Disquieting yes.
But it’s not a pandemic.
YET.
Not yet. But yup, this explains the rush (over a gov’t-long-holiday-weekend)to get out a document that has so many spelling, vocabulary, and syntax lapses I would not let my 7th grader out of the house on any given morning with that type of homework.
What do they take us for?
Come on PTB ---treat us like the intellegent humans beings that we are. Level with us and watch us rise to the occasion. Keep us in the dark and manipulate us and watch all H&# break loose when tshtf. It will be your worst nightmare.
I read somewhere, another flu board I imagine, that when asked about John Barry`s book President Bush replied that he thought that President Wilson handled it ( the 1918 pandemic) well.
Could explain the gov disinclination to tell us anything.
What about patient zeros contacts? Any news on them?
I miss Niman and his efforts to try to explain this greek for some of us…
Can Monotreme, Tom DVM, NS1, etc. PLEASE come back and explain H5N1’s newest trick?
Thanks in advance.
Well I just read about a dozen post on this from Niman at CE.
I think it’s even worse than I thought.
Here’s two that a ringing in my head:
1) ‘’It describes a coupe, of changes outside of the receptro binding domain being monitored by WHO. The M230I chnage matches all 3 seasonal flu’s, but the adjacent positions (226–229) match influenza B. Three of the four changes in the Nature paper are outside of the receptor binding domain described previously. ‘’
2) It means that H5N1 is one step closer to efficient H2H. The Nature paper indicates that the changes compliment each other. Kind of like rolling dice. If one die has just 3′s and the other has just 4′s, guess what happens when you roll them.
it would be nice if someone could explain what this means. recepto binding domain sounds like a home for X-men. I know enough to know this is bad, but I could not possibly explain it to someone else, though. Thanks JWB for your dice analogy.
The thing that struck me was that the PB2 E627K modification allows it to retain activity at a lower temperature. If you recall that is what is needed for it to be able to live higher up in our respiratory system. That means that we can sneeze/cough to spread it. Before it was way down in the warmer areas of the lungs and was harder to spread.
JWB item 2 I would guess 7 but TPTB seem to be betting that they will just stand on their corners.
Green Mom at 20:39
Among other things, the modification makes it possible for H5N1 to live higher up in your throat instead of way down in your lungs. It has to “grab a hold” on something (the binding site) for a place to live.
For example, let out all your breath naturally - that is “tidal air”. But if you try hard you can push out a little more. Well before H5N1 was only able to live well way down in that bottom part of your lung where it is warm and there was different binding sites. That means that people could exhale and not spread much of the virus. But if it lives up “top side” then you can easily exhale and spread the virus.
A pandemic needs to be easy to spread (that R0 number). So this modification just might let it do that. Luckily, there are only two times it seems to have done that and they were able to contain it (keep it from spreading).
The other thing in all this is that the modification is not where they usually look when they see if it is H5N1. That means that there may be some of those modifications out there (say in some birds or pigs or something) that has the “killer” modification but we are just not seeing it.
The bottom line is that the little monster has done those modifications before and still retained its 50%+ CFR (kills more than half of those that show clinical symptoms). If it did it twice already, then it is possible that this thing can go pandemic while retaining a 50+% CFR. That would make it at 25 times more lethal than the 2% of the 1918 flu.
Hope that is simple enough with being overly simplistic. I will leave it to the gang here to correct me and add to.
Green Mom at 20:39
DennisC at 20:48
1) and 2) are Niman’s quotes. Not mine. Those are two out of about a dozen that I can sorta understand.
DennisC at 21:06
Thanks. That helps.
Watch. The next thing they will find out about this b*sturd virus is that it carries little viral chainsaws to cut through your front door.
JWB- wouldn’t be a bit surprised!
Thanks Dennis- nicely explained. Thats what I thought but wasn’t sure. If my ppf hadn’t shorted out it would be going up!
DennisC at 21:06
DennisC, Thanks for the interpretation. Very sobering.
Oh yes, I don’t want to mislead anyone. I said there might be some H5N1 “hiding” in something like birds, or pigs or something. From Niman’s view (as I understand it) the virus is not hiding in birds (the sequences don’t match) but something else. And it looks to me that the only “something else” could be a mammal (dog?,human?,.. ) since none of the sequence modifications match birds.
A couple of months ago something like this would have sparked fierce discussion and debate. Now there are a mere 16 posts. Maybe one of the doctor mods could step in and fill the gap. I’d sure appreciate it.
I’d say that if they’re like me, they’re sitting here solemnly thinking “I’d hoped this day would not come.” Looks like it’s only a matter of time to me.
I can’t tell if the day came and went or is yet to come. The Egypt patient died a month ago didn’t she? There hasn’t been a pile of bodies in Egypt since. That’s got to mean something doesn’t it?
Orlandopreppie at 22:16 A couple of months ago something like this would have sparked fierce discussion and debate. Now there are a mere 16 posts. Maybe one of the doctor mods could step in and fill the gap. Id sure appreciate it.
Orlandopreppie, What is it you feel we should be debating? Not trying to be a putz. Seeking clarification as, to the untrained eye (i.e., mine), there appears little to debate. The news is already plastered all over US media, including Web MD with a very nice Idiots Guide to Polymorphisms article. In fact, it seems to be “out there” too quickly. Places such as Web MD are not breaking news formats. The fact that this is already posted there tells me the story was already “in the can,” waiting only on public release of the Nature article before being posted. If that is the case, it speaks to a pretty high degree of orchestration in rolling this news out to Jane and John Q. Public the likes of which we’ve not seen to this point.
, a steady drum beat…the update yesterday by DHHS. OSHA releasing updated rules for keeping employees safe. Bush in SEA. Stopover on Monday in Indonesia.
I don’t hear too many people disagreeing with the new information, but it is early yet.
Orlandopreppie at 22:16
Wonderer at 22:18 may be correct in the assessment - there may not be many gaps to fill.
Still, I agree, I miss (and have missed) the input of those now silent voices here. I understand, but mourn, especially now.
I’m hoping the ‘new’ forum lets bygones be bygones. I’m hoping there can be room here for all voices.
Not sure what happened with my post at 22:29. Part of it got lopped, but the gist is there.
Please prepare.
Deceleration can occur, but these events cross a new high-water mark.
The more similar H5N1 is to seasonal influenza, especially the Receptor Binding Domain (RBD), the more likely recombination events are to happen.
More strings of identity allow for more landing zones or attractant areas around which new genetic information may be exchanged.
If you align the two simplified examples, you see that these sections of the two viral strains share 16 nucleotides of identity.
Because they are so similar now, a landing zone or attractant area is in place for templating and bringing potentially the 2 preceeding and/or 2 trailing nucleotides, like this potential result in the progeny.
The stage is now being set because a contiguous string from the Influenza B RBD 226:230 has been acquired in toto by several of the Egyptian Human H5N1 viral strains. The M230I as well as others up and downstream may create or set the groundwork for creation of a more potent and transmissible strain.
Any connection between this info and the 12-week SIP info that went out to the embassies?
Edna Mode,
Really, WebMD? That’s too interesting.
NS1 at 22:37 Please correct me if I am wrong. If I read you Niman etal correctly, all that is needed now is for one person to acquire this specific form of the H5N1 and be a super spreader and the Pandemic is on.
If I am wrong PLEASE flame me. We really need to know and a little flame here is better than a Pan Flu later.
OKbirdwatcher at 22:38 Any connection between this info and the 12-week SIP info that went out to the embassies?
You think? ;)
A451-
The stage is being set in the gene code, but we haven’t seen the other signs reported yet, and they would be evident. HCW, media silence, R0 climb and travel restrictions.
PF51 is much more likely now, but it may decelerate and template in diametrical opposition.
As Edna Mode mentioned, WebMD has translated this study for the layman.
Two Threatening Bird Flu Mutations
…Both mutations already have popped up in humans infected with the H5N1 bird flu virus…The two human mutations give the bird flu virus the ability to attach to human cells. It’s the kind of mutation seen early in the 1918, 1957, and 1968 flu pandemics, warn Shinya Yamada of the University of Tokyo and colleagues…Previous flu pandemics came from bird flu viruses. Each time, the pandemic took off when the viruses learned to attach to human airway cells…The researchers suggest that health authorities look for these mutations in bird flu viruses isolated from humans. If found, they could be an early warning of a budding pandemic…
My interpretation is that H5N1 has almost all it needs to start the fire rolling across the globe.
The one thing it still needs, and will always need, is the perfect situation of enough humans in the neighborhood receiving sufficient viral loads and the ability to leave the neighborhood without getting stopped by distance or Tami blankets.
It is the human element, one that will at some point occur.
The virus will continue to shuffle the deck and spread around the world. When it hits on the winning combination, the pandemic will begin and explode out of the starting gate to a neighborhood near you abruptly.
The Egypt case may not have supplied H5N1 with the logistics to break out. OR….. the incubation period has lengthened…. if that happens, we are in the deep end of a very big pool, and nobody will have a life jacket.
OKbirdwatcher at 22:43 -WebMD
From the WebMD article (about the Nature article): “Flu viruses attach to receptor molecules on the outside of cells that line the airway…. Previous flu pandemics came from bird flu viruses. Each time, the pandemic took off when the viruses learned to attach to human airway cells…”
Comment: The little monster knows how, it is just a matter of time. And as NS1 said, the more the sequences are like seasonal human flu sequences the easier it is for H5N1 to acquire what it needs. Basically, the longer the matching sequences the greater the “hold” (more hydrogen bonding between the RNA pairs) between it and the “donor” sequence.
If I read it right, it has done it at least two times we know of. We were just lucky in containing it before it went through many H2H2H type cycles. The “if not when” statements are now clear. There is no more “if”. H5N1 has shown us it knows how. Not only that, since the sequences don’t really indicate bird recombination, it is in some mammal somewhere and most like still exists there. Sounds like a definite “when” now.
My prediction is still Feb or March.
Birds are still delivery agents and spreaders. Several mammalian species are likely reservoirs and incubators.
NS1 at 23:13
Birds are still delivery agents and spreaders. Several mammalian species are likely reservoirs and incubators.
A very, very dangerous combination, especially since they are not identifying or monitoring the reservoirs and incubators.
After the first instance of human-favoring virus isolated in Turkey, a few of us calculated how many human cases would need to be identified by WHO criteria to have a 95% probability of the mutation set occuring at least once more. This number worked out to be on the order of 1250 cases, total. However that also implies that *on average*, the ability would have arisen 5x by patient 1250, or about once every 250 patients.
Based on the earlier calculation it would not be terribly surprising to have a second isolation of such a virus now or in the near future.
This is, unfortunately for us, a time where scientists will learn a whole lot about the development of a pandemic virus. And even after they have watched this one do it, the future textbooks will show the route H5N1 took this time, and that’s what will be watched for the next time, with plenty of assurances that since its not doing exactly the same thing then as now, it is “unlikely”. Am I right in this development appearing to further support Niman’s “radical and unsupported” views?
Does anyone remember the Matthew Broderick movie, “Wargames”? At the end the computer was trying to figure out the launch codes so it could launch the ICBM’s. The air was tense as the computer figured the last character in the code.
This feels a lot like that.
Goju at 22:54
yeah… what it really needs is a crowded airport.. just wait for it to get here with all our offices and crowds, and plenty of opportunity.
the other thing that bugs me is Niman’s comment on CE regarding the sequencing done in the study, vs much of the sequencing done by WHO and friends… WHO and friends used eggs, vs the mammalian tissue the Nature study folks used - i gather from the comments that the egg isolation masks some aspects of the sequences --- so our large number of sequences may not be as complete as we’d thought. hope i’m wrong on that - please correct me.
c3jmp-
You are right on target.
Passage thru eggs causes progeny to develop characteristics that are useful for infecting chickens.
If you raise a child in the on Central Park West, they may learn to play the piano and excel in languages. If you raise a child in Harlem, they may learn to fight and excel in a different form of language. The environment, the culture, partly determines the outcome.
Careful researchers note the method of isolation and adjust their level of trust in the resulting sequence data.
The gene pool is much more open than we’ve been taught and influenza is one of the most promiscuous and gregarious viral products.
Bear in mind that the questions of isolating the causative strain goes far beyond the growth medium.
The concept of quasi-species is rarely discussed because we don’t really have suitable tools for reviewing the various forms of a particular strain that occurs in every host infection. We know that multiple forms are there; we just don’t have a highly reliable method of isolating them all.
Fiddlerdave at 00:59
The mathematical probability of the resultant Egypt human H5N1 strains occuring by shift and drift (reassortment or point mutation) is astronomically low.
On the other hand, Niman’s recombination model flows well with the inputs and outcomes.
NS1-- what time frame are we looking at?
Enza-
That is the big question. No one can establish such a thing as a time frame. We’ll only truly know when the death count rises in each cluster.
Remember, their are many, many variants that could produce PF51, but many more that won’t.
This turn of events says prepare now.
Wonderer at 22:18 “Id say that if theyre like me, theyre sitting here solemnly thinking Id hoped this day would not come. Looks like its only a matter of time to me.”
Yes, I’m sorry, but I think the same :/
NS1 at 22:37
….a more potent and transmissible strain.
A MORE! POTENT! strain? You don’t mean a higher CFR do you?
Fiddlerdave at 00:59 This is, unfortunately for us, a time where scientists will learn a whole lot about the development of a pandemic virus. And even after they have watched this one do it, the future textbooks will show the route H5N1 took this time, and thats what will be watched for the next time, with plenty of assurances that since its not doing exactly the same thing then as now, it is unlikely.
Yes, Fiddlerdave. Reminds me of when my sister had her third child the birth of which I attended. The crotchety old nurse kept saying, “We’re going to have to send you home. Should never even have admitted you. This [the labor] isn’t by the book.”
My sister delivered an 8-pound bouncing baby boy about an hour later.
By the way NS1. Thanks for explaining all this so well. I would be at a complete loss.
JWB @ 06:41 - “A MORE! POTENT! strain?” Why do I read this in the voice of Captain James T. Kirk? ;>)
Seriously - thanks to all on this thread for helping me to understand the science and the ramifications, troubling as they are.
Captain1 at 08:01
LOL!
Does anyone care to speculate about Niman’s prediction on CE about an upcoming news release on an event that has already taken place?
By the way, when Niman was asked to provide additional information, he predicted that the news would be received as a “blinding light”. What does he know?
Dr. Dave
I posted all of Nimans post related to that on a thread “Glabal Reheasel - what a story” . See JWB at 13:30 and forward. We came to an interesting conclusion.
sigh
Make that Global Rehersal
Since this thread has been/will be read by most on the fluwiki, I want to ask that some folks develop suspect case spreadsheets for different areas of the world, utilizing the “lookout posts” threads. Michelle in OK has done this for Indonesia, and I have been using the spreadsheet to produce a map of suspect cases every ten days. If this was done for other parts of the world we can have a greater understanding of suspect case locations and spread. I am willing to do the maps, but I do not have the time to develop the spreadsheets. Michelle’s spreadsheet is great in my opinion, but other spreadsheets would not necessarily have to be as in-depth if a person was not as experienced with Excel. I’m not saying this needs to begin today. Rather, I would like to see some individuals step up, choose an area, and begin inputting data when the cases begin to appear. (At some point after the pandemic begins rolling, counting individual cases will have to be tossed to the side and tracking only location data where cases are occuring will have to occur.) The spreadsheet could then be emailed to the mods for uploading on the ftp site, and I could create a map showing the geographical distribution and case numbers. This is a call to action for the fluwiki to prepare now ahead of time to track this type of data. Thanks.
Okieman at 09:14 Please where (email?) to send the info? I might get something about Finland. If the possible cases are made public…
Dr Dave at 08:11 Does anyone care to speculate about Nimans prediction on CE about an upcoming news release on an event that has already taken place?
Sure. Bush is in Southeast Asia. Meets with Indo leaders on Monday, Nov. 20. Returns stateside Tuesday, Nov. 21. Thanksgiving week is a notoriously sloooow week on Wall Street. U.S. markets are closed on Thursday for the holiday. Bare bones operations on Friday, which is a half-day. Then the weekend. Aside from financial markets, much of America is preoccupied with the holiday, traveling, cooking, making merry.
If the U.S. has any sway in when such an announcement is to be made (which I have to assume it does, but that might be too U.S.-centric; correct me if I’m wrong, please), I half expect that on Wednesday, Nov. 22, close to or shortly after U.S. markets close, there will be an announcement that WHO is moving to phase 4. In the U.S., it will play wrapped in Hallmark sentiments to embrace your family, give thanks for what you have, since your family is gathered anyway, begin making your emergency plans, and when you’re out at the Black Friday sales, do pick up some bottled water and canned goods.
This is, of course, pure speculation on my part. I have no inside information on this whatsoever except what I am observing going on in my own state and on the Wiki in recent days.
Edna Mode at 09:42
If that happens, that Friday will go down in history, as the biggest buying frenzy the planet has every seen, and will see for generations.
Edna Mode at 09:42
You’re good, Edna Mode, you’re good! :-)
Don’t know if they’re ready to announce, though…. Otherwise,your scenario is entirely plausible, and you’ve well covered the kinds of factors they will consider, if they can manage the managing of this thing. Somebody should really tell TPTB that we work cheap here, and would be pleased to lend a hand at any time with editing, scheduling, etc. ;-)
it’s _W_HO. But since 97.85% of you Americans are unaware that there is a world outside your borders, you think it all depends on thanksgiving and Bush and Wall Street.
Edna Mode at 22:48 -
Ummm…duh…connecting the dots…..:)
It would be perfect to announce around thanksgiving. Everyone is “home” Crap there go my vacation plans. Guess its going to be a different sort of vacation, of the year long sort. I think its a good time to top off them fuel cans.
I agree anonymous at 10:13. Announcements are not based on what is happening in the U.S. We American’s do have a very narcissistic view of our world. Holidays, Wall Street etc. do play a role in U.S. announcements however. Keep those thought processes going though Edna Mode!
anonymous at 10:13 If we’re talking about global financial impact, it does indeed depend on “thanksgiving <sic> and Bush and Wall Street.” I’m reasonably sure that the WHO is going to be sensitive to this fact.
And while your observation about Americans is certainly true, I lived in Europe for years and I noticed the same phenomenon there. Not as bad, admittedly, but certainly Europeans believe that the world revolves around Europe and its interests. I don’t think this is at all unusual; people are people are people, no matter where they happen to live.
Dr Dave at 08:11 -
Maybe the Nature article is the news release Dr. Niman was referring to. (?)
JWB at 09:54 <<Edna Mode at 09:42
If that happens, that Friday will go down in history, as the biggest buying frenzy the planet has every seen, and will see for generations. >>
You would think so, but I doubt it. Most people don’t even know what the WHO stands for, let alone what the ramifications of Phase 4 are. They are not paying enough attention to what is really going on in the world around them. They are busy working, shopping and watching TV.
In addition, the average person doesn’t believe that such a thing could actually occur except in the movies. Neither do they take action until they see others taking action. Herd mentality. I doubt that it will sink in until people start dying en masse in their own country and they are told that it is the bird flu.
Meserole
Non-American countries certainly can’t forget about America. Just in terms of media alone, American interests have a global monopoly on screen and airtime. (a dirty trick lasting from WW1)… so, people in general may always be self-centered, but there’s a decided qualitative difference with regard to the cultural experience other societies undergo. Even in countries with growing media exports, it is hard to get air time, screen time to see one’s own culture rather than an American culture on the air.
ricewiki Glad to see you back around.
ricewiki!!!!!
I didn’t know you were back on the forum — HI!
Hope you’re doing well, nice to hear from you.
If “there will be an announcement that WHO is moving to phase 4. In the U.S., it will play” as, so, nothing to see here, move along
and too much of the public will say, “Huh? That old bird flu stuff? Well, it took so long from 3 to 4; must be a long ways from 4 to 6, if ever. “ The local politicians will say, “I haven’t heard the voters asking me about it; so, pandemic must not be important…not my baliwick anyway. Why don’t you talk to the health dept? I think they have plans for that.”
sound of little viral chainsaws in the distance
OKbirdwatcher at 10:42 Maybe the Nature article is the news release Dr. Niman was referring to. (?)
OKbirdwatcher, that’s entirely possible, and I’ve wondered that myself as well.
Hi OKbirdwatcher & Edna Mode… On Curevents Dr. Niman stated that Yes this was the new info he was hinting at… He says there is only a very few changes left for H5N1 to go pandemic & since these changes are so small there is no reason to believe CFR will decrease…Words to that effect anyway
ricewiki at 10:48 Non-American countries certainly cant forget about America.
That’s that old post-WWII American hegemony thing. Not to worry. The sun is already setting on that scenario. Next up…? My money is on Latin America, but a pandemic could really change the global situation.
I guess we’ll have to wait and see what language we all need to learn next.
anonymous at 10:13 its _W_HO. But since 97.85% of you Americans are unaware that there is a world outside your borders, you think it all depends on thanksgiving and Bush and Wall Street.
Hey anonymous, your comment is both hostile and reveals a fundamental ignorance of what motivates many, if not all, Americans here on the wiki—that being an understanding that there is a big, wide world outside our borders, and that what happens in a remote mountain village on the other side of the world could well mean ruination in our own backyards.
Half the time I’m embarrassed to be American given the bad behavior our government frequently exhibits. But if you think that the US government with all its financial clout and political power doesn’t have the WHO’s ear, you’re sadly, pathetically mistaken.
I’ve had it with this Us/Them baloney when it is blatantly obvious to even a kindergartener that pandemic knows no borders and that we all, no matter our nationality or location, are peers in this disaster.
And anonymous, if you’re going to cast aspersions on 97.85% of ANY population, at least have the backbone to pick a handle.
End of rant. I have work to do.
Thanks for the confirmation WildBill.
so WHO shall announce: yep, we go to 4 now, because it’s thanksgiving in USA. They created this panel of world-leading experts some months ago to advice them with the phases and now it should all just be about TV-time (in USA !) and Wallstreet ?
Thanks WildBill - guess I checked the boards in the wrong order this morning;)
anonymous at 11:40 so WHO shall announce: yep, we go to 4 now, because its thanksgiving in USA.
My policy is to ignore negative attention-seeking behavior, so go bait someone else. :-)
NS1 at 22:37
Please, in very simple terms what is needed ie number of step(s) for what to occur?
Is it scientifically correct for me to assume that once the perfect strain of easily trasnmissable h5n1 is ‘created’ that a pandemic is to follow within a relatively short period of time?
Given that people are contagious before symptoms and travel is unrestricted …
Pixie at 10:06… we work cheap here, and would be pleased to lend a hand at any time with editing, scheduling, etc. ;-)
LOL, especially editing the #3 report at pandemicfludotgov
Grace don’t assume it’s only ONE strain.
So far there are 4 strains out there exhibiting the changes trending towards pandemic.
My biggest fear (ok nightmare) is for co-circulating clades to go pandemic at the same time.
Vaccine ? NLOL.
Game over.
http://www.curevents.com/vb/showthread.php?t=63135
See post # 10
OK. So the sh!t has hit the fan.
Next question:
How long before the sh!t hits us?
If they move from a 3 to a Phase 4, can we expect schools and colleges to take a break? I have a freshman in college.
Argyll.
Next question: how long before we go to phase 4? How about it WHO? Or will we be covered with s#!t before they call phase 4?
Regarding my posts last evening. Perhaps “debate” was the wrong word. I’m on my way to a Conference on literacy so I’ll clarify quickly. I need further explanation of the science. Those that can make sense of the technical were silent last night when I posted, and I checked often. That’s what I meant. I needed it to be written for the layperson. In months past that information would have been available very quickly. I’ll check in after I go get literate. Public School system is even providing the dinner meal…that can’t be good.
I have seen how terribly busy the grocery stores are when there is about to be a small snow-storm….I dont want to be at one when the cold hard facts about the BF are announced. There will be nothing left in stores..a mob scene
Folks:
I do not think this is the pre-it scenairo we all fear. S/w a doc pal very knowldgeable- this is basically a retrospective look at known human cases of h5n1 now that the virus that caused that particular person’s disease is available.
I am calming down a good bit.
Argyll at 15:40 If they move from a 3 to a Phase 4, can we expect schools and colleges to take a break? I have a freshman in college.
Argyll.
No
Phase 4 won’t make much difference to the “person on the street”.
It triggers some additional planning/surveillance by governments/corporations, but not much else.
Unfortunately there is nothing to stop a pandemic virus from going from 3 to 6 on the WHO scale nearly overnight.
Argyll, this would probably be a good time to ask the college what their plan is (or if they have a plan?). I think I would ask a different office what the rules are for “medical leave” or temporary withdrawal or ?
Those of us who can make sense of the technical have found the slow loading of the forum to be a deterrent to attempting a comment.
Argyll, on second thought, read the student handbook for the rules to see how you can keep your child home with the least penalty in case you act ahead of the college’s decision. Jumping the gun seems like it could happen with all this nervousness, but if it shows to be a false alarm, your child would want to go back without failing grades.
I am waiting for a call from a friend who is at a high level of state government. He is going to debrief me as to a meeting his department had today. His wife, who did not have tons of details, told me that, “Things are not good, and there is going to be an announcement in the next 10 days.”
Whether that announcement will be made by our state’s leadership or at the federal or international level, I do not know.
I have no further information at this time, and I must be away from the computer for the next hour or two.
I will post more as I learn it, probably later tonight.
I wish I could be calm, but….
H5N1 has been multipling its odds daily for years, using winged slaves, happy go lucky pigs, fat inept officials, a legion of willing smugglers, and selfish scientist.
Did I miss anything?
Anon in NH at 16:31
Now I feel nervous again.
Any inkling as what type of announcement? A generic get ready type of thing?
Now add this to our anxiety: Dr. Gregory A. Poland, chief of the Mayo Vaccine Research Group and associate chair for research at the Mayo Clinic department of medicine in Rochester, Minn. “We’re talking about one or possibly two mutations that would be sufficient to change the ability of the virus to bind to human tissues,” says Poland. “So we’re one mutation away from human-to-human transmission. Once the virus is able to do that, it’s taken another significant step forward it’s transmittable. “And once that happens, the pandemic starts.” Take ‘if’ out of your vocabulary. We absolutely, positively I will stake my life on it have a pandemic,” Poland says. “No one knows when, how severe it will be, or what virus it will be. But what we can say is that the leading candidate right now is the H5N1 virus. “There is no hope in keeping up with the evolution of this virus.” http://tinyurl.com/y4vdmy
Anon in NH - please post again! We’re dying to know, ok, that was a bad joke.
Now the evening will take forever. Please hurry Anon in NH.
Grace RN at 16:03 Folks:
I do not think this is the pre-it scenairo we all fear. S/w a doc pal very knowldgeable- this is basically a retrospective look at known human cases of h5n1 now that the virus that caused that particular persons disease is available.
I agree and at the same time strongly disagree.
I disagree that it is not the “pre-IT” scenerio. The polymorphism’s are apparant across different clades, not just the one from Egypt.
The mammilian reservoirs are there.
The geographical dispersal is of particular note.
I agree that it’s a retrospective look in order to come to that conclusion. Unfortunately it’s not an ACCURATE retrospective look, since WHO is using chicken cells for testing, thus not allowing the mammilian factors to surface.
This is a LOT more serious than most realize.
Ruth at 16:55
I wish that I read this post before I made A COMPLETE A$$ out of myself on CE.
They were discussing this article and I crapped on it without reading the last page. Live and learn. I guess I was expecting spin, and saw spin.
With that said. This is a good strong article. A primer/feeler for this mystery announcement perhaps?
Jane,
Thanks so much. Fine line with big dollars at college.
Anon in NH … looking to see your post soon, Thank you.
Argyll.
JWB at 17:14
I saw your post and I don’t think you made a complete ass out of yourself. :)
Bird Guano at 17:13 -
“This is a LOT more serious than most realize.”
I believe the word Dr. Niman used was blinding?
Under The Radar at 17:22
THANKS
All, I am still waiting for the call from my contact. It may not come for a couple of hours. I will post as soon as I hear anything from him. I truly have no additional information other than what I posted earlier. I know this must be driving you nuts. It’s driving me nuts, too. But don’t just sit here refreshing your screen. Go smell the roses. Cook something. Can something. Order something. Eat something. I will post by 10 or 11 p.m. EST at the latest. The person I am waiting for to call is at a function for at least another couple of hours. I myself am making a tasty dinner (canning the leftovers) and loving up my kids until I hear from my friend.
Bird guano at 17:13:
Could you explain why they are just using the egg cells? If they know it’s not complete why stick to it exclusively? Do they already know the tertiary mammalian host and don’t want it revealed just yet because it’s pets like dogs or cats?
Anon in NH - any elaboration on this, or is it just a direct quote?
Things are not good, and there is going to be an announcement in the next 10 days.
Leo7 at 17:36
(Or maybe more like 2-legged mammals?)
Leo7 at 17:36 Bird guano at 17:13:
Could you explain why they are just using the egg cells? If they know its not complete why stick to it exclusively? Do they already know the tertiary mammalian host and dont want it revealed just yet because its pets like dogs or cats?
Incompetence I surmise.
You would have to ask WHO as to their motives.
I’ve read some papers that it’s all of the above.
Dogs
Cats
Ferrets
Horses
And several other mammals.
I may have missed something earlier on. Do we have any reason to believe that Anon in NH’s friend’s information is bird flu or disaster related?
Thinlina at 09:19
Sorry to be slow about responding. Michelle emails the Indonesian spreadsheet to Dude and he uploads it to the ftp site (which he owns). I am not comfortable giving out his email address, but he may see this thread and post it himself. Otherwise, check the profiles link on the upper left hand side of this page to find the mods email addresses, or ask them on the “ask a mod” thread.
If/when you or anyone else watching the regional lookout posts start seeing multiple suspect bird flu cases then enter them into a spreadsheet similar to Michelle’s. Post a message on the thread that you have begun a spreadsheet (to prevent redundant effort) and gather case data as it comes in. (I will likely recognize something has started and will be paying attention to the need to develop a map soon.) When the spreadsheet has been uploaded to the ftp site I can then download it and create a map. The most important information for me to have is the location (nearest town or village) and the number of suspect cases. Additional info such as test results and number of deaths can also be added to the map if available. It is important that these maps only include info about suspect or confired bird flu cases which have been described as such and not “mystery illnesses”.
Hopefully, this sort of thing will not be needed and the Indonesian cases will eventually trickle off to nothing. But…if clusters begin forming in various parts of the world I believe we can gain some insights into spread by having maps based upon media reports of suspect cases. I could hope the government or media would produce these types of maps, but at the beginning I am afraid it will be up to us to connect the dots.
Hope for the best, prepare for the worst.
Prepare now.
okcinder at 17:57 I may have missed something earlier on. Do we have any reason to believe that Anon in NHs friends information is bird flu or disaster related?
It is. Sorry. I just assumed that was obvious given the thread I’m posting to. There has been a lot of activity at the state level per this friend. Essential workers in his dept. signed up two days ago on a hush-hush list to receive packages containing antibiotics for themselves and family members. That same day, the meeting to which I referred earlier was announced for today. The meeting was held. The five-second summary, “It’s not good, and there will be an announcement in the next 10 days” is a direct quote from my contact’s immediate family member. As I said before, I’ll post after I hear from him directly. I have no idea what type of announcement or at what level/from what direction it is to come.
It just dawned on me that this information meshes with something posted last week I believe (by Nann?) that her relatives who work at Boston hospitals were told there would be an announcement in the coming days. Can’t remember what thread at this point.
Stay tuned.
Grace RN at 13:44
Grace,
No one knows how many steps and anyone who says 2 steps or 1 step is overstepping his or her knowledge by a gap the size of the Grand Canyon.
The perfect strain has likely already been created many times in vivo, but did not have the perfect environmental or host conditions to reproduce well or to transmit. We written extensively on the conditions beneficial to pandemic . . . but the writings apparently are lost in the FluWiki I.
The answer to your question is that there is no perfect strain, but that there eventually will be a perfect combination of viral strains and the host / environmental conditions. Many, many possibilities exist for building the perfect killer virus. Ask JKT and the other guys, they build them for testing in their labs frequently . . . and they contain them.
The only way we will know that PF51 has started will be when R0 rises and the only way we’ll know that number is in retrospect from watching the size of clusters and the deaths of HCW (post-facto).
Information control will be the norm, so our back channels like FluWiki lookout posts will be the only hope of having advance notice.
I’d suggest that soon the moderators or others interested harden the wiki, be prepared to shift to backup and be prepared to possibly offer DVD copies of the archives on FluWiki I and this version.
Begin to learn who will be in your physical community group now.
Gather and Solve
More not good news---just got email from CIDRAP 2 minutes ago,
HHS says stockpiled H5N1 vaccine is losing potency.
What stockpiled H5N1 vaccine? For birds or people? Didn’t know there was H5N1 vax for humans…??
No reliable and safe vaccine exists for human H5N1. We do have many trial versions that have limited efficacy and no safety data at all.
This is like a damn movie.
(sigh)
Hi, All,
Spoke with my contact, and the long and short of it is this: The federal government is apparently going to announce updated pandemic management recommendations in the next week or two in a coordinated announcement to the public and states. States will be expected to bring their pandemic plans into compliance with the federal recommendations. The recommendations sound like a sweeping endorsement of the IOM recommendations (discussed at length in threads here a couple of weeks ago courtesy of anon_22).
The specific recommendations my friend mentioned that are being endorsed by the feds are:
1. Early school closure
2. No international travel
3. Cancel public events
4. Prophylactic treatment with antivirals (see note below) of household members of the sick
5. Social distancing
6. Voluntary quarantining
7. Leaning away from directing strategic stockpiles of antivirals to health care workers and first responders
Other highlights of the meeting include…
Goal: The goal of adopting the above recommendations is to decompress the peak and hopefully allow a degree of more managed chaos in health care and other infrastructure. The downside is it means people are going to need be ready (and I quote) “to hunker down” for a longer period of time than if the peak were short and steep.
Antivirals: As far as using antivirals prophylactically, that recommendation is in direct contradiction to another announcement that was made at the meeting stating that Tamiflu is not effective against H5N1. According to my contact, the meeting attendees were told Relenza “may” be effective. (Of course, we here all know there’s even less Relenza availability than there is Tamiflu, so that’s a moot point.)
Vaccine Development: Apparently, H5N1 is supposedly killing the embryos in which the vaccines are to be cultured rendering that method of vaccine development ineffective. I don’t know enough about this to make heads or tails of this info or to tell if what he was saying was totally off the mark. I did confirm with him in no uncertain terms that the meeting attendees were explicitly told that there would be no vaccine available. I know there have been comments on the wiki relating to the fact that testing for H5N1 cannot be done effectively using poultry embryos, but I haven’t paid close enough attention to that topic and didn’t have any insightful questions to ask him to get more detail. Sorry.
Planning Assumptions: As near as I can tell from what my friend told me, the planning assumptions are ridiculously low. My contact stated 1% CFR. I told him that was crazy. He responded by citing the mantra, “Will swap virulence for efficiency.” He knows I don’t buy that, but I didn’t want to push him on it and risk alienating him. (For anyone in NH, the good news is that only 4,000 are going to die. Phew!)
Mask Use: Heavy emphasis on use of N95 masks, or, in a pinch, surgical masks with pantyhose over them. Supposedly this has been shown to be as effective as N95s. As you all know, that’s not exactly a claim to fame.
Duration: Those in attendance were told to expect multiple waves that could last up to three years. That number startled me. I pressed him on this point to clarify whether he meant that subsequent seasonal flu seasons would be especially bad in the years immediately following the pandemic. He was firm that he was told the pandemic could last up to three years with time to restock between waves.
Trigger: Here’s the rub, folks. All of these measures will hinge on WHO announcing efficient H2H. I think we all agree a pandemic could be halfway around the world—literally—before that happens. For that reason, let me reiterate the critical point that NS1 made at 19:36… The only way we will know that PF51 has started will be when R0 rises, and the only way well know that number is in retrospect from watching the size of clusters and the deaths of HCW (post-facto). Information control will be the norm, so our back channels like FluWiki lookout posts will be the only hope of having advance notice.
And that, folks, is all she wrote. Hope this helps.
One final note: I asked if any recommendation was made to staff in attendance with regard to how long they should prep for and whether the feds were going to increase the two-week prep advice. No advice on number of weeks to prep for was made, and no information on the fed recommendations was discussed.
Anon in NH at 20:32
Thank you so much and very helpful.
updated pandemic management recommendations … coordinated announcement to the public and states.
Did they discuss any guess or expectation of how the public might respond to such an announcement, and how to handle that?
Anon in NH at 20:56
Wow. Thank You.
And I will add, damn it.
I have worked with many bio-pharma companies. I can’t tell you how it looks. I’m pissed. I saw 3 year projections. Didn’t think it could possibly get there.
We need to be strong. I wish everyone, the very best.
JWB, 3 year projections…where do you think they came up with that number? And what did you mean when you say I can’t tell you how it looks? 3 years…staggering to think about.
i got go pee.
geews.
4 new BF cases in Egypt - I was wondering where the strain went that is more like seasonal flu.
Watch for an increase of cases in Egypt over the next couple of weeks. If that happens, I believe we are a go.
Goju - Egypt and Indonesia…. both appear to be bubbling with clusters and h2h events happening with too much regularity at this point. A pandemic with multiple clades essentially launching simultaneously from different foci… that’s the killer event (pardon the pun).
Goju, what is a “go” ?
Hello DoubleD I haven’t seen you for a while. I have a bad feeling about Egypt. I am afraid this is the start (from the virus point of view). We should know in about 2 weeks if it is going H2H there and in 4 weeks know about what the R0 is.
I think the virus has all the right sequences there- except… I don’t know if the strains there are Tamiflu sensitive or not. That may be our salvation since they haven’t used much Tamiflu there in the general population. But then again the Hajj start in a little more than a month or so.
DennisC at 01:47
the Hajj start in a little more than a month or so.
and there will be travelers from all over the world. Will they stop over in Egypt or will it only be Saudi Arabia?
DennisC at 01:47
If we could get a look at the full sequence for the Egypt cases, we’d be in a better position.
DennisC - at 01:47
Waving back at ya! I have been around - just choose to post only when I have something meaningful to contribute - or cannot hold my tongue any longer! ;)
I have been following several things that have kept been gripping my attention of late.
I am growing increasingly concerned about a multipronged problem. The stewpot for pandemic is getting more complete and unfortunately it is running concurrent with troubling information about abrupt climate changes (as in very abrupt) coupled with record low world grain reserves. Not feeling real chatty as a result of what I am seeing.
DennisC - I forget what RO is, could you remind me? Thanks.
DD-
Are we down to about 40 days of grain reserve now?
BeWell-
R0 aka R naught: The other number that is frequently mentioned in the influenza case and infectious disease epidemiology is called the Basic Reproductive Number, usually designated by the symbol R0 (pronounced R naught). It is the expected (average) number of new infectious cases in a completely susceptible population produced by a single case during its entire period of infectiousness. Like transmission probability, this simple definition hides some subtleties. See Disease Transmission Primer.
ANON-YYZ at 01:54
There will be enough people from Egypt, traveling to Saudi Arabia to make the question moot.
bump
Anon in NH at 20:32 — thanks!
As I recall, anon_22 made some mention of this fact: back in May, the feds put out a timeline for various departments involved in pandemic planning to get together, get their plans in order, and the time frame given was — reports to be done in 6 months. Which as anon_22 pointed out, would be late November.
So these reports, the flurry of federal activity we are suddenly seeing, all the finalized reports we are getting — we are very attuned to every phrase and nuance and possible outbreak, so we might look at these reports and “Major Big Announcements” rumored to come out and think — OMG this is IT — when in fact, the big announcement is “just” the release of these reports.
For most people who haven’t even been thinking about PanFlu, I think looking at these reports will be a huge shock.
And yes, thinking not of a pandemic YEAR but a pandemic 3-year period — is huge.
How can a pandemic last 3 years? I guess I’m just basising my question on the history of pandemics in general. Has a pandemic ever lasted 3 years?
cottontop at 08:22
Social distancing and inforced travel restrictions and quarantines can slow down the spread so that we get to enjoy the pandemic longer. It’s a tradeoff that TPTB have decided to do.
cottontop — if you think of the entire period, not just the waves, you could say the 1918 pandemic was really about 2 years — 1918 to 1920.
Anon in NH at 18:18
There has been a lot of activity at the state level per this friend. Essential workers in his dept. signed up two days ago on a hush-hush list to receive packages containing antibiotics for themselves and family members. That same day, the meeting to which I referred earlier was announced for today. The meeting was held.
Is anyone else really annoyed to hear this? I would also like to receive a package of antibiotics for myself and my family and would be willing to pay to do so as no one is my family is an essential worker. Just saying.
I never looked at it like that. It’s just that we’ve been talking about this pandemic as if it would last up to a year, and now we’re hit with a 3 year stretch, possibly. I can deal with the thought of 1 year. But 3 years? Guess I’m really gonna have to stock more krispy creams! ;-)
NS1 at 19:36
Thank you! I have been leery of anyone who can point a finger and give precise predictions. The very randomness of viral replication makes it all seem like a crap shoot.
I agree with your ‘retro PF51’ awareness. Every day without evidence of growing populations of h5n1 infected people and HCW’s is a blessing and part of the quiescent period of prepping that too many people seem to ignore.
The way I understand it, the travel restrictions, school closures, quarantines, etc. are to lessen the impact on hospitals, health care, in each wave, make it more manageable. The same amount of people might get sick, just it would get spread over 3 years instead of 1. But hopefully within 6 months a vaccine would be developed, which if that’s true it would reduce the numbers. After people begin receiving the vaccines (if available) or become resistant from having survived sickness, they would be able to get back to work or school.
So even though 3 years is a long time for a pandemic, if a vaccine is developed, after the initial six months or so society would slowly start returning to normal.
Suzi- By year 3, we could be completely back to normal, with a vaccine. Question- once this goes pandemic, and goes through it process of infection, that strain dies off?
Anon in NH
re: “Essential workers in his dept. signed up two days ago on a hush-hush list to receive packages containing antibiotics for themselves and family members”
This could referring to a form I had to fill out months ago-as did all the police/fire/rescue etc for our entire county-listing any allergies to the antibiotics commonly used against ANTHRAX [ie cipro and doxycline] that either or my family could have. It was part of the Medical Reserve Corp paperwork I did.
and re: “No advice on number of weeks to prep for was made…”
IMHO, if they thought something big and serious like panflu was imminent something on this topic would have been said.
Not to minimize whatever could have been said, but I’d wait for the proof of the pudding.
We know a pandemic will occur at some point in time, and it could be h5n1. we know we should prepare ourselves and others as best as we can. So why wait for an announcement from others?
I believe the plague years in Europe lasted from 1348–1351 (3 years).
I remember being at an ‘away’ football game with my cousin and we were kicking the other team’s butt. My cousin was being obnoxious and some of the home crowd told us we should quiet down because “it ain’t over ‘till the fat lady sings.” My cousin, who by the way is a pretty rotund guy, smirked back at them and said, “She may not have sung yet, but I sure can hear her humming her warmups!”
That’s the feeling I have now. But more along the lines of the sh#t may not have hit the fan yet, but I can hear the fan running, and there is a definite stinky odor around!
NS1 at 02:27
“Are we down to about 40 days of grain reserve now?”
Don’t want to hijack this thread - so I will point you to two relevent articles on the subject.
[[http://www.ft.com/cms/s/0c021878-5a16-11db-8f16-0000779e2340.html]Grain Lowest in 25 Years]
[[http://www.energybulletin.net/21815.html]Grain Drain]
Now back to your regular program…. ;)
cottontop at 09:23
As I understand the process, the pandemic flu strain becomes the “regular” flu strain and hangs around until another pandemic strain wipes it out. It is however, much less virulent, although the regular flu seasons right after a pandemic are particularly nasty.
ANON-YYZ at 01:54 the Hajj
People from all over Egypt will be going to Mecca and sneezing. I think the Hajj starts around Dec 22 this year. TPTB will have to make a dicession within the month to have travel restrictions or not. If you see travel restrictions go up in mid Dec then that whould be a big signal.
BeWell at 02:26 R0, That gives the number each case “multiplies”. So if the average person with the flu gives it to two more people then it is an R0 of 2. Anything over 1 means the will be more and more cases. The bigger the number the faster spreads. If it is somewhere below 1.5 then you have a chance to “put a blanket on it” and contain it. Somewhere above that and it is unlikely that we could “out run it” and put a containment “ring” around it one you have a few dozen cases. We where lucky in Turkey and Iraq. We contained it before it was still just one or two cases.
I am not saying that TSHTF yet, but there is a lot of stuff (strains and modifications) stacked up behind the Egyptian fan and it only takes a flip of the switch. Don’t stand in front of the fan. And I hope that WHO can put a lid (tamiflu ?)on the stuff before it is too late.
Three years is nothing compared to Nabarro’s statement below. If you can’t open the URL and want to read the article, please let me know and I’ll try posting it again.
Nabarro estimated that the H5N1 avian influenza virus will remain a major animal health issue for most of the world for at least five years, and perhaps 10 years, because it is very virulent but at the same time can survive in certain communities of birds without symptons for long periods.
Suzi at 09:07 The way I understand it, the travel restrictions, school closures, quarantines, etc. are to lessen the impact on hospitals, health care, in each wave, make it more manageable. The same amount of people might get sick,
No. The same amount of people do not get sick. That’s the point. St. Louis vs. Philly. Check it out on the TLC threads.
Grace RN at 09:42 Not to minimize whatever could have been said, but Id wait for the proof of the pudding.
Yes. And lets hope the proof comes soon. TLC is our best hope.
Hillbilly Bill at 10:09 As I understand the process, the pandemic flu strain becomes the regular flu strain and hangs around until another pandemic strain wipes it out. It is however, much less virulent, although the regular flu seasons right after a pandemic are particularly nasty.
Exactly right, HBB, at least that’s how a leading epidemiologist answered that question when I put it to her.
Hajj starts around Dec 22…
H5N1 In Egypt has shown it has pandemic potential…
WOW. The dinner table is being set and Dec 22 the feast may begin.
This post should have been called “Check” not “Checkmate” - sorry.
This year Hajj is between 29th Dec and 3rd Jan - the following is advice from the UK Health Protection Agency.
[snip] Health advice for Hajj travellers UK travellers to the annual Hajj Muslim Pilgrimage to Mecca were today urged to make sure they’ve taken all the appropriate health precautions before making the journey.
Robert Booy, Honorary Professor of Child Health at Queen Mary, University of London , added:
Particularly in winter influenza is a major risk and although authorities in Saudi do not yet require evidence of immunisation, influenza is a serious risk to pilgrims and I would strongly urge those in an at risk’ group to consider vaccination before they travel.
Edna Mode, what’s TLC?
Thanks!
It seems oddly appropriate to see the ominous news coming out of Egypt. After all, DPDB (de powers dat be) have been in de Nile for a long time about BF.
Under The Radar at 12:11
Targeted Layered Containment, it has it’s own thread: What is TLC
sorry should have read: its own thread. Now I have to go in hiding from the grammar police. Oops, sorry should be capitalized. Sorry, sorry, mea culpa, through my fault, through my fault, through my grievous fault…..
From Recombonics:
“A second teal isolate, A/teal/Egypt/9885-NAMRU3/2005, is low path H5, with regions that match H5 low path in Europe and other migratory isolates in Asia. However, the Egyptian isolate has regions of identity with high path H5N1, including other Qinghai strains. Moreover, many of the polymorphisms are found in H5N1 isolates in China. Thus, the low path H5 in Egypt has evidence of recombination with H5N1 in Asia, including the Qinghai strain.
“”“The acquisitions of high path polymorphisms by low path isolates are cause for concern. H5N1 sequences can also be found in low path H5 in North America also, in addition to swine and human polymorphisms.”“” These acquisitions continue to offer opportunities for changes in virulence as well as receptor binding specificity, as Qinghai isolates in the Middle East continue to acquire mammalian polymorphisms, of which PB2 E627K has become fixed.”
Yikes at 13:23
These acquisitions continue to offer opportunities for changes in virulence as well as receptor binding specificity, as Qinghai isolates in the Middle East continue to acquire mammalian polymorphisms, of which PB2 E627K has become fixed.
Can that be taken to mean a lower virulence is possible as H5N1 aquires human and other mammalian polymorphisms?
I’m “yikes.” I have no idea. Maybe somebody can explain it.
Oremus, LOL! Thanks for the info. :)
Niman: The acquisitions of high path polymorphisms by low path isolates are cause for concern.
Niman is worried that the low path will pick up high path changes and become more virulent. It’s the low path becoming more virulent he is worried about.
Can someone please go to the Rumours Thread and untangle ADuckOrangeMercury’s post? Either here or there is o.k.
Three years, sounds impossible, but if we recall, the first wave was the Spring of 1918, and from Barry’s book The Great Influenza, “The year 1920 would see either (sources differ) the second or third most deaths from influenza and pneumonia in the twentieth century.” snip.. “Only in the next few years did it finally fade away in both the U.S. and the world. It did not disappear. It continued to attack, but with far less virulence, etc.”
Please read below. Has anyone seen this previously - it has been up for a few days but I am trying to find out how recently it was posted.
STATE DEPT SITE re/info if Phase 4 declared
Pandemic Influenza
The purpose of this section is to ensure that foreign missions, international organizations and their members have a source dedicated to providing current information on issues related to the U.S. Governmentfs response to threat of pandemic influenza.
In the event the Director General of the World Health Organization announces that the world has entered gPhase 4 of the Global Influenza Preparedness Plan (Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans), information will be posted on this site specifically addressing the measures the United States is taking to address pandemic influenza. This information will describe issues that may arise regarding such measures and the privileges and immunities enjoyed by some members of the foreign mission community.
In accordance with the Implementation Plan for the National Strategy for Pandemic Influenza, the Department of State hopes to ensure that the foreign missions, international organizations and their members are aware of the U.S. Governmentfs efforts and resources that will be brought to bear in a coordinated manner against the threat of pandemic influenza. Such efforts require (or will require) the participation of, and coordination by, all levels of government and segments of society. State and local governments will be prepared, with information and guidance from the federal government, to take actions to best protect individuals residing in the United States.
NauticalMan at 14:59
Remember that it did not “start” in the spring of 1918. Check out The Lancet (the British medical journal), July14, 1917 edition, which describes a virulent outbreak with exactly the same symptoms, speed and mortality rate in the huge British troop tent city at Etables, France - where Empire and Commonwealth troops from many of the countries later afflicted were living cheek-by-jowl in vast numbers. And live duck and pigs were kept there in equally large numbers, as foodstocks, too (and, unwittingly, to complete the transmission cycle).
Also the Annual Report of the Secretary of the Navy, 1919 shows that there was a smaller outbreak in the winter late 1916 and into the first of 1917.
It is just is was more locallized and traveled slower. So someone could argue that it was “epidemic” before and not “pandemic” until late 1918.
So the point is that it could last much longer than just 3 years.
Oremus at 12:45 sorry should have read: its own thread. Now I have to go in hiding from the grammar police. Oops, sorry should be capitalized. Sorry, sorry, mea culpa, through my fault, through my fault, through my grievous fault..
LOL! In real life I AM the grammar police, but you’ll find plenty of typos in my posts. Most editors grant each other dispensations for grammar mistakes, typos, etc., in e-mail and whatnot. Otherwise, we would all go insane!
DennisC at 15:33 So someone could argue that it was epidemic before and not pandemic until late 1918.
Good points. And, IMO, historians will look back on the period of time from 2003–2006/7 in much the same way.
Commonground: FrenchieGirl was good enough to translate the “Orange Duck” post in the Rumors thread. Stuff (analysis, primitive continuity operations) is happening but don’t look for transparency when the new WHO head comes.
The chinese are preparing a documentary on the fall of the United States, with analogies and comparisons on our situation vis a vie illegal immigrants, and overextention militarily. Like Russia and the WE Will Bury You period, they are always predicting our doom and demise. But they are still trying to pull in as many American tourists as they can, and are planning to build extensively underground in Beijing as the city is booming. As far as SIP for 3 years, heck I wouldn’t consider doing it for three months. People like me will just think, “oh what the hell, let the chips fall where they may.” Anyone here imagine they would or could do so? If they could, would their families go along? I doubt it.
The chinese are preparing a documentary on the fall of the United States, with analogies and comparisons on our situation vis a vie illegal immigrants, and overextention militarily. Like Russia and the WE Will Bury You period, they are always predicting our doom and demise. But they are still trying to pull in as many American tourists as they can, and are planning to build extensively underground in Beijing as the city is booming. As far as SIP for 3 years, heck I wouldn’t consider doing it for three months. People like me will just think, “oh what the hell, let the chips fall where they may.” Anyone here imagine they would or could do so? If they could, would their families go along? I doubt it.The Chinese are comparing us to the Roman Empire.
Visit URL for full PR Release
http://news.corporate.findlaw.com/prnewswire/20061114/14nov20061111.html][PR Release URL
WASHINGTON, Nov. 14 /PRNewswire/ — The U.S. Department of Homeland Security (DHS) and The Advertising Council unveiled new public service advertisements (PSAs) today to support the Ready Campaign. Ready is a national public service advertising campaign designed to educate and empower Americans to prepare for and respond to emergencies.
The new PSAs unveiled today include television, radio, print, internet and outdoor versions created pro bono by BBDO New York. Also released today is a television ad featuring First Lady Laura Bush discussing emergency preparedness. All of the new PSAs highlight the fact that many families have not yet taken the steps needed to prepare for emergencies including getting an emergency supply kit, making a family emergency plan and learning more about different emergencies and their appropriate responses.
diana at 16:15 The Chinese are comparing us to the Roman Empire.
If they were making the documentary about the UK I might have to agree with them.
thnx for fixing the link
Average Concerned Mom at 8:32 re: the packages of antibiotics. Yeah, it bugs me a lot, too. I got an appreciative look from my dh though, who is fond of saying “I’m so glad I married a smart wife!” when I read that to him — we may be “swimming with the fishes” but we do have a stock of fish antibiotics.
I have up to now considered Tamiflu just too expensive for us to consider affording, but I’ve passed one of those subtle trip wires for me that said: now’s the time. So I asked hubby to ask the dr. today on a visit for an unrelated condition to ask whether he would write us standby scripts for it. No go; the doctor said he’d recently been sent a letter that the last batches of Tamiflu may have been defective.
Hmmm. As I told hubby, it won’t be available for people like me or you.
Dennis C at 15:33
Thanks for jogging the old memory, do remember that there had been earlier incidents, but do not remember where I read same. What I do remember is the more recent info regarding the fact that there were much earlier pandemics such as 1890? Think Barry mentions that the possibility exists that one of these earlier epedemic/pandemic may have actually lessened the CFR in the 1918 pandemic. I am amazed at the research and the detail that Barry includes. Easy to see why this project started at a 2–3 year one and ended up taking him 7! Keep going back to the book and learning more as I go, none of it very comforting. IMHO the next one could very well be worse. Let’s hope not.
Average Concerned Mom at 08:06
As I recall, anon_22 made some mention of this fact: back in May, the feds put out a timeline for various departments involved in pandemic planning to get together, get their plans in order, and the time frame given was reports to be done in 6 months. Which as anon_22 pointed out, would be late November.
There are various activities scheduled to bring together both the results of the IOM meeting and the various consultations including the ASTHO, plus input from other stakeholder groups. I wouldn’t expect any announcement before the new year if I were you.
Just so people don’t get even more up’s and down’s than they are getting now. :-)
NauticalMan at 19:09 Dennis C at 15:33
Researchers during the era of 1920–1940 postulated that the unusually large curve of young and healthy dying was due to immune naivety. They postulated that the older generation had partial immunity due to the 1890 pandemic.
Link to the issues discussed at the IOM meeting here and the consultation process run by Keystone Center and ASTHO here, with commentaries from various people who attended those events in Seattle and other cities.
NS1 at 19:49,
They postulated that the older generation had partial immunity due to the 1890 pandemic.
Not the 1890 one. Possibly sometime in the mid-19th century. Cos the only group that had a lower death rate than seasonal flu was the 65 and older.
Northstar at 18:24
……the doctor said hed recently been sent a letter that the last batches of Tamiflu may have been defective.
Hmmm. As I told hubby, it wont be available for people like me or you. …..
Northstar,
I have heard the reports from Japan about Tamiflu causing problems with children (like jumping from high places), and it will now come with warning labels. I realize that it may very well be a campaign to dampen the rush for tamiflu when the SHTF. But the letter stating that it’s defective is a new spin that I haven’t heard.
There are many doctors lurker here. Have any of you received such a letter? When? What exactly does it say?
This development, along with the decision now that HCW won’t be the first in line for vaccine, (puts on tinfoil hat now), means somebody else is in line for all of these things. Who? The military?
Looks like the PSA’s will be coming out which will help further educate citizens. Was thinking why not use the “education” system and have kids do projects on emergency preparedness at school? They are tomorrow’s leaders and might be the key to linking preparedness at home. We could take it one step further and set them for display in the school media centres?
This is a huge untapped resource, IMHO. The schools are a JIT network — waiting to teach on preparedness. Fundraisers = preparedness”raisers.”
Argyll.
Do we know if the children that received Tamiflu tested postive for avian influenza?
I recall reading in The Great Influenza that some suffered neurological problems ( similar to what they are describing with the Japanese children) as a result of pandemic influenza of 1918.
Argyll.
anon_22 at 19:56
NS1 at 19:49, They postulated that the older generation had partial immunity due to the 1890 pandemic.
The Barry book clearly asserts that the 1889–1890 pandemic was thought to have confered partial immunity.
I’m not saying that the work is definitive, only that the statement has been made there.
No. The last batch of Tamiflu is not “defective”. Your MD was just avoiding telling you that he doesn’t feel that prescribing you a medication for a condition that you don’t have is not appropriate. Period.
And the real undertone in this story is that we currently don’t have that underlying immunity with H5N1.
Perhaps yet another reason why the CFR is so high ?
NS1,
Yes, I know that John Barry said that. But he wrote the book quite a while back, and a lot more (still not enough) has been known about this since then.
If you haven’t done so already, I would recommend JKT’s latest videocast Great Teachers - Influenza: Past Pandemics and Future Threats, particularly at the Q&A there were really interesting questions and discussions about 1918. Also some interesting comments about different types of 2,3 or 2,6 receptors, plus of course preliminary data of their pre-1918 work with fragments from 15 patients testing positive for H3. Which also corroborates with the idea that any partial immunity in 1918 would have to come from before the 1889 pandemic.
RPh at 20:21
Well, money talks.
I think it’s time to play hardball. Ask your doctor for a Tamiflu script. When he says no, pull out a piece of paper, or better yet, a business card from another doctor, hand it to him and say, “Then please transfer ALL of my medical records here to this doctors office.” And start walking for the door.
It worked for me.
You have collectively today (after reading the whole discussion here) caused a somewhat gigantic intake of breath and a leap to pull the psychological “trigger” for TSHTF. It seems that we are on the cusp now.
Would anyone care to summarize or render a hypothesis on what kind of lead time we have to get ready??
Please, I am open to any input. I think there are a lot of people out here that need some kind rationale.
Thanks to any and all.
Bird Guano at 20:24 And the real undertone in this story is that we currently dont have that underlying immunity with H5N1.
Perhaps yet another reason why the CFR is so high ?
Yes. Plus the ‘underlying immunity’ with 1918 is only a hypothesis.
And I am 50/50 about that.
Because if elderly people have weak immune responses, why should their immune protection be so good that they have a lower death rate (per population, not CFR) than previous non-pandemic years?
In 1957 and 68, we know for sure that people had partial immunity, cos the virus was formed by reassortment, yet the deaths in the elderly was more than previous years in both instances.
Perhaps the elderly were protected because of poor immune response, not prior immunity.
In the videocast, JKT made one really interesting point about pathogenesis in 1918. Normally some of the internal proteins act to block the host immune reactions, including the exaggerated immune reactions that you sometimes see in those with robust immune systems.
So there could be 2 possibilities to explain why it was so deadly. The first is that the virus was so virulent that it was able to overcome these immune reactions. The other and opposite hypothesis would be that it was so poorly adapted to humans (having just newly switched host species) that it was unable to overcome these exaggerated immune responses, which were the real culprits.
If you take the second hypothesis, it may very well explain why the elderly were spared.
Only thing I can say is, I never knew virology could be so interesting…
Hide in the Hills (and wait) at 20:38 You have collectively today (after reading the whole discussion here) caused a somewhat gigantic intake of breath and a leap to pull the psychological trigger for TSHTF. It seems that we are on the cusp now.
I’m not as alarmed as some. I’m concerned about the evolving pattern of a dominant strain of avian H5N1 in China, but that’s chronic, not immediate, and way not as concerned as most other people (at least on this forum) about the findings in the Nature paper. My thoughts on that are on the rumors thread as well as copied to the H5N1 receptor binding thread.
JWB at 20:34 Ask your doctor for a Tamiflu script. When he says no, pull out a piece of paper, or better yet, a business card from another doctor, hand it to him and say, Then please transfer ALL of my medical records here to this doctors office. And start walking for the door.
Baaa-haaaa-haaa! Nothing personal, JWB, but that would so not work where I live. There are NO, yes, I repeat, NO practices with openings for a 25-mile radius. Transfer to a new PCP? Not happening until some of the local practices add more docs. My doc (who, thankfully, I like) has a caseload of 4,000 patients. And I live in a fairly rural area.
More to the point, there are so many issues with Tamiflu that make it not worth the trouble.
First, you need to double dose. How many of you have enough on hand to do that? Most can’t get a script for one course, much less two.
Second, the exorbitant price if you don’t have insurance. If you have enough to double dose, then maybe. If not, spend your money on food and water storage.
Third, per GSK and Roche (heard it with my own ears), to be truly effective, you have to start dosing within hours of infection—i.e., before you even know you’re sick. I don’t know about you, but I sure don’t possess psychic diagnostic powers. ;)
Fourth…oh, never mind. You get the idea.
Edna Mode at 21:15
Third, per GSK and Roche (heard it with my own ears), to be truly effective, you have to start dosing within hours of infectioni.e., before you even know youre sick. I dont know about you, but I sure dont possess psychic diagnostic powers. ;)
I would say if there is definite history of exposure eg confirmed cases in your community, and you were not in strict 100% SIP, and you get a fever, I would start treatment if a temperature of >38 does not subside after a couple hours, without the use of antipyretics, of course.
I would shorten that to 1 hour if its someone at a high risk age group eg teenagers.
That’s just me, and not according to any official recommendation.
If a patient asked me for a tamiflu script, and I felt it was not clinically indicated, they could walk. Period. It is my license, and I could care less about their money.
However if someone were to come to me and explain that they understoot the threat of panflu, wanted to take approriate measures to protect them and theirs, I would do what I could to help. It would depend. I do not respond positively to blackmail. Kelly
anon_22 at 20:46
The Cytokinic Dysregulation threads noted in my profile extensively explore the issue of Influenza interferon-mediatiing genetics including reviewing some of JKTs work. Simply because everyone continues to repeat exaggerated immune reaction does not make the case exist.
I don’t believe that the evidence bears either of these speculations very well.
Consider a third possibility that is the only one supported by observational evidence.
Virulence is not a factor, nor is replicative rate, if the immune system detects the infection and responds promptly. The genetic expression of Interferon creates a cell bath that is suppressive of viral replication (protein manufacture and assembly). Additional cytokines, in parallel, are called into place that create an inter-cellular replication suppressive response. This responses are interweaved and are part of the innate response even in a naive host.
Therefore if the host responds promptly, an intra-cellular response and an inter’‘’-cellular response occur almost simultaneously.
In simple terms, the H5N1 and the 1918 strains in question have the ability to fool the immune system into delaying the Interferon response. The virus basically says, “Keep moving, nothing happening here.”
The high replication rate coupled with the delay allows viral particles to fill and lyse the host cells before the innate response even begins. The host doesn’t begin to recognise the problem of infection until the system is overwhelmed for all practical purposes.
Then of course too many cells are dead and too many viral particles are free for the normal, phased immune response. The normal defenses have been circumvented by the silent and stealthy enemy. So the body goes into a limited self-destruction apparently trying to save the whole by sacrificing some of the parts.
Unfortunately, the parts that were left unshielded at the forefront are the necessary parts.
In my estimation, these outcomes occur because of a delayed immune response that has been long observed and well-proven by numerous bench researchers.
I believe that we must cause the immune system to recognise the infection immediately, without delay, and to engage the ordinary anti-viral interferon response.
I don’t know what happened in 1918. No one including JKT knows what happened in 1918. If you take your own words about genetic studies, you can see that looking at sequences only shows us so much. The 1918 virus is very different from the H5N1 that is threatening the world today and may very well be extremely different.
We are far to presumptuous in thinking that they are parallel and that their methods of killing will be parallel.
NS1,
I didn’t say anything about H5N1 and 1918 being parallel.
You are making very many categorical statements. I don’t necessarily disagree with all of them, I just don’t know there is enough research anywhere to support them.
Anyway, I’m going to bed. Talk some othe time. :-)
A22,
Good Evening.
We tend to frequently access that H5N1 will follow the same trajectory and behave similarly to the 1918 Brevig. So we fall into a pattern of comparative thinking and speaking.
Thanks for your posts NS1. Very informative!
Humored, Grace and DoubleD,
Thank you for your kindness.
Please remember that there are many other Points of View on these topics that have been deeply discussed here many times in the past. Doing a search and reading the earlier threads will open your eyes to some fantastic debates rich in content and ideas.
NS1 at 22:23 In my estimation, these outcomes occur because of a delayed immune response that has been long observed and well-proven by numerous bench researchers. I believe that we must cause the immune system to recognise the infection immediately, without delay, and to engage the ordinary anti-viral interferon response.
Good and interesting points NS1. In particular, do you have any thoughts on *how* to get the immune system to recognise the infection immediately?
NS1 23:29
Doing a search and reading the earlier threads will open your eyes to some fantastic debates rich in content and ideas.
So true. I did just that after the first time I read your posts on the Michigan H5N1 thread a few weeks ago.
Like Edna Mode at 23:34 I would also like to know your thoughts on how to get the immune system to recognise the infection immediately.
Thank you.
Edna,
Best precept is substantial detoxifying now. A healthy cell has many defenses to a viral infection.
Point concept takes about one month of preparation and involves plants that deeply nourish proper interferon response.
Unfortunately clinical trials will not take place.
I’ve discussed many individual facets of the full program in previous threads noted at the NS1 profile.
NS1 23:45
Thanks for the reply. I hope you continue to post. I will look at these threads now.
Influentia2,
Many of the earliest posts on the original fluwiki seem to have been lost. If the moderators can regroup and repost the original forum threads, we’d have a host of solid info.
Preparing for something like this pandemic is much more than buying a product, doing an exercise or avoiding a certain food. It’s almost a living style. How much healing can you handle? preceeds itself now with How much prevention can you handle?
You see, I don’t believe for one second that any treatment for an PF51 infection will ever be consistent and safe if adminstered at the time of infection. I certainly wouldn’t hold any hope for a treatment to be useful at the point of symptom presentation.
Medical science isn’t offering us much hope. We truly know so little after expending so much intellect and capital that I sometimes wonder if a conventional answer will ever exist?
So if you have no valid post-event solution, what do you do?
Prevent the Event.
Make you body as pure and fully functional as it was designed to be. Remove toxins and increase nutrients and I don’t mean anti-freeze-laden vitamins.
Thanks, NS1. I will try to read as much as possible over the weekend. I’m sure I’ll have questions, though! :)
Feel free to email if I’m not using the forums.
NS1 - I am in complete agreement with your position of purify and deeply nourish the body. I would add to that excellent personal and environmental hygiene and promotion of subtle energies of the body via appropriate methods (hatha yoga, chi gung, some kinds of massage, etc) and that is likely the best anyone can do. I follow the Ayurvedic approach. The use of Neti is excellent for many reasons.
I am in the process of putting together a small, insignificant website detailing some of these methods (and some other helpful, simple, cheap and personally used survival basics) and hope to post a link on FW when it’s up and running.
NS1 00:09
Only some of the threads will not work. I read some several weeks ago until I had a headache, being relatively new here I have had a lot of catching up to do. The thread about fevers still does work and I think that is the thread that I needed to read. However, after reading the post at 17:43 on that thread, I have another question but I will email it to you if you don’t mind.
Point concept takes about one month of preparation and involves plants that deeply nourish proper interferon response.
If there is a thread about that comment that still works direct me to it. We are very curious here about this aspect of preparation.
Thank you.
BeWell-
I look forward to reading it.
Thank you. I figure if even one thing is useful to one person, it’s worth it. I will post it here or I guess on the new FW when it’s ready.
My email is: MayAllBeWell at gmail dot com.
NS1 at 00:09
Many of the earliest posts on the original fluwiki seem to have been lost. If the moderators can regroup and repost the original forum threads, wed have a host of solid info.
Sounds like a great post pandemic mini-series :
“Tonight at 8, part 2 of, The Lost Fluwiki Posts: Fact or Fiction. You decide.”
NS1 at 22:23
That has to be one of the most intriguing post I’ve ever read. Fitting that it’s on a tread named “Checkmate” !
Grrrrr…..THREAD….not tread
I can reread a prepost 18 times and it looks fine! Hit the post button, and as soon as it comes up….NOOOOO!
Is there a sniglet for that?
JWB,
A significant portion of circulating viral strains today carry some type of interferon-mediating genetics.
H5N1 just happens to have a tendency to couple the high replication activity with genetics to strongly suppress the host cell’s innate immune response.
NS1 at 05:11
This is all so fascinating to me. I want to personally thank you for taking the time to even post back and forth with me. I have so much learning to cover that I feel unworthy of your time. Thanks for your patience thus far and I realize events will probably dictate that your attention merits other avenues.
In light of the recent cerebral vacuum here, I will go so far as to say that I speak for many other posters (and lurkers) that your post here are so valued.
I’m looking forward to exploring those mystical archived threads, as well as your future post.
JWB,
Read widely and follow your interests. Ask lots of questions until the information makes sense to you.
what’s with WHO not mentioning these mutations from Iraq,Azerbaidjan ? Is it OK, are we comfortable with it ? Since I haven’t seen disussion about it…
Apparantly the sequences had been in the protected database, so all the 16 reference laboratories knew about it, but no one mentioned it to public for half a year. And no reporter, not even the forums are asking why. No expert comments about it. Correct ?
anonymous at 06:19
The study was only published this week. The WHO does not do their own research on receptor binding.
I suspect even if they got data from the researchers, which I very much doubt, they still could not disclose the data without consent from the researchers prior to publication.
The scientific world has not seen fit to address this issue of sharing preliminary data without jeopardizing right of first publication. It is an issue that should be addressed urgently, IMO.
Edna Mode:
In particular, do you have any thoughts on *how* to get the immune system to recognise the infection immediately?
If they can get this mab in respiratory form Bavituximab shows great promise in clinical trials.
JWB at 04:03 Sounds like a great post pandemic mini-series : Tonight at 8, part 2 of, The Lost Fluwiki Posts: Fact or Fiction. You decide.
Funny!
I went to my family doctor yesterday ( Friday 17th- November) for a simple check-up. While there I asked him for a prescription of tamiflu. He looked startled when I asked. His reply was that the USA government is stock piling it, and they ( the doctors ) were told not to give tamiflu to anyone, unless they actually have the flu. I went away with NO prescription for it. He said there is going to be a pandemic…which he called the “ swine-flu’ , I knew he meant different. He quickly changed the subject. I was in a fog all night after that visit with him. Very scared
snow lover at 11:03 In many countries of Europe doctors have been told the same. Almost a year ago.
snow lover -
I got lucky - asked my doctor for anti-viral scripts last fall (fall 2005) before they were told not to write them. Just got under the wire on that one!
What your doctor was willing to tell you - that’s the kind of information we need to pay attention to.
Ask and you shall receive. Closing this for length.