 1024 cases at 30 days, each creating another 1024 in 30 another days.

In the last big one (1918-1919) about 70% didn't get sick. The current thinking is that 98% were exposed. Of the lucky 70% some unknown percentage were asymptomatic Typhoid Mary types.

Yeah, but people were much more isolated then.

The odds of someone showing up in East BF, North Dakota who had been in a major city recently was pretty low. The US population was much more dispersed and there was less travel, except for the returning vets. I knew people who had never left the county they were born in. The long range transportation nodes were pretty much limited to rail, and ship. No planes to bring it in from overseas in eight hours or less, while travelers were still asymptomatic. Domestically, the same applies on rail service here. Fewer travelers, shorter distances, longer travel times (days, rather than hours) back then.

Medical care in most of the country was still largely doctor visits, rather than hospital based, though I suppose the Doc could be a vector till he showed symptoms. The spread of cases in hospitals was likely lower, as people stayed home, were treated at home, and were cared for at home only by immediate family members.

These factors would lead me to note that the spread of a similar bug today would be less detectable, less capable of isolation, faster disseminating, more difficult for hospitals unaccustomed to mass casualties, and more disruptive to society.

On the positive side, we have the advantage of being able to see/understand the threat, ID it, take precautions, treat patients more effectively (in low numbers) and possibly develop a vaccine or treatment.

TR

With all the talk about H2H and H5N1 I thought I would post something that is not getting much attention in the media. Man's best friend is already fighting the flu.

Cornell University documented in Sept 2005 that some dog fatalities in 2004 were caused by the Equine Flu virus H3/N8. The Equine Flu jumped from Horse to Dog.

Anyway, it is real, it is contagious and if you haven't heard about it, here are some details. Suggest talking to your local DVM about your area and the risk.
About 10% of the dogs which get this need to be euthanized. This was first identified in the USA. Depending on the vet you talk to you will get a different opinion about it's ability to spread.

http://wsunews.wsu.edu/detail.asp?StoryID=5452
http://www.vet.cornell.edu/news/dogflu/

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