There is an interesting opinion commentary by Crawford Kilian about avian flu and the CFR rates and ramifications of a high CFR that might be of interest to everyone. Here are some excerpts (it is a fairly long commentary):
<snip> And if I were to base my thought experiment on the WHO report published last month, I’d probably use the following passage on page 15 as my starting point:
One especially important question that was discussed is whether the H5N1 virus is likely to retain its present high lethality should it acquire an ability to spread easily from person to person, and thus start a pandemic…should the virus improve its transmissibility through adaptation as a wholly avian virus, then the present high lethality could be maintained during a pandemic.
So let’s base our synopsis on a virus that keeps its “present high lethality.” The Spanish flu of 1918–1919 infected about a third of the human population, as far as we can tell, and killed about two to three per cent of those it infected.
That was a very high case fatality ratio (CFR). Most discussion of H5N1 has assumed an avian flu pandemic would inflict a similar mortality. Given our far larger world population, that’s a very discouraging prospect.
But H5N1’s present CFR, worldwide, is just under 60 per cent. In Indonesia, it’s 76 per cent. In Vietnam, it’s 45 per cent. (Cambodia’s six cases have all been fatal, but that’s a very small number.)
Well, in this SF novel, let’s assume that a human-to-human (H2H) mutation breaks out with the capacity to infect one in three, and with the same CFR that it now has — 60 percent. Let’s give it a gimmicky title: H2H 60.
<snip> In this thought experiment, let’s assume that the first wave of H2H 60 infects 10 per cent of the population in two months. So within eight weeks of the original outbreak in Asia, 30 million Americans are sick and 18 million are dead. Canada suffers 11 million sick and 6,600,000 dead. The U.K. — England, Scotland, Wales, and Northern Ireland — has 20 million sick and 12 million dead.
Staggering as this toll seems, it’s paltry compared to the deaths in Asia in the pandemic’s first two months: China sees 130 million fall ill, with 78 million dead. India loses 65 million. Twenty-four million are infected in Indonesia, and almost 15 million die. Worldwide, 360 million are dead.
This is just the first wave. The second, five or six months later, takes almost 850 million additional lives. By the time the pandemic has run its course, two billion people have been infected and 1.2 billion have died.
<snip> A good science-fiction novel isn’t just “what if” — it’s also “what’s more.” If avian flu sustains its 60 per cent case fatality ratio, the “what’s more” includes the collateral damage: those who die of diabetes, heart disease, cancer, and violence.
The collateral damage also includes those who die because no one has made or transported their medication, and those who die of simple starvation. And it includes those who are simply traumatized by death on a scale not seen since the Black Death arrived in Italy from the Black Sea in 1347.
<snip> My synopsis doesn’t hold out much hope for those who hole up. They expect to live on the bottled water and freeze-dried meals stored in their basements, to listen to news bulletins on their hand-cranked radios, and then to emerge — with their dogs and cats — into a quiet new post-pandemic world.
Having lived through the Cold War debates on whether to admit your neighbours to your fallout shelter, I expect these persons to be killed or robbed precisely because of their foresight. Never mind that some are buying weapons to defend themselves — someone with more weapons eventually turns up on their street. Vancouver, San Antonio and Manchester are no different from Kigali in 1994 or Darfur in 2006.
<snip> But such novels (including Vonnegut’s Cat’s Cradle and Shute’s On the Beach) haven’t done a thing to move us off our self-destructive course. A novel about H2H 60 wouldn’t save a single life, no matter how many copies it sold.
We will save lives by accepting the implications of the WHO report and similar expert assessments, and by taking concrete steps to prevent a pandemic before it spreads. The same is true of global warming and the destruction of the world’s fish. Playing “let’s pretend” about these threats will only distract us from a life-or-death struggle.
Something about how this is phrased or set up doesn’t click for me (and I don’t mean about the possibke high fatality rate, collateral, systems collapse, ect; that has sounded possible since back years ago when I read some scientist saying H5N1 was making him lay awake at night.)
(“the capacity to infect one in three,” …”let’s assume that the first wave of H2H 60 infects 10 per cent of the population in two months.”… I don’t think that works with the math; new cases every day adds up awfulyl in 10 or 12 days, right? but, I skipped my coffee this morning.)
Some sort of error about “those who hole up” and …”We will save lives by accepting the implications … and by taking concrete steps to prevent a pandemic before it spreads”… being opposites, or, lets’ hear the details left out of “taking concrete steps”; I wish it were possible but I don’t think the majority will get convinced -against the corporate machine whatever- to all do way-of-life-changing things that will get us all through pandemic, nor stop climate change, nor save all the fish - but, we need to do as much as we can.
For lack of leadership by the politicians/ bureaucrats who control the budget, money, military, media, whatever; perhaps the people who are trying to prepare their households are doing what they can?
The only “pretend” I’ve seen is either the people who can’t bear imagining it happening at all, or, officials making elaborate plans for a 1968 pandemic, and public reassurance or silence, rather than publically discussing the dire warnings and acting on a household/municipal community-building level?
There is more in the article that I did not post, so maybe in its entirety it makes more sense.
As far as for those who hole up, I do not agree totally with that premise. I think (a guess mind you) that the author was trying to get people to work with their neighbors and communities rather than being self centered, but it is difficult to feed a community by yourself. I seriously people are going to attack their neighbors for food, but who knows.
I do agree with the statement regarding fictional accounts, though. Works of fiction will only reinforce to people that the potential for a pandemic (or a severe pandemic) could never happen - it is just a fantasy created by authors to sell books. It will reinforce any information coming from scientists as unbelievable because it mirrors the fictional story.
Why wouldn’t that example be “infects 30% of the population in the first two weeks”, given how much we travel and associate at work, transit and schools?
Anyway, extremely difficult to get communities working together when officials are trying to discourage any awareness of pandemic influenza year alert, “panic” or loss of authority in making or implementing “plans” - or whatever their real objection is for keeping this off the local public stages.
Maybe the American public will worry about the draft instead… Govt needs to bring it back- and, can use it to distract the public from H5N1, all at the same time? (ha ha)
From the sound of this article it’s time to stop trying to educate your neighbors, and time to study Darfur for warlord tactics.
those are not happening under airborne /fomite contagious, dead in a week, global supply chain collapse, ect… conditions