This post comes from some observation and discussion we’ve had over many weeks. I wrote an article about it at my other blog. The gist of that was the dilemma in risk communication between ‘it’s all hype’ and ‘we’re all doomed’.
We need to make sure we stress that although a pandemic is inevitable, a 1918-style pandemic is not. That’s a possibility with enormous consequences, and we do need to prepare for worst case, but 1918 style is an if and not a when.
A friend of mine with a sharp eye noted this article today decrying the hype. Yet the person decrying the hype uses more hyperbole than any public health person they criticize:
I would love to find that guarantee of a pandemic ‘only months away’ from anyone anywhere in print. OTOH, by stressing what’s known and what’s consensus, we put ourselves in a position of not having to defend against the charge of hype and fear-mongering. We are simply being reasonably prepared. If everyone prepares for a 1968 pandemic, and agrees it’s prudent to do so, we have made progress. From that, we can build.
BTW, while we’re on the communications topic, let’s try and separate bird flu (in europe now) from panflu (which is what we fear). CNN had a disappointing show two nights ago on bird flu, whereas Fox has an upcoming show tonight on panflu. Different topic and hopefully, handled differently.
DemFromCT. A 1918 style pandemic is not inevitable? I respectfully disagree with you. History has shown a repeated pattern of pandemics of this or greater magnitude.
When’s it coming? ;-)
How do you know?
What’s the probability?
These are all the tough questions we don’t have answers to. Becuase we don’t, it’s prudent and necessary to prepare, but you can’t guarantee one’s coming any more than I can guarantee one’s not, at least in a time frame that anyone would consider relevant (say, 5 years or less).
I worry about H5N1 as much as anyone, but there’s too many unknown unknows.
DemFromCT. Those who do not learn from history will repeat it. There are patterns in nature and history that are repeatable. There are occurences that are absolutely unique. Post-1918, H5N1 is absolutely unique and every scientist in the field knows it…whether they are on the record or not. Science wihout debate is not science. Scientific debate repressed by confidentiality agreements results in stagnant science…no innovation, no advancement.
Here is an analogy to the current situation regarding H5N1. There is a transplanted Asian scientist who for thirty years did everything possible, from Canada, to have a Tsunami warning sytem installed in the Indian Ocean. Words cannot explain the effort he made. The last significant tsunami occurred in 1830 in which 25–50,000 people died. The answer he was given….not going to happen again.
Speaking of extremes:
Tom, I have tried hard to find information about a flu pandemic worse than 1918, but have been unsuccessful. What have you learned?
Here is a list of known flu pandemics from the CIDRAP website: (http://www.cidrap.umn.edu/idsa/influenza/panflu/biofacts/panflu.html#_Historic_Perspective
)
1729, 1732, 1781, 1830, 1833, 1889, 1918, 1957, 1968
Years between pandemics, starting with 1729:
3 / 49 / 49 / 3 / 56 / 29 / 39 / 11 / [and now 38+]
(This is the list I use to demonstrate that pandemics are not “cyclical,” and therefore we are not “overdue” — although we are almost certainly at increased risk over the “average” year, because of the presence of H5N1 in the environment.)
Path Forward. This has been covered but I’m not sure which thread. Maybe, Dem or Melanie can direct you. Dr. Osterholm wrote last spring in The Coming Pandemic. an article in the New England Journal of Medicine (I think May 2005…search it if you can…there are other articles by the same name so make sure it is the NEJM article), stated that the 1830 pandemic was of comparable virulence. Others are repeatedly mentioned anecdotally. This article by Dr. Osterholm is the best I have read on the subject. It should be interesting to note that 1930 to 1918 equals 88 years. Add 88 years to 1918 and you get 2006.
Kaballah and numerology i can’t help you with. But here’s the Osterholm reference, May 2005 NEJM. ;-)
Here is a question for the experts (I’m just a common man with silly questions) - In reading through the WHO’s website I see where they say we have 2–3 days at the most to contain a serious h2h outbreak (I can find the referernce if you wish). I also see in watching news reports that 2 weeks are often necessary to confirm HPAI in humans. My question is: How can an outbreak be contained in a 2–3 day timeframe when definitive testiong takes 2 weeks? I’m sure there is a good answer to this and I have overlooked something. Please educate me. (sorry if this is the wrong thread for this question - please feel free to move this post)
NW – at 14:19
The US and CDC recemtly announced a test that works in 4 hours to detect H5. It’s still being distributed to key labs throughout the world. The H5N1 confirmation takes days, but any human with h5… well, fill in the blank.
we’re always racing technology against nature. Vaccines are another example. I hope we win.
Tom, Thanks for the NEJM reference.
Path Forward. As discussed in the other thread, some references state that the 1830 pandemic was not a virulent one. To answer another question before it is asked. I defer to Dr. Osterholm, in a peer reviewed medical journal; I would argue the best, most concise medical journal in the world.
DemFromCT – at 14:23 - Thanks for the response.
If I could contribute one last thing to this thread. DemFromCt raises an important issue given recent events. The title of this thread is moderating the extremes…not moderating the extreme. I happen to believe, given my analysis of a deplorable lack of evidence, that a highly mutable virus + a large enough template = opportunity = mutation = eventually a pandemic. My personal opinion, given my analysis of the variables, is that the eventual pandemic will be bigger than the 1918 pandemic…but as I have said before, Dr. Butcher et al could be right and I could be completely wrong.
I understand that DemFromCT and Melanie are risk analyists and risk communicators. When the WHO, with Dick Thompson as spokesperson, were charged with communicating the risk of a flu pandemic, they chose to produce data without anything in the way of qualification. They took their data from the 1968 pandemic which was just as much an ‘anomaly’ as 1918 but in the other direction. I notice that they have not been called to account for this action.
I have not been able to post or read any updates since 3:00 today.. what happend?
Server glitch, now fixed.
And Tom DVM is quite right. The intent is avoiding the minimization of the coming pandemic, along with using the realistic description of the chance of a possible 1918-style disaster.
Some sort of middle ground is needed: that a pandemic of some kind, from some flu virus, is inevitable and that a 1918-style pandemic is possible (but not inevitable, at least this time around).
Somewhere with WHO and the UN, the range from Thompson’s 2–7 million, to Nabarro’s 150 million, has been lost.
DemFromCT, your analysis is correct. Even the experts that think H5N1 is “the one” refer to the “possibilities” of a pandemic being 1918 like…which some seem to interpret as being the prediction of that expert. I know of no credible expert that is predicting H5N1 being “the one” with confidence that it will be 1918 like.
Someone at WHO says they prefer the lower estimate because they want people to “prepare not panic”. My own feeling is that fear is a great motivator and it might be time to instill some of that about now. Business especially need a kick in the butt. Leavitt is sure trying, going to all 50 states. God bless him. He is indeed a public servant of the highest order.
NW, please read the link I provided at the top (under ‘article about it’)… see Sandman’s interp. Obviously, i agree, but that’s where the thought behind this suggestion comes from. Fear is a motivating factor, but we have to make sure it’s a realistic, defensible fear.
Let’s not forget, that even if we are fortunate and the next pandemic is “relatively” milder than 1918, that for those unforunate enough to get ill and die, it’s 100% CFR for them….
Grace, a 1968 pandemic will overwhelm our medical system just as surely as a 1918 style pandemic would. It’s only a matter of degree… a huge difference, but a ‘mild’ pandemic is like a ‘mild’ tsunami.
It is certainly the case that we can’t say, for sure, that H5N1 will become a panflu. It is also true that we can’t, for sure, say that the next panflu will be severe. However, we can look at the available data to estimate the most likely outcome. IMO, all the data suggests that H5N1 is likely to cause a severe panflu, quite possibly worse than 1918. Reasons:
1. It is widespread. Reports lag the geographical spread.
2. Unprecedented ability to infect, and kill, a wide range of species.
3. Increasing opportunities to spend time in human hosts.
4. Highly lethal to children and young people.
5. Animal studies provide further support for its ability to cause severe pathology.
6. Acquisition of polymorphisms thought to be related to the 1918 virus’s ability to adapt to humans and cause severe pathology.
At this point, the only argument against H5N1 becoming a panflu is that it hasn’t happened yet, so therefore it never will. The only argument against H5N1 causing a panflu as bad, or worse, than 1918 is that this doesn’t happen very often, so, its unlikely to happen to us.
The arguments against H5N1 becoming a very nasty panflu seem unconvincing, to me.
DemFromCT – at 18:41
Read it and see the logic involved. Leavitts approach is quite calm and without scare tactics also. I applaud his efforts but am thinking it takes quite a bit more to get any business to invest time and money into pandemic preparedness when the primary goal of business is to make money not spend it on hypotheticals. I work for a billion dollar company which as far as I can tell is completely unware of this issue. The risk needs to be made real. How do you make a risk real? In this case its tough because the experts say “We don’t know what the risk is”. That will not leave anyone trembling in their boots let alone spending bucks on planning for an event that may or may not happen. That is the problem here. I almost feel that hyperbole is justified in the sense that laying emphasis on the probability rather than the possibility is more likely to get a response. It is quite possible in communicating this issue to choose either flavor of persuasion. Erroring on the side of emphasizing the risks and probabilities to me doesn’t seem like a mortal sin if it results in intelligent planning and preparation. I am not talking about lying I am talking about what politicians, business folks, advertising etc. do every day to get their point across. Emphasize the data which makes the point which gets the response you are after. I can say 1–7 million may die or 150–500 million may die. Both are valid estimates (because we don’t know!) I would argue that the highjer number would be more likely to get someone to take notice and do something. If that is not a bad thing then why not use that number?????
Maybe some people on this site give the impression of expecting the worst, but I think even they know, it’s still just a possibility. The public at large is far from being overly fearful, and can understand the truth of there being a range of possibilties. As DemfromCT says, treat the public like grownups. Don’t make the decision that people can’t deal with an explanation that is longer than a sound bite. We live with probabilty estimates everyday in our weather forecast; it may rain, it may not. If the TV. starts beeping and you read a crawler message about a tornado warning, there’s no concern about causing undue fear, they just want you to get the hell into the basement. You know what the odds are, your house won’t blow away, but you should prepare as if it will. It may be a dinky tornado that skips around and briefly knocks over a few items, or it may be an F5, mile-wide wood-chipper that plows out a track for 40 miles. People understand there’s a range of danger and it may not affect your neighborhood;- but get the hell into the basement anyway. This is unfamiliar territory for the scientists, leaders and media; they are not accustomed to making a pronouncements about a pandemic alert and are very hesitant to do so. I think not getting people to take action is a greater ethical mistake, than informing the public enough to prepare themselves. The fact that the future has some uncertain probabilities, doesn’t mean everyone should be left in the dark. Right now, that is how I would characterise most of the public. The Top Officials may feel the right time to sound the warning is when the Pandemic actually touches ground. That’s an easy choice but not the best service.
NJ Preppie and NW: You are right. Even a warning of 150 million dead is not likely to engender panic as many will remain unmoved. I showed my brother statements from WHO to prepare, from the US Government sites to prepare, warnings from government officials that states will be on their own, our state’s plan which says hospitals will be over-run, data from Nigeria and Indonesia, opinions of many scientists saying that a pandemic is a legitimate concern and he still says “There is only a minute chance of anything coming to pass.” While we all agree that it is anyone’s guess and that my brother could, in fact, be correct; it does not bode well for convincing anyone to forego the cost of going to the latest movie for the purpose of spending that money on extra food.
NJ Preppie: The governmental authorities will face the same problem with earthquakes, if they ever get better with their predictive technology. Do you evacuate Tokyo and its environs or San Francisco, if there is a good probablity of the “Big One”, and when do you do it? And how long does everybody stay out? And how would you even do it, in a logistical sense?
But, on the other hand, building codes are very stringent in both cities, even now. Where are the enforced “building codes” for pandemic planning on the part of business? Should Congress impose another unfunded mandate that increases the cost of doing business? You can bust a country or a household with too much “insurance”. Where is the happy medium?
Many Cats: Show your brother Monotreme’s “brief” at 19:14. That is about as incisive as you can get. Lots of punch in that little package.
Medical Mavin: That’s why I admire Monotreme—he is trying to save the world, Monotremata and all! :)
Nonetheless, the idea that only a severe pandemic can get folks to prepare is, I think, in the end not correct. What’s more likely to happen is this: every passing day it doesn’t happen is a reinforcement that the non-preparers were ‘correct’.
I think it’s more sensible to do that which is prudent. Want to convince a billion dollar company to prepare? Introduce them to other billion dollar companies that are preparing. They may not listen to us, but they surely would pay attention to the competition.
There needs to be multiple methods to reach the greatest number of people . Some watch Oprah. Some watch Fox. Few trust the government, but some still do (and for them, there’s pandemicflu.gov and international equivalents). As TomDVM pointed out selsewhere, there’s CDC and their equivalents.
And stay away from touting as fact that which is worrisome but not inevitable. That way lies a loss of credibility.
Thanks Medical Mavin and Many Cats.
DemFromCT: I agree we shouldn’t say things will definitely happen that we don’t know for sure will happen. On the other hand, we have to give people reasons to take panflu more seriously than asteroids hitting the earth, supervulcanoes blowing up Yellowstone and mega tsunamis wiping out the east coast. The 6 reasons I think H5N1 will evolve into a severe panflu are all facts. I think it is difficult to interpret these facts as suggesting a benign scenario, although I’m sure some will try.
I really like the list. It’s a list of why it should be taken extremely seriously, and not a list of why it’ll definately happen. There’s nothing benign about it.
Dem: I would agree with you in this sense only: those who have ears to hear will listen whether the threat is great or whether it is small if they are convinced that it can be mitigated to some extent through their actions, and if doing so does not become burdensome financially. Those who do not have ears to hear will not listen until the person next to them falls over dead. The problem I have is in perpetually attempting to get those who do not have ears to hear to change their nature. My family is near an earthquake fault zone, down-wind of a military chemical depot and may soon be down-wind to a boatload of radioactive waste, all threats considered so “minute” by my brother that any prepartion is unnecessary for any of them, even taken as a whole. I would have hoped that warnings to prepare from international, national and local officials and scientists would have prompted a little concern, but the results would have been the same whether the predicted death toll was 2 or 200 million world-wide. Similarly I am sure many businesses are looking at their competition and chuckling that they are using monies preparing for the “minute possibility” of a disaster as opposed to advertising, etc. Preparing for any potential disaster makes sense, but there are enough folks without ears that I am concerned that death may have to pay a visit before some of them take “minute” possibilities seriously.
It builds, Many Cats. First one business, then another, then you can’t afford to be left out. Same with people. The European experience will help.
In the end, some folks won’t listen at all. That’s the way of the world.
I have followed this subject since before it was discovered to infect wild birds (a year or so). I say that only to give a perspective of my perspective. My gut tells me that this virus has too many opportunities in human hosts not to go H-H. My math and my research in virulence says that it will be worse that we are predicting. In the end, you can lead, but nobody has to follow. So what works to educate people, a very simple bar graph over time posted with a big link, which shows things like, countries infected (birds) each month, people infected each month and mortality. You could do it in weekly intervals. When folks see the trend, they get the picture. It might work better than all the verbiage here and references to experts, NEGM, CIDRAP, etc. Please lets try to reach some people with something like that.
Dude,
And what are you going to do to make better outcomes? Share your expertise, please.
Melanie, I am not sure what your question is really asking? I don’t mean to be non responsive to your question. I want to do whatever it takes. My expertise…math, engineering, social policy, law, consumer rights, prison reform, national antiwar activist, 3 elected offices, cosmology, astronomy, computers (networks/web hosting/sales/troubleshooting), infectious disease followup, and national housing policy. What I plan on doing is helping people in my social circle understand.
Hi There
How old do any of you believe the influenza virus is? My hunch is that it is hundreds of millions if not billions of years old. It has been here well before humanity. And will be here after we are all gone.
There are several human flu pandemics every year- and have been for my entire life. Yet somehow we never get past 1918 when we go backwards- as if God created flu in 1918. not so.
The influenza virus was not even identified until 1933. Before that it was just the Grippe. How can any of us speak confidently about what was or was not a flu pandemic? It is only in the last few years that Taubenberger demonstrated the H1N1 of 1918.
What is enormously clear to me is that we know so little about this virus- but it seems to know so much about us. I think it might raise us like battery chickens. Lets hope like hell that it’s “wedding” does not take place. Could result in a viral banquet with us as the center piece.
Flu viri has been killing birds, beast and wo/man for millions of years- and doing it every year. WE could be legends in our own minds (clint eastwood)
Nippon Rinsho. 1997 Oct;55(10):2505–11. Related Articles, Links
[History of influenza epidemics and discovery of influenza virus]
Shimizu K.
Department of Microbiology, Nihon University School of Medicine.
Influenza epidemics occur almost annually, sometimes taking on a global scale and turning into pandemics. According to Noble, the first clearly recorded epidemic was one that struck Europe in 1173 to 1174. In Japan the first comprehensive review of epidemic records was made by Fujikawa in the early 20th century, who listed 46 epidemics between 862 and 1868. Of the ten pandemics since the 1700s that have been certified by Beveridge nine have struck Japan as well. The human influenza A virus was discovered in 1933 soon after Shope succeeded in isolating swine influenza A virus in 1931. Since the discovery studies in the influenza have made immense progress and have contributed greatly to not only virology but also immunology and molecular biology.
Hi There
How old do any of you believe the influenza virus is? My hunch is that it is hundreds of millions if not billions of years old. It has been here well before humanity. And will be here after we are all gone.
There are several human flu pandemics every year- and have been for my entire life. Yet somehow we never get past 1918 when we go backwards- as if God created flu in 1918. not so.
The influenza virus was not even identified until 1933. Before that it was just the Grippe. How can any of us speak confidently about what was or was not a flu pandemic? It is only in the last few years that Taubenberger demonstrated the H1N1 of 1918.
What is enormously clear to me is that we know so little about this virus- but it seems to know so much about us. I think it might raise us like battery chickens. Lets hope like hell that it’s “wedding” does not take place. Could result in a viral banquet with us as the center piece.
Flu viri has been killing birds, beast and wo/man for millions of years- and doing it every year. WE could be legends in our own minds (clint eastwood)
Nippon Rinsho. 1997 Oct;55(10):2505–11. Related Articles, Links
[History of influenza epidemics and discovery of influenza virus]
Shimizu K.
Department of Microbiology, Nihon University School of Medicine.
Influenza epidemics occur almost annually, sometimes taking on a global scale and turning into pandemics. According to Noble, the first clearly recorded epidemic was one that struck Europe in 1173 to 1174. In Japan the first comprehensive review of epidemic records was made by Fujikawa in the early 20th century, who listed 46 epidemics between 862 and 1868. Of the ten pandemics since the 1700s that have been certified by Beveridge nine have struck Japan as well. The human influenza A virus was discovered in 1933 soon after Shope succeeded in isolating swine influenza A virus in 1931. Since the discovery studies in the influenza have made immense progress and have contributed greatly to not only virology but also immunology and molecular biology.
DemFromCt wrote at 17:53 wrote: “Some sort of middle ground is needed: that a pandemic of some kind, from some flu virus, is inevitable and that a 1918-style pandemic is possible (but not inevitable, at least this time around).”
Tom DVM wrote at 16:28: “When the WHO, with Dick Thompson as spokesperson, were charged with communicating the risk of a flu pandemic, they chose to produce data without anything in the way of qualification. They took their data from the 1968 pandemic which was just as much an ‘anomaly’ as 1918 but in the other direction. I notice that they have not been called to account for this action.”
Lord knows, communicating the next pandemic is hard, and there are no experts in how to do this — only students.
At the start of SARS — before anyone knew yet whether it was the start of an influenza pandemic or not — WHO’s David Heymann said that WHO was “building a boat, and sailing it at the same time.”
Just as Flu Wiki participants are trying to figure out how to communicate the next pandemic, WHO is trying to figure this out as well. It would help to notice — and acknowledge — when they learn lessons and change course, even if they do not signal that change as clearly as some (including me) would like.
In the spring of 2004, after asking the CDC’s Martin Meltzer to model elements of a possible pandemic, WHO placed on its website a pandemic preparedness article which included a section on the “Consequences of an influenza pandemic.”
One “factoid” from that article, which continues to generate valid disapproval from many flu wikie participants: “Although health care has improved in the last decades, epidemiological models from the Centers for Disease Control and Prevention, Atlanta, USA project that today a pandemic is likely to result in 2 to 7.4 million deaths globally.” http://www.who.int/csr/disease/influenza/pandemic/en/ (spring 2004, still online as of today, February 20 2006.)
Many people were very critical of this stand-alone estimate, because it appeared in many official WHO statements with no mention that it was a best-case estimate. The number was perceived by people who knew pandemic history as an attempt to down-play, while it was simultaneously perceived by newbie reporters and newbie officials as fear-mongering.
Many articles were written, critiquing the way WHO and the U.S. HHS and other agencies were communicating the next pandemic, and offering suggestions.
WHO continues to learn how to communicate a pandemic, just as people on the Flu Wikie are learning. In January 2005, WHO posted a document called: Avian Influenza: Assessing the Pandemic Threat, which includes a beautifully-written — but agonizingly painful — section called “Forecasts and Dilemmas” (starts on page 42 of the pdf document). This includes the following statements (http://www.who.int/csr/disease/influenza/H5N1-9reduit.pdf ):
>Best-case scenarios, modelled on the mild pandemic of 1968, project global excess deaths in the range 2 million to 7.4 million.
>Other estimates that factor in a more virulent virus, similar to that responsible for the deadly 1918 pandemic, estimate much higher numbers of deaths. Both scenarios are scientifically valid.
>This mixture of unknowns and certainties creates a familiar but difficult public health dilemma: what priority should be given to preparedness for an inevitably recurring event of unpredictable timing and an outcome that is also unpredictable but could be catastrophic?<
The “Forecasts and Dilemmas” section of the document is a brief, painful, and powerful read, and may be a useful citation for those of us trying to get others to struggle with pandemic preparedness.
“What is enormously clear to me is that we know so little about this virus- but it seems to know so much about us. I think it might raise us like battery chickens.”
I know it wasn’t intended this way Clark, but for some reason this struck me as funny… The image for some reason of a virus raising us like chickens… jeez… maybe its not that funny… but for a minute there…
Thanks, Path Forward – at 10:03
Another thing that WHO is doing better is giving us more frequent updates. We should acknowledge when they do better.
And when you said we’re all students, you ain’t kidding.
I love that Haymann quote. He’s currently in charge of eradicating polio - it’s not like the rest of the world goes away just because of H5N1 worries.
Has anyone picked up on the irony? We are abslutely sure about mortality rates and disease vectors from 25 years ago, 88 years ago and further back- BUT in 2006, with all of our electron microscops and helicopters, we can’t figure out if a duck has died of H5N1 or frozen to death?? (is it this, or is it that, this or that?)- Must send to Lab.
Hi Anon47- it was sort of a joke. I had this image that all of human civiliization was just constructed by the Great Flu Virus- The Flu Viri could raise huge flocks of humans to have on hand for their wedding feasts. That we are being farmed. Just a weird thought- sort of like , now the shoe is on the other foot.
clark – at 04:48
I think the reason that 1918 is mentioned so often is that it was an especially deadly flu, and there are (relatively) recent reports on it’s casualties. Also, there are photos and the spector of the first World War coming to an end. It gives people a sense of time. They can see the 1918 flu and say to themselves “Wow! That really wasn’t that long ago.” To try and visualize problems that occurred way back in 1173/1174 is unfathomable to most, more likely giving the impression of Plague rather than Influenza. Humans, by nature, have relatively short memories. In another hundred years, 1918 will be all but forgotten.
clark at 14:33:
I useed to have thoughts like that many years ago when I was doing independent chemical research while in college….
BroncoBill:
Lucretius-“And soon it will have been, past any man’s recall”.
Hi Bill- a chemist? cool. It is not that far fetched- when you read about parasites and how they take over the minds of their hosts- This might be off topic but maybe not. H5N1 is a top predatory parasite. Maybe this is a way to think about the virus.
Mind Control by Parasites
Bill Christensen
Technovelgy.com Sat Feb 11, 8:00 AM ET
Half of the world’s human population is infected with Toxoplasma, parasites in the body—and the brain. Remember that.
Toxoplasma gondii is a common parasite found in the guts of cats; it sheds eggs that are picked up by rats and other animals that are eaten by cats. Toxoplasma forms cysts in the bodies of the intermediate rat hosts, including in the brain.
Since cats don’t want to eat dead, decaying prey, Toxoplasma takes the evolutionarily sound course of being a “good” parasite, leaving the rats perfectly healthy. Or are they?
Oxford scientists discovered that the minds of the infected rats have been subtly altered. In a series of experiments, they demonstrated that healthy rats will prudently avoid areas that have been doused with cat urine. In fact, when scientists test anti-anxiety drugs on rats, they use a whiff of cat urine to induce neurochemical panic.
However, it turns out that Toxoplasma-ridden rats show no such reaction. In fact, some of the infected rats actually seek out the cat urine-marked areas again and again. The parasite alters the mind (and thus the behavior) of the rat for its own benefit.
If the parasite can alter rat behavior, does it have any effect on humans?
Dr. E. Fuller Torrey (Associate Director for Laboratory Research at the Stanley Medical Research Institute) noticed links between Toxoplasma and schizophrenia in human beings, approximately three billion of whom are infected with T. gondii:
Dr. Torrey got together with the Oxford scientists, to see if anything could be done about those parasite-controlled rats that were driven to hang around cat urine-soaked corners (waiting for cats). According to a recent press release, haloperidol restores the rat’s healthy fear of cat urine. In fact, antipsychotic drugs were as effective as pyrimethamine, a drug that specifically eliminates Toxoplasma.
Are parasites like Toxoplasma subtly altering human behavior? As it turns out, science fiction writers have been thinking about whether or not parasites could alter a human being’s behavior, or even take control of a person. In his 1951 novel The Puppet Masters, Robert Heinlein wrote about alien parasites the size of dinner plates that took control of the minds of their hosts, flooding their brains with neurochemicals. In this excerpt, a volunteer strapped to a chair allows a parasite to be introduced; the parasite rides him, taking over his mind. Under these conditions, it is possible to interview the parasite; however, it refuses to answer until zapped with a cattle prod.
He reached past my shoulders with a rod. I felt a shocking, unbearable pain. The room blacked out as if a switch had been thrown.. I was split apart by it; for the moment I was masterless.
The pain left, leaving only its searing memory behind. Before I could speak, or even think coherently for myself, the splitting away had ended and I was again safe in the arms of my master…
The panic that possessed me washed away; I was again filled with an unworried sense of well being…
“What are you?” “We are the people… We have studied you and we know your ways… We come,” I went on, “to bring you peace.. and contentment-and the joy of-of surrender.” I hesitated again; “surrender” was not the right word. I struggled with it the way one struggles with a poorly grasped foreign language. “The joy,” I repeated, “-the joy of . . .nirvana.” That was it; the word fitted. I felt like a dog being patted for fetching a stick; I wriggled with pleasure.
Still not sure that parasites can manipulate the behavior of host organisms? Consider these other cases:
Not all science-fictional parasites are harmful; read about the Crosswell tapeworm from Brian Aldiss’ 1969 story Super-Toys Last All Summer Long (the basis for the Kubrick/Spielberg film AI), which keeps people who overeat from becoming obese. Not to mention robots based on parasites. Read press release on evidence for link between Toxoplasma and schizophrenia, Suicidal grasshoppers. Story via blogger Carl Zimmer and his readers. http://news.yahoo.com/s/space/20060211/sc_space/mindcontrolbyparasites
clark - Ummm, I’m not a chemist, nor did I study chemistry. My experiments were performed with a control group of one in decidedly off-campus locations. The aforementioned thoughts usually took root late into the night…
A bit off topic for this thread, clark?
I’m sorry. If I wanted to know about Sci-Fi and ‘mind-parasites’, I’d turn to the Sci-Fi channel. Generally, parasites are happy to live and grow in their hosts without shedding to other hosts. Viruses live to shed to other hosts and don’t care where they go.
Yeah, you are right- we were, however, talking about the extremes. TomDVM talked about the intelligence of parasites. You would have to say that this virus is behaving intelligently- even strategicaly.
Another point is that “moderating the extremes” inplies that there are two extreme points of view with everybody else distributed between, out along the line. Not so. As you probably know- I don’t agree with either “ëxtreme”. I think we are foolish to limit our thinking when dealing with a virus that seems to have almost unlimited abilities. I mean you have to take your hat off to an organism that can colonize half the planet in a matter of months- and have the other half lined up in its sights. And have the human race running around in circles like a chicken with its head cut off. I would have to sum up our response so far as total, ineffectual confusion. Killing chickens and burying them in pits seems to be our only solution. What is that going to do? Force the virus to look for another host maybe???
BroncoBill:
It’s science, but not fiction. There might be some basis for making such an argument; for instance consider how coughing and sneezing serves the virus as well as the host, and how the virus might have ways of encouraging that sort of thing. I agree, however, that it is mostly off-topic here. If I wanted to discuss it, I’d go Here.
clark, asking someone to stay on topic isn’t limiting one’s thinking… there are other threads. ;-)
You picked an interesting topic to wander off on, though.
clark re: “And have the human race running around in circles like a chicken with its head cut off.”
we may need to use another expression for the stupidity of the masses.
Bronco Bill wrote:
In another hundred years, 1918 will be all but forgotten
Yeah they’ll be taking about the 2006/07 pandemic.
I think the 1st mild wave of attack has already started. In the UK I know of a lot of people who have recently been suffering from flu. There were also instances of 20 or so schools been shut because so many of the pupils had succumbed to the ‘winter flu’ virus, as they put it.
Scary times ahead :O(
Wasn’t that how the Daily Show did their bird flu map: Chicken icon in China; cut the head off and it flapped and splattered red all over the other countries…
It does seem like the extremes of saying, “Pandemic won’t happen” vs “We’re all gonna die” have a lot in common; no action required.
I know someone, (Dr. Osterholm? Peter Sandman?) said the same thing, can’t find where just now. But, it is frustrating to try and get the public told that there may be risk of a wicked bad outcome, but, a lot of individual planning will make a person more resiliant against a variety of the slings and arrows of outrageous Fortune…whether we have a pandemic or not. Giving people information about how to plan is not fomenting “panic”.
“It does seem like the extremes of saying, ‘Pandemic won’t happen’ vs ‘We’re all gonna die’ have a lot in common; no action required.”
Man, I think you really nailed it there.
Pete --- Don’t forget that this IS the normal Flu season, and UK generally closes schools when more than a few kids are sick. Not saying that it doesn’t raise some eyebrows, but remember that there are Influenza viruii besides H5N1.
I don’t believe “the first wave” has begun. There’s still no proof of H2H transmission, and if BF had been found infecting school kids in UK, we’d ALL know about it by now!!
Bronco Bill- you are completely right- I should have edited out the science fiction stuff from the post (15:17)- copy and paste is a bad thing sometimes- It was only after I posted it that I realized I had included so much superfulous crap.
The stuff about parasites taking over the mind/behaviour of the host is not science fiction- It has however, inspired alot of science fiction. Parasites have been around for millions of years and know their way around the neigborhood.
I think the real problem (now I am getting back on topic, DemFC) is that those who believe that the H5N1 is just hype, a media beatup and a conspiracy to boost Roche’s share price- do so because they have a real belief in the superiority and infallability of the Human Race.- We will prevail because we were born to rule. We are the GodSpecies. Unfortuenately, this is often the extent of their argument. “Don’t worry, some genius nerds in a Skunk Works somewhere will invent a UberVaccine or SOMETHING invulnerable.”
Our status as the Celebrity Species does not necessarily give us a “get out of jail free card”.
clark----“Our status as the Celebrity Species does not necessarily give us a “get out of jail free card”.
LOL!!! Look how many ‘celebrities’ are either in jail or on their way!!! We as a race could very well be next!!
Cffullmoon:
“It does seem like the extremes of saying, ‘Pandemic won’t happen’ vs ‘We’re all gonna die’ have a lot in common; no action required.”
I haven’t ever seen or heard anyone say “we are all going to die”. Who has ever said that? I however don’t believe that all the prep I can do is necessarily going to save me (if TSHTF) or my family either. I am prepping with vigor- but not necessarily with the idea that it is going to work for me.
I do believe that the best response is the herd response. If we can get our brains collectively around this challenge- and act well as a herd- protecting our children etc- then I think we will come through this in better shape than panic and/or sefish me me me behaviour.
I would far rather hang out with people who have been considering the down side of this than the “put on a happy face” crowd. They are going to be panicing if TSHTF and very pissed off. They will have to deal with the realities of a pandemic as well as huge changes in their mind scapes. Then of course, they could be correct. I have been wrong about things pretty regularly over the years.
>At this point, the only argument against H5N1 becoming a panflu is that it >hasn’t happened yet, so therefore it never will. The only argument against H5N1 >causing a panflu as bad, or worse, than 1918 is that this doesn’t happen very >often, so, its unlikely to happen to us. >The arguments against H5N1 becoming a very nasty panflu seem unconvincing, to >me.
not the “only” argument. But what’s wrong with these arguments ? One of the most convincing arguments to me in the whole discussion. Other than “Chinese New Year”,”G228S”, “Aids in Africa”,”WHO withholding data or lying”, or those arguments usually seen in interviews with virologists.
you risk-communicators, you want to convince only the silly people ? And only by the power of your sympathy, your intelligent wording and proper presentation ? You are convinced that the risk is high and others should be convinced to prep too, but you don’t want to specify the risk or objectively argue why it is high. This can only work, when the counterpart is silly enough to focus on your personality or presentation rather than the facts. You need to specify the risk and its magnitude. You need to quote people with accepted expertise and quote them with their estimates. No other way to convince critical,intelligent,unbiased people. If you aren’t addressing those but the masses, then just imitate some politician’s election campaign or some company’s advertisement-spot. There is enough research how to be successful with this. You can even lie, no problem. The end justifies the means. But earlier or later you will have to convince _some_one about the reasonability of the position and then you’re back to expert-estimates.
so DEM is also “risk-communicator” ? Until some months ago I didn’t even know that such a job exists. Then Sandman,Lanard,Melanie,DEM. I guess, these risk-communicators don’t like probability estimates because it puts their own job at risk : why do we need a risk-communicator, when the same can be done better by just a number for a probability or expectation value ?
Clark: I very much appreciate being reminded of mind control by parasites (15:17). Fascinating. Nature never ceases to amaze.
I guess one of the reasons I am less hopeful that we’ll escape this one is that these viruses generate a swarm of mutants inside the bodies of victims — that’s the RNA virus survival strategy. Natural selection is its tool. This particular virus is extraordinarily successful burning through substrate, and we’re big game - a vast untapped reservoir of substrate. Can we outsmart something without a mind, not even alive, that may even be a progenitor?
eyeswide,
One could say the same thing about every viral threat, but it is a little too Stephen King for me. These aren’t intelligent agents, they are opportunists.
clark – at 17:14 “get our brains collectively around this challenge”
Monotreme has started to focus on water. http://www.fluwikie.com/index.php?n=Forum.DoYouKnowWhereYourWaterComesFrom
There’s this “flashmob” idea, whereby someone(s) invite the others around some topic and places. This might work. Let’s just “search” for the word “water” in this wiki and elsewhere, and selforganise (or organise each other) around that. Do that for a week. Rinse and consolidate. Focus on something else for another week (yes, some people will stay fixated on water, so be it!), etc.
The aim for each week might be:
It might be a biweekly thing at least at the beginning.
The sequence might be what Dr Nabarro suggested: “water, power, food”. I believe “internet” (or “communications” more generally) is the next priority in line (right after “power” on which it depends).
We could of course run these parallelly, but I don’t think we have the (wo)manpower right now. And we may want to learn from the first “cooperative thinking” exercise first.
Ok, I’m copying this to a thread of its own: http://www.fluwikie.com/index.php?n=Forum.CooperativeThinkingExercises
Hi Melanie. What is intelligence? In my neighborhood, everybody is dreaming of winning lotto, owning an island, having their own softwatre buisness. Most do not succeed. However there are always a few Bill Gates and George Bushs and Jackie Kennedys who know how to open doors. You have to admit that this H5N1 virus is not your standard wart virus or tobacco leaf virus. It is a super star virus.
I’m not a risk-communicator or an aerospace engineer, but it sounds like gs is sitting at about 98% thrust and someone is about to slip off the brakes?
GS-
If we can’t get those folks that are in charge of the situation and WHO have access to all the data to make proper estimates, why do you continue to ask all of us to make guesses and call them estimates?
I say collect as much of our own data as possible from a friend of a neighbor of the guy who walks my dog in Vietnam, India, China, Turkey, et al. Collate. Weight the data according to source credibility and then and only then, use our statisticians and curve-analyzers to plot some graphs all with the dozen or so appropriate disclaimers.
But if we are going to guess, then let’s form a few guess categories in declining order of probability of accuracy:
Estimate: all data is available, most has been validated.
Quesstimate: some data is available, some data has been validated.
Quess: sparse data is available, limitations are identified, little is verified.
Now, gs, slip off the brakes, visit the troposphere, stay warm, think about it all, drift back to earth and PF51 and let’s cobble some models together.
Let’s define some categories and start harnessing some of this immense brainpower to fill the files with some pretty pictures to communicate where we are and where we might be going.
Today for me the G’s are Q’s. Flip Quesstimate to Guesstimate and Quess to Guess please.
Start making a list of your pals in the Peace Corps, low level Embassy staff, tour guides, retired expats, et al that might be able to provide on the ground eyes in some of these places?
gs, we are all risk communicators. Wrap your mind around that. But as Path Forward says above, we are all students at it.
gues(s)timate,questimate,etc. Is it good English ? No such words in my dictionary.
guesstimate is a made up but common word. Guess plus estimate, indicating more intuition and less science.
Definition of “guesstimate”: noun; informal; an estimate based on conjecture.
Well….THAT link didn’t work now, did it? Duh….forgot the third “w”!!
Regarding the “worst case vs. best case” debate for predicting severity of the next pandemic:
Why should WHO pick the most spectacular infectious disease event in recorded history (1918) to base estimates on? Would this be responsible? They would leave themselves open for charges of fearmongering.
OK, they’re using best case numbers, but really, once you’re talking about excess deaths in the millions in a very brief period of time, I think people get the point. I’m not sure bigger estimates would translate into a broader uptake of the message, or result in significant changes in behaviour…
Otherwise- if you read recorded history, you will find that 1918 was not the most spectacular infectious disease in history. You are correct in terms of the last 100 years. You are wrong in terms of the last 10,000 years.
We seem to be in a tizz. I think what is happening is the virus is progressing, but in a manner that we have not anticipated. It is spreading completely around the world in birds- and looks to be around indefinately. Not the short, sharp assault on humanity that we have all been expecting and preparing for. Regarding the worst case best case scenario- what is actually happening is something else again-
Clark-
You’re right on topic and target.
The virus is progressing, but we, here as collaborators, don’t seem to be . . . progressing and self-organizing.
Regarding the worst case best case scenario- what is actually happening is something else again-
another reason to not emphasize the extremes and to prepare for whatever… all the ifs, not the whens.
‘’we, here as collaborators, don’t seem to be . . . progressing and self-organizing. ‘’
There’s good stuff happening in the water threads, the rest of the wiki, collaboration locally and off-wiki. Not enough, not soon enough, and less than we want in terms of resilient communities. We don’t, however, know how much time we have or don’t have. And we don’t know how rapidly the ‘progressing and self-organizing’ needs to be.
it’s hard when there’s been no historical precedent.
This wiki is breaking new ground … now let’s keep the planting on schedule. So many stand to reap from this effort if we sow well now.
Also, we don’t know how fast this might explode (in a good way). I do know that after pushing some people for prepping, after a time of frustration, a few came back to me on the same week - “look what i’ve been doing”.
Maybe the last mile may be covered in no time.
We just need to go on pushing. If we manage to have a few essential “templates” they might be copied all over, and be quite helpful. Add a bit of luck and a few more might make it.
Now, maybe you feel just a bit of optimism? Well, now the “water” thread needs your help ;)
Melanie: I’m not making a Lamarkian argument at 3:41. Organized matter persists because it can. Recent studies have shown that RNA viruses are not “sloppy” when they create a mutant swarm in a body; they do it because it works and those that have done it in the past thrived. Natural selection in realtime. Recent studies also have raised the possibility that viruses are indeed the first (almost) life-form, the progenitor. So, nothing is extreme here, just interesting in light of recent work. This virus is particularly unnerving because it’s so successful and it’s arguably so successful because we’ve not yet figured out a way to defeat it. I hope we can do that before our immune systems have to absorb it.
BTW, I have no idea about what Stephen King is about — I don’t do popular culture and haven’t had a TV for 40 years.
> DemFromCT “gs, we are all risk communicators. Wrap your mind around that”
there are these official risk-communicators working for the government
or WHO or such. Their main task to talk about the pandemic-disaster but
prevent people from “panicing”. Where panicing involves doing things
which would be reasonable for the individual but bad for the community,
like buying Tamiflu, giving up the job, moving to the countryside,
leaving the US, buying arms, getting depressive, creating new parties,
starting a revolution. They often aren’t telling what they really think
they are saying what government/WHO wants them to say or they are
just somehow building/supporting the collective consensus
NW:”Both are valid estimates (because we don’t know!) I would argue that the highjer number would be more likely to get someone to take notice and do something. If that is not a bad thing then why not use that number?????”
because people might figure out that you’re being dishonest and not saying
what you really think ? E.g. I often see these “commercial advertisements”
in newspapers, TV. I’m _very_ sceptical about most of their statements
and opinions. You don’t want official announcements to fall back
to that level, do you ?
I don’t understand the title of this thread.
Clark at 17:14/ The “We are all going to die” remark was made to me by one of our local mayors. I was returning a call from Carls wife, and he picked up the phone, so I asked him about the towns preps. He’s a blunt no nonsence man I’ve known for 20 years. His blunt response. “Yeah, we are all goin to die.” Anothe mayors response to a pandemic threat question a few days prior, “Whats pandemic? Never heard that word” answer “BIG”. Carls response was not as a mayor, but as someone I know and understand. He would have used another phrasing for a concerned town resident. With me it was just a quick, throw away phrase that he knew I would not take amiss.He said at that point he hadn’t anything from the state, but to contact the next town to which his was tied in with.This man is an excellent mayor,truly interested in his towns welfare. Local government at its best.
read the link in the first comment, gs, for a better explanation.
I was with a group of clergy colleagues. I brought up panflu. The response was, “It’s all hype.” Those were the very words used. I was surprised no one commented further, as they are a pretty well-educated group.
Later, I took a person to her doctor’s office. In the waiting room a magazine article was affixed to the wall, with highlighting. I went over to read it. It was “Bird Flu paranoia, a lot of hype.”
I mostly keep my mouth shut. It is interesting to observe how awareness will come, or not, and how.
I have heard by many folks I have brought it up to “it’s all a big spin up” or “it’s all hype” as well. People here think it is being made up by the politicians to be an issue in the next elections in an effort to push for health care reform or to point out how wonderful the current administration is focussing on this for our safety, or that they are wasting our money on this needlessly. No matter what political persuasion I was talking to, both sides seem to think the other side is spinning this up to their benefit.
Forget trying to tell anyone that the flu won’t just pick dems or republicans as victims…
TreasureIslandGal – at 14:48 “Forget trying to tell anyone that the flu won’t just pick dems or republicans as victims…”
I have heard this argument as well, and from some darn intelligent people. I myself am a bit skeptical of domestic (you sound like you are discussing upcoming mid-term American elections) fear-mongering which has been a ready and oft used tool of the current administration.
However, this is not just about the U.S. Try pointing out to your skeptical acquaintances that for this to be conspiracy, all the governments of the world are in on the gag. I’ve found that to be enough to sometimes be enough food for thought to shut up even the most vocal skeptic.
It’s a symptom of the times that anyone would even think for a moment this disease has anything to do directly with politics or for that matter American politics. Sad, really. This is a global issue of concern and preparation. How this planning and preparation plays out however, will certainly reflect the different political approaches of the various nations.
strums his guitar and sings.. “Here I am stuck in the middle with you.. Worst Case on the right, Best Case on the left.. here I am stuck in the middle with you”
The original post is from Feb… 5 months later, it’s still my viewpoint. ;-)
Closed to maintain Forum speed.