Continued from here.
Last post on previous thread:
Tom DVM – at 22:16
Hi Racter. I am from a profession (specifically farm animal veterinarians) that is required to do a lot of things through intuition alone…and it kind of gets to be a habit after a while…and you either learn to trust your intuition or forget it altogether.
Speculation is just that, speculation. No one knows anything about this virus and the track record of experts reflects the fact.
Some of the things we have been discussing don’t make sense to me based on my intuition and training but that does not mean that their incorrect.
I don’t believe genetics can fully explain the cluster in Karo and elsewhere based on my genetics training but the alternative I came up with has too many hoops to jump through to be true either…so at the moment we do not know. It also does not make sense to me that 70 % of the world’s population can escape this virus…a lower percentage may escape the first three waves but may not escape the waves of aftershocks (epidemics) that will occur…it’s just not the way nature works based on my experience with nature.
As far as the computer modelling goes, the fact that I am not a big fan would probably not surprise you. I will take a human brain over a computer anyday…or better, a hive of minds as Melanie says!!
The bottom line is we are quickly reaching the spot where the rubber hits the road and we will know some answers one way or another…because my experience is that you make hypotheses and then with nature you always find out if you were right…
…I will be more than happy to be wrong in this instance.
I have really enjoyed our conversations.
Bump
Tom:
We do know that it’s an influenza virus, and while the track record of known influenza viruses may not be a perfect guide, it’s better than nothing. The microbial asteroid strike scenario gets a lot of coverage, and our media-trained minds natually gravitate toward that sort of thing — but while we’re speculating, it’s just as reasonable to speculate that the current behavior of this virus is nothing very much out of the ordinary for an avian influenza flirting with mammalian species boundaries. There isn’t any logical reason why “we don’t know” should automatically invoke “we’re screwed” as the default, but that’s what it seems to do for a lot of people.
We have some basis for supposing that H5N1 may be more virulent than previous pandemic influenzas. A lot of that basis is that we have no particular basis for supposing that it will decrease in virulence from what we’re seeing now. I don’t see any basis whatsoever for supposing that it will will be significantly more transmissible than previous pandemic influenzas. We certainly are not seeing it doing that now, and I haven’t seen any attempts from within the scientific community to make a case for such a position. There are, on the other hand, some reasons for supposing that the epidemiology of influenza viruses follow certain patterns because these naturally follow from the mechanics of transmission and incubation of the virus, and from behavioral aspects of the host. There is a limited period of time during which each host can infect others, and a limit to the number of effective contacts the average host makes with other susceptible individuals during that period.
By the time H5N1 is downgraded from a pandemic virus to a strain of seasonal flu, it will make its rounds with a substantially lower attack rate, making it much easier to avoid — but perhaps even more importantly, we’ll have a vaccine.
If that really were the choice, I would too. But computer models are not intended as substitutes for human thought, and I doubt if a single epidemiologist ever stopped thinking when these models became available. Computer programs do not participate in the actual thinking; they merely provide us with a fast way to examine the consequences of changing some of the assumptions we make when we do the thinking.
Creating such models may be helpful in itself if it forces us to look more closely at assumptions we may be making without realizing we are doing so. Human intuition is a wonderful, amazing thing — one of the great mysteries of the universe, in my opinion — but it is (by definition) the realm of the hidden assumption; it’s knowing without knowing how we know. Much of the business of science is dedicated to bringing hidden assumptions out into the light where they can be tested. Remaining committed to this is vital, because as wonderful and mysterious as human intuition is, it’s also very often wrong — hence the familiarity of names like Copernicus, Lamarck, Michelson-Morley… Niman… (maybe; we’ll see).
I have too. I especially like it that there doesn’t seem to be much risk of things turning ugly even when we disagree.
Thanks Racter.
I think, unlike other scientific hypotheticals, we are not going to have to wait too long for the answer.
I don’t think that influenza comprehends the term order, I think it capitalizes on disorder and therefore, doesn’t follow the track of most other pathogens.
I see influenza a little bit like the ‘bumper cars’ we see at exhibitions…there is a certain randomness to its behavior.
I think we have to get our heads around the fact that it has already demonstrated that it has the ability to make the required genetic changes in its template. It has done it not once but repeatedly since 199? in China. All it has to do now is follow its own template.
I think the odds of SARS going global were far lower than the odds of H5N1 at this point producing a pandemic.
I think we have to get beyond anti-virals and vaccines in the short term and get to infrastructure and supportive therapies that can be delivered at home with telephone support.
Like I said, I don’t think we have ten years or five years…everything else is up in the air at the moment.
In conclusion, there must be a reason that this is the first viri in 100 years that is by all appearances, following the exact same pathway as H1N1 did in 1918. We should not understate that correlation. Thanks.
A reminder of a good link:
Racter and Tom DVM: I believe that rather than a vaccine being the savior for avoiding the “aftershock” epidemics (after avoiding the first three waves of the pandemic) it will be simple, consistent sanitary and avoidance practices. They are the same practices that I employ during flu season now, nothing extraordinary that other people would notice. We know how often the regular flu vaccine now misses the mark, and people still get infected for whatever reason.
And the longer you stretch out this process of being exposed and infected by the H5N1 variant (if it is the next panflu) the better off you will be. Various processes that we have discussed can “defang” it through time. That is the hope, and, I believe, the likelihood.
For families with children still in school the vaccine route will have to be relied upon, if you get them past the initial waves. Schools are truly germ factories, and kids are kids, messy.
For years I went without a flu shot working in the medical industry as a District Manager for a medical supply company. I was in and out of clinics and hospitals on a continual basis in the midst of flu season, and I contracted the flu only once. I avoided vaccination because of a reaction that I had to the flu shot over twenty years ago, (it does happen!).
Medical Maven. I think you’ve got it exactly right. The truly boring preventative measures are actually the most effective and the only option in the short-term…the good news is they actually work!!
…the ‘magic pills’ don’t work today…but may work at some indeterminate point in the future.
Treatments creating false expectations, in my opinion, will be nothing but trouble in a pandemic.
I honestly believe the world governments planted the antiviral seed into the brain of mankind to slow the fight or flight syndrome. Most of us on the Wikie have come to terms with this situation. We are fighting! I sincerely hope I don’t have to face the time when mankind resorts to flight due to governmental fears. Tamiflu is nothing more than a temporary facade. The way this virus is mutating, it will not be long before it breaks down these walls and moves on.
Like Tom,DVM, I plan on using my insticts. Since government has told me, “You are on your own”, then government needs to leave me alone. I have no doubt that I know what is best for my family. At least I’m not playing stupid head games! gina
gina,
If you think the “world governments” are that organized, you don’t know government. I live in DC, take it from me, it doesn’t work that way.
Melanie,
Did I come across that way? I must have really toned down in my old age. As far as governmental organization, I do believe we have hit on an oximoron. Believe me, I know how DC works. I worked for the FBI at one time.
Off hand, I can think of a few places where the sign “Pass the Buck” should be placed. At least it would balance out “ the Buck Stops Here” signs! gina
Tom:
Now there’s something I agree with one hundred percent. The snake-oil salesmen will be out in force, and we’re going to be hearing about the wonders of echinacea, goldenseal, garlic tablets, vitamins, and a host of herbal and homeopathic concoctions utterly worthless for treating infection by an aggressive influenza. I don’t know how much actual trouble it’s likely to cause; seems like it would mostly be like chicken soup: it couldn’t hurt.
I’m a firm advocate of vaccination, however. The nature of the virus dictates that formulating each season’s vaccine is a crap-shoot, but I have no reason to reject the studies indicating that partial immunity is conferred even when it’s not a direct hit. The notable difference, after all, between an ordinary seasonal strain and a pandemic strain is precisely that being a novel virus — a new subtype — no one’s immune system has any experience with it, or anything like it. While it’s true that the regular flu vaccine often misses the mark, and people still get infected for whatever reason, far fewer people are infected, and the healthy ones seldom DIE from it. If it makes a difference whether they aquired antibodies through infection with a similar (but not exactly the same) strain, or through vaccination for a similar (but not exactly the same) strain, someone kindly explain why.
Flu vaccines are guaranteed not to work if people don’t get vaccinated, and most people who decide not to get vaccinated base that decision on bad information (mercury causes autism, their cousin so-and-so got a flu shot, and came down with the flu the next day, etc, etc). People like that are a danger to me, because a chronic condition makes a dose of even a seasonal flu practically a death sentence. That danger inspires fear, and the fear easily turns to anger. It takes real effort not to lash out at that sort of ignorance, and my track record there isn’t perfect, but at least I’m working on it. Naturally, I can’t expect everyone (strangers, anyway) to get vaccinated to protect ME, but when chitchat with a nurse at the clinic I visit (in dire need only during flu season) revealed that she got heat from her employers for calling in sick (and she really was sick), it’s hard not to get upset. It seems reasonable to expect a health care facility to adhere to a higher standard than that. I won’t go anywhere near a hospital or clinic during a pandemic as long as it’s still consensual on my part.
During flu season, no unvaccinated person enters my home (and I’m not the least bit bashful about asking). But relying on that alone would be stupid, and I’ve also had a lot of practice at social distancing. Anon_22 really nailed it upthread: it’s about small returns. Literally paying attention to how many feet of space there are between you and the next person in line at the store is surely of at least some small benefit, and one fortuitous application of alcohol gel hand sanitizer might be the thing that saves your life.
Racter, I know that you were not speaking to me personally regarding vaccination, But I believe that people like me (who are in a very small minority) who have the ability to rigourously, consistently apply sanitary and avoidance practices are exactly the ones to refuse vaccination and to leave the ALWAYS limited supply of vaccine to the majority. I am sure that if we roll through and survive panflu that the first available batches of vaccine for the “aftershock” epidemics will have more than enough takers.
Racter. I agree 100% with you too. I guess my point was two-fold.
1) In this world, you have to take things on ‘faith’…that goes for snake oil sold by non-professionals and snake oil sold by Governments and snake oil sold by healthcare professionals.
I’m sure you have heard the stories about shortages of morphine during the second world war. They injected water and the soldiers felt like they had 100% pain control.
2) We have to do what worked in 1918 because no matter how you cut it, they did a wonderful job of regulatory medicine under the circumstances they found themselves in. I am sure that the present healthcare system does not have similar capabilities…it has been too long and many skills re: epidemics have been lost to history which is largely ignored.
I firmly believe that vaccines and anti-virals, for various reasons, are as much snake oil as kickapoojoyjuice. They are real interesting to talk about or get funding to reasearch but the facts are we aren’t going to be able to rely on them…at least not for ten to fifteen years!!
So that leaves us with masks, gloves, social distancing, learning to keep hands from eyes, nose and mouth in public and better hand washing techniques etc. …We don’t have to research to determine if these things work, 1918 tells us they work.
On the other off-patent drugs I mentioned, we don’t need to be told that vaccines against secondary bacteria give us an advantage over 1918. We don’t need to be told that broad spectrum antibiotics as prophylactics will help prevent secondary bacteria etc. etc….these supportive therapies work and are a significant improvement over 1918…
…the problem is that in a pandemic we aren’t going to have any of these drug therapies that will work because the volumes required are going to outstrip yearly requirements by tens or hundreds or thousands or hundreds of thousands times with no grace period to scale up production.
It’s no fun for researchers to talk about amoxicillin or oral electrolytes or prednisolone…its a lot more fun to talk about vaccine research or antiviral therapies or antiviral research etc.
Well it’s the boring stuff that will save your life, my life and the lives of others. The problem is that none of us will have access to any of these drugs and I really mean that you will not be able to beg, borrow or steal enough of these supportive therapies to treat yourself or anyone else…
…and that is the real tragedy. They came to the table too late and compensated by concentrating on fire works rather than water proof matches.
We need regulators to act on faith now. Faith that this pandemic is going to happen. Faith that the virulence is going to at least match 1918. Faith that if it doesn’t happen they have no concern what history thinks of them if they acted in good faith and with the best information avaliable at the time.
Their predecessors were not afraid of decision making and not afraid of what others thought of them…they were only concerned with doing the right thing…Come Hell or High Water. Thanks
Tom DVM: “We need regulators to act on faith now………”
Great writing in that passage, inspiring. Hope the right people are reading it in the right frame of mind.
TomDVM I totally agree!
“the problem is that in a pandemic we aren’t going to have any of these drug therapies that will work because the volumes required are going to outstrip yearly requirements by tens or hundreds or thousands or hundreds of thousands times with no grace period to scale up production.”
As to your call for Gov’t to act on faith and prepare, forget about it. They lack the vision or the courage. It’s pathetic but in today’s world with all our technology and all our varous Gov’ts it’s likely to just vanish when TSHTF. Technology can’t replace simple human virtures like patient strong intelligent leadership. Gov’t today and Corps. are run by an extremely self-interested and short-sighted generation which I’m afraid will fail when really put the test. God knows I hope I’m wrong not dead right.
This is sort of off the fence, but with the newest information concerning the large eruption expected on the southern San Andreous fault line, is anyone noticing an increase of prep in southern California?
MM:
There’s a bit of a paradox here. One of the reasons flu vaccine supplies are always limited is that the pharmaceutical companies who produce them have found doing so not to be the most profitable use of their resources. One of the reasons flu vaccines are not profitable is that in a typical year, millions of doses go unused and, since each year’s formulation is different, must be discarded. Research has shown that the persistence of urban myths surrounding the use of flu vaccines contributes heavily to the refusal by so many to seek vaccination even when availability is not a problem. I think flu just isn’t a very big blip on most people’s radar.
Tom:
Echinacea is a good example. I dismiss its value for two reasons. One is that I don’t understand how it’s supposed to work, and haven’t been able to find anyone offerring to explain that. The other is that I have looked at the studies, and the results just don’t support it’s effectiveness against viral infections. (If I recall correctly, one such study was funded by a company that markets echinacea, and their own study indicated that it didn’t do anything). The “support” for its effectiveness seems to consist entirely of anecdotes and testimonials, the cornerstones of snake-oil marketing.
I understand how a vaccine works. I understand why it might not work, or why it might be less effective some years than others, and why it therefore should not be regarded as foolproof protection. I’ve also seen the studies, and the results of those studies strongly indicate that vaccination is effective against influenza (though the results vary from one demographic group to another, again for reasons that do not seem completely shrouded in mystery).
All of this does require faith.
I have to have faith that the studies I’ve seen were well controlled, that the mathematics were not flawed, and that their results have been accurately and honestly reported. I have to begin with faith that the controlled study really is more reliable than the anecdote or the testimonial, and that the current state of the art of virology provides an adequate understanding of the mechanics of aquired immunnity that everything we think we know about this isn’t completely wrong.
But it isn’t blind faith. At least… the point at which I become blind is so far down the scale that it involves no more faith than does flying in an aircraft, driving over a bridge, or flipping the power switch on an electrical device.
Medical Maven glennk Thanks!!
Racter.
Seems like we are going to proceed on all sides of the discussion with a lot of faith and little security…
…If I felt the urge to learn tight-rope walking I would rather not learn at the Grand Canyon with no net…
…this is not my preferred starting point from a pandemic, particularly from the perspective of a medicine man who has been in the same position and suffered and observed significant consequences before.
bump
1918 did get a few things right - by the then conventional medical community (the folks who went to medical school)…
Calico – at 13:03 - Excellent reading! Just think….if the Internet were around during the 1918 Spanish Flu era and quackwatch.com read the material at your supplied link, I wonder what they’d say? Did you notice all of the persons that contributed their experiences in the article could today be confused with individuals with an ND after their name instead of MD?
Racter,
Excellent points. I have exactly the same challenge with regards to echinacea etc even though I do use it from time to time.
I do think however that the use of the word ‘faith’ sometimes confuses more than clarifies, because it could mean trust in the consistency of both standards and flaws of science, so that one can get a reasonably accurate risk assessment given a collection of information. Or it could mean complete surrendering of one’s cognition, even placing one’s judgment on hold for some, and taking someone’s utterances as truth. The first usually refers to a system or methodology, the second has to do with people or institutions. I think the ability to distinguish what you are placing your faith on may hold the key to self-evaluation.
Calico – at 13:03
At the beginning of the last century, the eclectic system was an officially recognized branch of North American medicine. They were eclectic in the sense that they integrated whatever worked, including herbal medicine and homeopathy. It appears that the list mentioned in your link refers to homeopathic remedies exclusively.
cub, I’m not sure, but I think Libradol and a few of other other items were not homeopathic. From a statistical standpoint, though, it is a good sampling of which homeopathic remedies were effective against h1n1 in 1918. If h2h h5n1 presents similar symptoms, including as a pneumonia, then the information will be useful.
mmmelody, this is the first pandemic during the internet age. That alone makes it a fascinating development to me. There will be a lot of folklore out there, but it won’t just be neighbor to neighbor. It will be international.
Tom: Your last paragraph in post at 9:18 just keeps getting overlooked (except by me). All that work to find the rosetta stone to H1N1 turns up negative. Somethings just cannot be changed, maybe they were set into motion by events we living now have long forgotten. Post at 16:16 inspired. totally. Problem with your suggestions is they just don’t have any shock and awe value. It’s a sad commentary when PR is more important than health care. Last week we had a 31 yo ARDS patient who was doing cleanup work on homes in Mississippi. We tried everything…finally we got special permission for an antibiotic that doesn’t even have a name but a number..it saved his life but almost took out his kidneys. You just can’t live with ARDS anywhere but in a well staffed ICU with pulmonary specialists on standby.
Leo7 Thanks!!
I would predict that before we are done, my colleagure will get so frustrated that all will be using full credentials and names.
One thing for sure. There’s significant brain power on flu wiki…enough to move mountains.
If I could find the time to get away from my computer chair….I move my mountains one grain of sand at a time.
Racter, while you speak of ‘urban myths surrounding the use of flu vaccines’, remember those who manufacture and market them have budgets that drown those of any researchers who might want to study the properties of natural, low-profit antivirals. Sure, it’s foolish to think that garlic is going to save you if you start coming down with PF. Maybe it will help, maybe it won’t. Maybe if you are eating it all along it will stop an infection from getting a foothold in the first place. It may stop people getting too close for starters! All wholefoodstuffs have beneficial properties. If we didn’t need these we could live on twinkies and vitamin pills.
Tamiflu is based on star anise. Aspirin is based on willow bark. Griffonia simplicifolia produces 5-HTP, useful as an antidepressant, appetite suppressant and sleep aid. The reason brand name drugs come about is because only synthetic substances can be patented. Natural substances don’t make money. It’s in big pharma’s best interest to ridicule what nature - which is so far outwitting us in the BF stakes - has to offer. The Chinese will be adding star anise to their tasty beef stew and cakes while the west lives on rehydrated potato granules so they can afford to buy tamiflu.
Big pharma has nothing to benefit from curing, instead it creates legal drug addicts with governments’ blessing (just look at the case of stomach ulcers). Big food kicks off the process by aggressively marketing crap, as there’s no profit in good wholesome food. We do our bit by being proud and greedy, overworking ourselves so we can afford a better car than our neighbour and demanding cheap (thus rubbish) MacDogfood, and pumping ourselves full of caffeine, sugar and nicotine to squeeze the last reluctant drop out of our adrenals. Nutrition is the bottom line. You eat rubbish, your body doesn’t function properly. If we all focused on getting ourselves as healthy as possible we’d have much less to worry about and to medicate.
FWIW I think I’ve had the flu maybe once or twice in my life. If more, it wasn’t so bad that I remember. I won’t be poisoning myself with pharmaceuticals just to ensure those who haven’t respected their bodies are protected. They are welcome to my share of the magic bullet that government/pharma (probably can’t) provide. Apologies if you have a chronic condition that it is not in your power to do anything about. I don’t mean to be offensive, I just feel very strongly about this. I guess we will all individually do what we think is best.
Nice one Dizzy. Well said!
Dizzy,
While global pharmaceutical manufacturers do have large budgets (and spend that money developing successful products), there is much research being devoted to natural and herbal remedies … research being conducted by individuals and universities around the world. Bear in mind that, in the academic world, the old adage of “publish or perish” still holds true. University researchers are eager to find some claim of efficacy for herbal remedies, test that efficacy, and publish their results in a peer-reviewed professional journal.
Your reference to star anise is a good example of that. A quick search of PubMed, the portal to the National Library of Medicine, shows 54 articles on star anise … everything from its use in killing adult mosquitoes in Thailand to its use in preventing sepsis. There was also an article about seven cases of adverse neurologic reactions in infants seen with the home administration of star anise tea. The fact that you have to get that information from PubMed rather than from a large pharmaceutical manufacturer doesn’t surprise me: I don’t expect Mack Truck to spend money advertising bicycles and I don’t expect Pfizer to spend money advertising whole grain diets.
Dizzy - There was no big pharma in 1918. There was no bigfood either. No just in time way of life. Many more people ate uncomtainated whole food every day. Herbalists and homeopaths abounded. And people walked, every day…And they died when the flu hit, every day…
…uncontaminated…
Hhmmm…I’ve never had a flu shot simply because I never thought I needed one, though it honestly never occured to me either that this might put anyone else at risk (as opposed to, say, going out sick and coughing on people, which is obviously to be avoided). Truth is, I never thought of flu as something to be afraid of—until H5N1, which I put in a whole different category. As kids, we all got the measles, mumps, whooping cough, chicken pox, etc., etc. — our mother would put us together if one got sick so that we’d all get it at the same time. I don’t recall any of us suffering terribly and thus never thought of those diseases as dangerous either, until I saw an adult get sick with chicken pox.
I guess I, like I’m sure many others, still subconsciously have that old mindset re exposure making you stronger and building immunity. (Like allowing some exposure to germs here & there—we don’t use antibacterial anything). I’m not saying this is right or science-based, just something instilled, that many of us never question until confronted with the competing views aired above, which offer lots of food for thought.
Prazza - thank you. I was expecting more to be flamed for deviating from the script! It may still come, even before I finish typing this :-)
Dennis, yes, natural drugs can be powerful and have side-effects too. Why do you think they are used as an active ingredient in pharmaceuticals labelled ‘do not exceed the stated dose’? I wouldn’t touch Chinese medicine with a stick, it is too complex thus risky in the wrong hands, and takes a lifetime to master. I’m not formally trained in alternative medicine but after 20 years using it (personally, and among friends/family) I have a feel for what works, and for me it works better than pharms. I don’t normally preach but I will defend it’s benefits.
I also take your point about advertising what you sell. I simply don’t feel it’s fair to say ‘no studies have been done’ when we are talking about the little people trying to do good for the right reasons versus the big people with all the money in the world to prove that their cure is ‘the one’ in order to make even more money. The only contest is our instincts versus our need to be blindly reassured what to do.
I’ll go my own way, we all will. My instinct says nature is smarter than us every time so make use of what it offers and pay attention to your body. I fully appreciate Tom’s reliance on his instinct. Animals can’t talk to us and tell us what’s wrong, but as a lifelong animal lover/keeper myself I know you get a feel for what’s up (speaking of which my cat has this moment just eaten a very large moth - so I’ll know why there’s puke on the carpet later). With much more experience he has a feel for a bigger picture, I respect that. The only times I’ve got myself in trouble was when I ignored my inner voice. My inner voice didn’t worry about Y2K or SARS, but it’s paying attention to H5N1.
Now that I’ve knocked this somewhat off-topic, a reminder: the thread is ‘A Current Threat Assessment II’. Oops!
anon – at 18:34, there were other common nasties like smallpox, cholera, scarlet fever, tuberculosis. I acknowledge that vaccines and improved healthcare/knowledge have played their part in combatting these and allopathic medicine can certainly take credit for this. [Perhaps we will see a lot of already susceptible people (aids, CF etc.) succumb. Sounds horrible but maybe that’s what 1918 flu did.] Families were larger, life was harder - we didn’t have dishwashers, washing machines, cars. People worked in unsanitary conditions and didn’t know what germs were. H&S at work was nil, think coal mines. There was wholefood but was it plentiful? And we had just come through a world war.
I don’t know what’s right for everyone, I just know what’s right for me. We should be so much further forward health-wise, but have set ourselves back by wanting too much of the wrong things and being herded along like sheep by governments who have their own best interests at heart. I can only say that it gives me comfort knowing what path I will follow, and that it doesn’t depend on having access to scarce resources or being angry at a government for failing to provide something I’ve come to believe is precious when really I know nothing about it’s safety or efficacy.
If I may redirect a bit, I’m interested in hearing updated threat assessments from anyone who’s been following this for a while. Are you more or less worried about something imminent than you were a year ago?
I only started following H5N1 closely last summer, when one story hit me over the head with the just-in-time factor. Shortly after, Katrina drove home the vulnerability of our “advanced” western countries, all our embarrassment of riches notwithstanding. Until then, I’d been following H5N1 with interest and detached concern—in the same vein as things like peak oil, climate change, earthquakes, West Nile, the latest carcinogen, etc.
I still question why one would focus so disproportionately on this particular threat and was having some success in pushing H5N1 back into the background until the Karo cluster. Since then, I’ve been reassessing and once again, not liking what I’m seeing. I’m not as convinced as Tom that this will hit this fall, but adding up the pieces and looking back at the apparent trend line over the past few years, I’m seeing a degree of inevitability that wasn’t as apparent before. Additionally, recent experiences have only confirmed my fears about just how hamstrung most national governments (and therefore WHO) are in terms of their ability to confront this honestly and transparently.
Hi Name.
Actually my prediction was not exactly this fall but the 2006/2007 flu season and my reasons for making that particular prediction in Jan. 2005 are unknown to me today but were primarily based on intuition…which has served me well in the past.
For what its worth (which isn’t a lot), in my opinion, we are putting input into are subconcious constantly. Each of us has particular skills or trained professions that results in a slanting of inputs to areas of interest. These various inputs are complied and analyzed subconciously and at usually an inappropriate time pop into your head without any concious stimulus on your behalf…this is my definition of intuition.
Next time you have a seemingly unanswerable problem…just tell yourself you will let your subconcious work on it and it will let you know when it has the problem solved…like a computer…and if you can relax, you will be surprised at the results.
You asked how I feel vs. last year at this time…more sure than ever that unfortunately we will have a pandemic sooner rather than later.
If you think about it, nature has a certain inevitability to its overall patterns. It just doesn’t quite work on our timetable (1918–2006 may seem like an eternity to us but may be the equivalent in nature to months in our time. A tsunami hit Asia in 1825 and killed I think 25,000 persons…next one in 2004. The west coast is on a fault line that produces a giant quake every 400 years?…I think you see the point.
We should not get lulled to sleep by this short interlude, although I would suggest everyone take a break and enjoy the summer.
A couple of things to keep in mind:
1) Something is helping this process along…something has been pushing mutations in all pathogens: viruses bacteria and parasites…could be global warming, could be sunspots, could be something we don’t know anything about.
2) Nature has been and is continuing to be helped by regulatory actions or lack thereof in Asian countries: hiding outbreaks, antivirals to poultry, substandard live vaccines etc. etc. etc.
The point is that Nature doesn’t need help but the kind of help it is getting is going to bring this pandemic sooner than it would have otherwise…
…therefore, this is a multi-faceted intricate disease complex that is ready to go. If you believe in slow step-wise processes for nature then it could be decades…this is not my experience as a veterinarian and for that reason I think it will be soon but would be more than happy to proven totally wrong…I do not under any circumstances want to experience a pandemic…I don’t need to be right quite that bad…if you know what I mean.
Name – at 20:49
If I may redirect a bit, I’m interested in hearing updated threat assessments from anyone who’s been following this for a while. Are you more or less worried about something imminent than you were a year ago?
More concerned. Because of the Karo cluster. There is no way to put a positive spin on H2H2H. A few more H’s and we’ve got a pandemic. The other thing that concerns me is that the kill rate is not going down.
I will say the progression is more gradual than I thought it would be. A year ago, I thought a pandemic would either happen relatively soon or not at all - I leaned towards the former. Instead, there has been a very slow progression towards a pandemic. Gradual, but relentless. Not what I expected.
Before You Put Your Faith in Drugs, Read this
by Steve Connor
A senior executive with Britain’s biggest drugs company has admitted that most prescription medicines do not work on most people who take them.
Allen Roses, worldwide vice-president of genetics at GlaxoSmithKline (GSK), said fewer than half of the patients prescribed some of the most expensive drugs actually derived any benefit from them.
It is an open secret within the drugs industry that most of its products are ineffective in most patients but this is the first time that such a senior drugs boss has gone public. His comments come days after it emerged that the NHS drugs bill has soared by nearly 50 per cent in three years, rising by £2.3bn a year to an annual cost to the taxpayer of £7.2bn. GSK announced last week that it had 20 or more new drugs under development that could each earn the company up to $1bn (£600m) a year.
Also See: Demolished: The Myth That Allows Drugs Giants to Sell More Dr Roses, an academic geneticist from Duke University in North Carolina, spoke at a recent scientific meeting in London where he cited figures on how well different classes of drugs work in real patients.
Drugs for Alzheimer’s disease work in fewer than one in three patients, whereas those for cancer are only effective in a quarter of patients. Drugs for migraines, for osteoporosis, and arthritis work in about half the patients, Dr Roses said. Most drugs work in fewer than one in two patients mainly because the recipients carry genes that interfere in some way with the medicine, he said.
“The vast majority of drugs - more than 90 per cent - only work in 30 or 50 per cent of the people,” Dr Roses said. “I wouldn’t say that most drugs don’t work. I would say that most drugs work in 30 to 50 per cent of people. Drugs out there on the market work, but they don’t work in everybody.”
Some industry analysts said Dr Roses’s comments were reminiscent of the 1991 gaffe by Gerald Ratner, the jewelry boss, who famously said that his high street shops are successful because they sold “total crap”. But others believe Dr Roses deserves credit for being honest about a little-publicized fact known to the drugs industry for many years.
“Roses is a smart guy and what he is saying will surprise the public but not his colleagues,” said one industry scientist. “He is a pioneer of a new culture within the drugs business based on using genes to test for who can benefit from a particular drug.”
Melanie – at 21:35 --- This could very well turn into a huge fire-storm for big pharma. Roses echoes what patients have been saying for years and years.
OTOH—He could be saying this as a way to help to push for stem-cell research and genetic testing to customize prescription drug therapy for individual patients.
BB,
Read the rest of the article. He is flacking for customized treatment but admits that we don’t have the foggiest notion how.
I’ll share this with you folks just for an idea of where and why my perspective of healthy respect for influenza comes from.
From December 22 to 24, 1998 I spent 48 hours administering hospice care for my father as he lay dying of fast acting lung cancer and emphasymia , in the middle of an ice storm that kept knocking out power, shutting down his oxygen generator and having to run a secondary supply from a tank of liquid O2 on the back deck. His lungs slowly were filling with fluid and dying and he moved in and out of consciousness before finally succumbing with my mom, my wife, my uncle, aunt beside him. I spoke the last words to him, and I closed his eyes after we knew he was gone. Christmas for my 18 month old son was not normal, needless to say.
By mid-January I began to feel weird at work one Thursday, even got into a yelling match over something I can’t even recall now with one the top managers. When I got home I had a fever of 101 F. By the next morning I was at 104 F, vomiting, hurting so bad my wife could barely guide me to the car to get to the doctor. I had the flu, the quick test was decisive. So I was back home, in bed, barely able to get to the bathroom 5 feet away over the weekend. By Monday morning my lower chest hurt with every breath and I couldn’t seem to get enough air. Back to the doctor, a chest x-ray, and the result was pneumonia. So I went home again, and went on Cipro. Unfortunately, I reacted badly, hallucinating and unable to rest, so we had to switch drugs within 48 hours. For the next 2 weeks I was only conscious for a few hours at a pop, could barely eat, and forced fluids as much as I could. The 3rd week I was finally cleared to go back to work, but I was 25 pounds lighter, and weak for another month.
A few times I know I feared dying like my dad had earlier. Ever since, given the chance I get flu shots and try to avoid being around folks with the flu. Twice more I have had pneumonia during bad colds, and I do fear a pandemic strain and how bad it could be. I see the threat coming as one of not just the flu itself, but also the secondary infections and any of the complications that can be just as fatal. That is what I feel is the real threat in third world societies - the lack of facilities and medication for pneumonia is likely masking H5N1, and we have limited ability to find out differently.
Monotreme,
“I will say the progression is more gradual than I thought it would be. A year ago, I thought a pandemic would either happen relatively soon or not at all - I leaned towards the former. Instead, there has been a very slow progression towards a pandemic. Gradual, but relentless. Not what I expected.”
I went through 3 stages - the first 2 as you described, but now I am also concerned about an abrupt transition into a pandemic situation not from the strains all over the world, but from a sudden reassortment event in south china. Compared to the rate of change even in Indonesia, this scenario is actually scarier and totally unpredictable. But it doesn’t necessarily mean sooner, it can be soon, or it might never happen (which is less likely given the reassortants are showing progressively increasing virulence to mammals).
Roses is a very smart guy and absolutely correct and startlingly honest. Actually, in some cases big pharma does know which genotypes are associated with success with a drug and which ones are not. There is alot of suspicion that they don’t publicise this because it will cost them money. Right now, patients are moved from drug to drug until they find one that works for them. Lot’s of unused but paid for pills in people’s medicine chests. If genetics were taken into account, the overall cost of prescription drugs would go way down because you’d either get the right drug the first time, or be told that none of them are going to work for you. Trying selling that to the bean counters at big pharma.
I doubt that it will “turn into a huge fire-storm.” The story is 2½ years old. “Published on Monday, December 8, 2003 by the lndependent/UK.”
One of the hazards of using CommonDreams.org as a reference source. “Breaking News and Views for the Progessive Community.” Oh, my…
I’m pretty much with anon_22, waiting for an anomolous mutation in Indon, which is just about the worst case scenario.
Melanie at 21:53 - “He is flacking for customized treatment but admits that we don’t have the foggiest notion how.” We do have the foggiest. Successful application of homeopathy has always depended on individualized assessment. It is one reason why the traditional double blind is difficult to apply to homeopathic remedies. Statistically, especially for acute conditions, it is easy enough to recommend an effective remedy, but to be consistently effective must take into account the peculiarities of the patient and/or his current symptoms. My homeopath cured my eczema, or at least gave me a tool that I can take once every several months as necessary to stop the rash in its tracks. She will probably never encounter another patient to whom that particular remedy would work.
TRay. Thanks for putting things in perspective for me.
Calico,
Actually, in allopathic medication, things haven’t moved forward much. I have never had much success with naturopathy or homeopathy.
Dizzy: “while you speak of ‘urban myths surrounding the use of flu vaccines’, remember those who manufacture and market them have budgets that drown those of any researchers who might want to study the properties of natural, low-profit antivirals.”
Remember that antivirals and vaccines aren’t EVEN the same thing, and that manufacturing the latter (currently) involves real live virus cultured in real live chicken eggs. For a lot of people, “pharmaceutical” appears to mean “chemically synthesized”. For me, it means more like “carefully formulated and extensively tested’, which is a lot more than I’d expect from the friendly neighborhood witch doctor.
Remember too that those who develop, manufacture, and market flu vaccines do so on one of the industry’s lowest profit margins, which is why all but a few companies have abandoned the practice altogether, which is why the U.S. gets half its yearly supply from foreign manuracturers (manufacturer, actually, as in ONE).
Is that good enough for ya?
Racter – at 22:12
For me, it means more like “carefully formulated and extensively tested’, which is a lot more than I’d expect from the friendly neighborhood witch doctor.
Racter, let me take this opportunity to tell you that I frequently crack up at your posts. You are one of the most eloquent writers on any flu board, bar none. I always enjoy reading your posts, even when I think they are completely wrong.
Not sure I get your point. Lots of pharmaceutical companies are making lots of profit, but most of them aren’t doing it by making flu vaccines.
And I gotta say the spin on the “Our Drugs Do Not Work on Most Patients” article made me dizzy. If “Big Pharma” came up with one drug that worked for half the people with a certain need, and another that worked for the other half, the complaint could still be brought either that its efficacy rate was no better than fifty percent.
Hey, Monotreme, I appreciate you saying that. I just… love words, I guess. I left an important one out of my response to Melanie you zapped your last post in front of: “against”. See where it was supposed to go?
…could still be brought against either that its efficacy…
Is that right?
Words, I love to read them, but am too impatient on these boards to write well.
I’m like Hemingway, I need a good day to write one paragraph. Well, OK I’m like Hemingway except that I that I couldn’t write a paragraph as well as he did if I had a year.
I’m with TRay75. One of our guys (teenager) went from bad allergies in May to sinus infection to pneumonia for most of June. I kept waiting for the kid to “snap out of it” because usually he’s through with an illness in a couple of days. It was amazing how long this round of “crud” went. Our doc advised bed rest and said it might take 2 to 4 weeks to be back to normal. We went through an amazing amount of juice, kleenex and cough syrup with codeine (the last so he could sleep). The coughing was exhausting.
This was an at-home illness (doc saw no need for more) and I was zapped by the home care. Very insightful for days to come. I now think some codeiene in the medicine chest is a must.
Racter at 23:18 - All very well to say that one medicine working for half the group and a second medicine working for the other half should be acceptable for the Big Pharma products. I agree. However, that complaint is invariably used to trash similar altmed results when the test groups never took account of the necessary individualization.
“Altmed” is a pretty broad category. The biggest complaint I have with most of what I’ve seen in that category is precisely that when the studies use double-blind protocols, the results aren’t “similar”; in fact, not even close.
Racter – at 22:12, thanks for pointing this out. I know vaccines and antivirals are different, I was referring to the spending comparison and mentioned both in one paragraph, thus my post ended up badly worded. I don’t want to harp on about the vaccines (the risks of cancer, asthma, allergies and autoimmunity, never mind links with autism), but again those who produce vaccines can flannel their way out of adverse publicity with smooth marketing.
Altmed is a broad category, and is that a bad thing? Some of the above posts note that there’s no one-size-fits-all solution with any meds. Truth is it’s what most of the world’s population rely on or will have available. Besides, while we worry about having tamiflu, people in the developing world die from lack of clean drinking water, not lack of pharms to treat cholera.
Finally, maybe the results aren’t similar because we are shoehorning a natural product into a bureaucratic, rigid system of assessment. It smacks of my god is the God, yours is a false god. I have edited so many unexciting medical papers it’s a wonder I haven’t poked my own eyes out. I have the greatest respect for the motives and integrity their authors, but it’s obvious that a lot of allopathic medicines and treatment outcomes are far from consistent and ‘require further research’. That’s humdrum and it doesn’t make the news, but it comprises the bulk of research.
Once again we’ve strayed from the topic, although it could be argued that (ICBAT?!) lack of a working treatment method (prevention/cure) is relevant to the scope of the threat.
Dizzy:
Maybe they wouldn’t need to if they weren’t such a tempting target for bloodthirsty litigants. I’ll point out again that other companies have found a simpler solution to the problem: they simply quit making the vaccines. Do you feel safer as a result? I don’t.
Yes, I’d say you’ve hit the nail right on the head there. Astrologers often complain about the very same sort of stodgy, old-fashioned dichotomy between fact and fiction. I’m trying to imagine alternatives: “Four out of five dead-heads recommend bananna peels as a cure for impotence…”
Reality is real. We may not understand the complexity of what’s there, but it is real.
Vaccines may not be a perfect solution to infectious disease, but they are better than getting the disease in almost every case. The big problem with them is that the ROI is low, and the risk is high given the present litigious environment. One possible solution is informed consent and waivers.
The mods will be conferencing on the 30th to talk about threat assessment, anti-virals and vaccine production. The reveres, Dem and anon_22 will be traveling or on vacation for much of August, so we figured we should get together one last time before everyone hits the road and more limited internet access. I’ll put up a new “Ask the Mods” thread tomorrow, July 16 EDT in the US, for questions you’d like us to address on this conference call. Or send us email.
q- what readily attainable legal environment could be adopted to promote more rapid development of efficacious vaccines?
a - see Pandemic Influenza: Domestic Preparedness Efforts and read p.30–31
A lot’s being done.
The last two to three weeks, we have seen some noteable news about:
1. GSK is working on a vaccine that looks promising
2. CDC made an announcement of ‘can’t-make-it-transmissible’
3. FAO announced releasing all animal sequences
4. Indonesia announced releasing all sequences
5. Indonesia new Karo clusters turned out to be false positives
6. Thailand has 2 deaths with unclear sources of infection
7. Laos has bird flu outbreak
8. Vietnam has suspected human case
9. Malaysia is on high alert on bird flu
10. Other (not H5) bird flu outbreaks in Europe
11. Despite some earlier expectations, no bird flu outbreaks reported in North America yet.
12. Non bird flu events (hurricanes, heat wave) have tested our infrastructure
It seems to me the risk posture should have changed some what. You may think this is time for a yawn, although I would like to hear thoughtful updates from this community.
Check out Malik Peiris’s assessment here
Thank you.
I saw it, and I would also like to hear more view points, covering not just how likely, how soon, but also impact.
ANON-YZZ,
Insufficient data. All we are all doing is guessing.
Melanie – at 19:01
Sorry, I don’t get it. Do we have less data than before? Haven’t we always been guessing?
Or is your vote that none of the 12 examples I cited above changed anything?
Therefore no need to take this further.
I would accept that as your update. Thank you.
I do feel there is some significant events there.
What we have are news stories. What we don’t have is scientific data. The judgement of the mods after our conference call on Sunday for threat assessment is that even the reveres, who are sceptics, are worried. Dem, anon_22 and I have been worried for sometime so getting the reveres on board is no small thing.
Melanie – at 19:13
OK, I might have misunderstood the intent of this thread. I wasn’t looking for science only, based on the list of 12 examples. I didn’t want to start a new thread that looks similar to this one. However, I do think there have been many random thoughts surrounding that list on this forum. It might be useful to have these thoughts crystalize into something clearer. Should we stay here or should we discuss this on a new thread.
I thought several of these examples indicate a shift of some kind.
Is there something terribly wrong with this discussion at this time?
Nope, this is an entirely appropriate discussion.
ANON-YYZ
This topic has come many times on Flu Wiki, and other flu boards many times. And for good reason. It is *the* question most people are here to get answered. It is also the hardest question to answer.
I have been following this for over a year, and my opinion is that actual situation, in terms of hard data, is more dangerous than it was last year, or even 6 months ago. The trend via public announcements and the media has been very erratic, swinging from dire warnings to pollyannish wishful thinking and then back to dire warnings. However, actual preparations by many national and some local governments have gotten much more serious. [A notable exception is New York City where the populace has received almost no information about the possibility of a pandemic. And no attempts have been made to prepare or protect health care workers or first-responders.]
Melanie.
“What we don’t have is scientific data”
That’s what seperates the ‘men from the boys’…metaphorically speaking.
Monotreme and others, do you have an idea why there’s not proper official prepping in New York?
Thinlina.
In a word: Triage.
My opinion is that New York City has been written off as unsaveable. I think resources will be targeted towards cities than can be saved.
Monotreme- Who is it that you surmise has written the city off? The Feds? NYC government? NY State? The residents?
I agree that NYC is probably unsaveable, but at what level do you think the decision will be made not to even try?
And doen’t that imply a flood of sick and dying New Yorkers ultimately making their way into NJ, Connecticut or anywhere else they can get to to get away from the Wite-off conditions?
Scary! But not unbelievable.
That’s “Write-Off conditions”
Monotreme - Which cities do you think are “savable”?
Eccles,
I think the President has made the decision. He also has the authority to seal off New York or any other city using force, if necessary. Anyone who has ever tried to drive out of NYC during rush hour knows how laughably easy it would be to seal off most of the city (and Long Island). The Bronx is the only borough where this might be difficult.
I don’t know if Governor Pataki or Mayor Bloomberg have gotten the same briefing that their counterparts in Florida (especially Orlando) or Texas (especially Houston) have gotten.
The mainstream media in NYC have done almost no stories on pandemic flu. And almost all of the ones they have done are of the Marc Siegel “Don’t worry, be happy variety.” The exception is the Wall Street Journal, which has done an excellent job. But how many New Yorkers read the WSJ? Most New Yorkers are focused on terrorism as the main threat. The media they consume, Daily News, NY Post, local TV, radio, etc. have given them no reason to think that a pandemic is even a remote possibility. Health care workers and first responders have been told absolutely nothing. Most of their bosses have been told absolutely nothing. At the very highest levels, there have been very limited table top exercises that make ridiculously optimistic assumptions.
dd – at 20:36 Which cities do you think are “savable”?
In general, mid to small size cities near agricultural regions.
I also get the sense that Orlando and Houston are priorities for the federal government, for whatever reason.
I also suspect cities with important military bases will be priorities.
Of course, I’m just guessing on all of this.
I get the unsettling feeling that the cities that are savable are the ones that someone with power cares enough about to expend resources on.
Makes some sense to me in a cynical sort of way.
New York would be one of the most likely to be first; it would spread pretty far within it before symptoms are evident. The WSJ readers and superrich can afford to isolate or move to summer or out of country houses, the upper middle class is already in their gated communities. Ditto SF, Los Angeles, Chicago, Atlanta, KS and Dallas — all air travel hubs.
Truth be told, though, I don’t think there are many “out in the middle of nowhere” cities that are unlikely to get cases in the first week. We’re too connected by trade and transit. Some of those little out of the way towns have proven to be havens for meth, people smuggling, car and truck chop shops, etc. and etc.
And most of our soldiers will be going home from abroad to small town America.
There is so much illicit travel and smuggling going on, I think it will be a real suprise how porous the borders are for people as well as germs. Legitimate businesses will honor quarantines, but I don’t think it will stop those already breaking or unaware of the laws.
I’m beginning to think maybe the way to go is personal protection — kind of the boy in the bubble lifestyle, or the funny allergy kid’s fishbowl head bubble and filters. Germ lock entry ways and sterile home environments.
dd@ 21:00 I have to say this, and it is not intended as a political statement, but as an empirical observation of the thinking and operating practices of the current administration, but I believe that the “Red” cities are savable. The “blue” cities are not.
The idea that the President is writing off major cities sounds a bit paranoid, although the recent administration proposal/attempt (passed in the House but having trouble in the Senate) to move the National Guard out from under the state governors’ control to the President’s in time of disaster does support the cynical view. I think the real problem is that many in the current administration do not really believe in governing seriously (Katrina and FEMA under Brown), but rather than get into a political rant, the alternative is family and local response and organization. If we are talking a 10% to 40% chance of pandemic this next year; of 30–40% infection and 5–50% case fatality rate, the cynical politicians will make a few speeches (or have surrogates do that) warning people so as to cover their asses and then hope nothing happens or the disaster is so large it seems like an act of God. I would like to see more non-Tamiflu tests on mice/ferrets of ameliorative treatments like prednisolone, statins, vitamins and herbs, ACE inhibitors, etc. that might be made available in quantity to reduce the impact of whatever happens. I do not think that isolation over many months will work for many people. Other ideas?
Personally, I think all urban centers are at great risk, the ultimate result will depend on a whole lot of factors that we can’t determine now, such as the virulence of the virus at a particular place, or time of year that it hits (eg a wave that arrives when schools are out during the summer will cause far less problems). Remember that in 1918, there were great variations to lethality and transmissibility in different cities.
Eccles - You summed up my darkest suspicions.
Whether a city is saveable or not depends to some extent on the participation and concern of the grass roots. TPTB would likely pick the battles that are winneable to conserve on resources. If a city has a ‘don’t care’ attitude, then it would not be able to compete for attention of resources.
It’s harder for a bigger city to have a sense of community, but collective effort is not impossible. New York as an example responded very well during 911, despite all of the image problems one would normally associate with a big city.
Don’t give up just because you live in a big city. Every ounce of effort helps.
My boss plays pool, she had a top pool champ from thailand at a local bar show up for demo’s… last week. I asked the boss how long she had been in the states and just 2 days. If…____ The entire office could have been infected and I would have brought it home and spread it everywhere without knowing. I didn’t know about this until 4 or so days later.
ANON-YYZ,
I have great affection for NYC (which is one reason I write what I do). If the pandemic is mild to moderate, I think you’re right about New Yorkers pulling together to get throught it. But if the pandemic is severe…
A severe pandemic is not comparable to 9/11, a hurricane or any other temporary crisis. It will unfold over weeks and months and will affect the whole country and the world. NYC is heavily dependent on other areas of the country for basic necessities such as food. What happens when production goes down? When transportation is disrupted? How much will reach NYC? I’m sorry to say this, but putting up sandbags when a tsunami is coming in won’t do anyone any good.
Monotreme – at 19:35
I have only been on this forum since March and don’t know what happened last year with Vietnam, Turkey, Thailand, among others. There seems to be ‘relapses’ in Thailand and Vietnam, and Indonesia with the latest (false positive) Karo clusters seem to be on very high alert. Is the Indonesia (especially Karo) strain distinct from the others, and if yes, what happens if the Vietnam/Thailand strain meets the one in Indonesia, possibly via Malaysia? Given that Myanmar is reclusive (I saw news of Thai PM sudden meeting, arranged only with a few hours, with Myanmar’s junta on Thursday) and Laos being communist and finger-pointing with Thailand, what is your take of the situation in Asia?
Living outside of NYC (in CT) I agree that the city should be doing so much more. While it has pulled itself together before (9/11, blackouts, etc.) it would be a tough place to be if TSHTF and say power or water went out,even if just for a little while. Living without power is one thing. Thinking you might get the flu and die is another. Or not being able to find food. People crammed together - it could get very ugly. Even in CT I find people very apathethic and never see anyone buying preps when I shop. I can’t figure out why people around here don’t seem to think it will happen.
heddie - we read WSJ and are not super-rich! It happens to be the best business journal out there. And it has done a better than average job with bird flu news.
ANON-YYZ,
All of the strains come from more or less direct from China, including the Indonesian strain, which is a bit surprising. However, after they get into a country they each go their own way. The human Indonesian strains were just released and I haven’t had a chance to look at them yet. There are definitely anomalies in the sequences which I haven’t resolved in my mind, yet.
No doubt that other countries in Asia and elsewhere are not revealing all of their outbreaks, animal or human. However, I suspect China is still the key player for the evolution of H5N1.
I do not think that it is a red state/blue state issue on purpose, if it is in fact playing out that way. If Florida and Texas are paying more attention to the issue it is probably due to the fact that the President has close relationships with the Governors of those states. Here in Oklahoma, with a Democrat for a Governor, I think the issue has been taken less seriously than it should. If not the Governor, maybe those that have been appointed in the top positions. Is it because they care less about the people of Oklahoma? No. But rather they just may simply be less inclined to agree with the Presient and his administration that this is an issue of great importance. A mistake in my opinion, but an understandable mistake. It probably would be the same (but turned around) if we had a democrat for a President and a republican for a Gorvernor. The fact of the matter is that we have a highly polarized country with fairly poisonous relationships and distrust between the parties. It should not be this way. As Lincoln pointed out in a major speech during a pivotal period in our country’s history, “A house divided can not stand”. Our house is terribly divided, and the seriousness of the situation may be just as pivotal now as back then. All politics from all parties must be put aside to prepare for this threat. Look at the FluWiki. DemFromCT is obviously an ardent democrat. I’m a republican. But here on the FluWiki, we and others just like us, just as passionate about their politics, set them aside to try to prepare people (all people) for a flu pandemic.
On the subject of writing off cities, I think it is an abhorrent concept. I suspect there is simply a recognition that in cities of high density and population the disease will blow through so fast there will be nothing to be done but clean up afterward. This is not writing them off, but rather simple pragmatism. It will be terrible beyond belief, but what can be done? I know of nothing that could seriously relieve the situation. As was mentioned earlier, the small to medium size cities have the best chance to deal with the problems arising from a flu pandemic. Country folks such as myself will have to get along on their own. I strongly believe that to be true, and have prepared such that we are able to do so.
I believe the threat is dire, and becoming more so with each day that passes.
Check in with Dr. Bob Gleeson as often as you can.
I find it hard to believe any government would write off the cities. After all, TPTB operate out of cities, not villages. If cities collapse, it will be anarchy. Whether cities are deemed defendable are a different quesition, and perhaps the degree of mitigation and what is considered to be an achievable outcome, goal, or measurement of success, in the minds of TPTB may be lower than a sparsely populated part of the country.
There is no reason any city should mentally throw in the towel. If you look at an example of a city state such as Singapore, the city is the country, then there will be more vigilance than a geographically more dispersed neighboring country such as Malaysia. Signs are Singapore is better prepared than Malaysia. Just one example.
The big “signature” cities are not only unmanageable in a logistical sense they are also BIG targets. You have to have people to have anarchy.
Anon - YYZ. If H5N1 gets out with a fraction of its current virulence, it will be beyond the capacity of any government…that goes for all cities.
The battle will be fought at the local community or neighbourhood level.
H5N1 is about everything uninmaginable. There is no silver bullet. Any hope we have hinges on doing the unthinkable. I am clear about how impossible it will become for cities. I am just saying we don’t have a choice. We have to defend the cities.
Ask yourself this question (most of us here live outside of cities - my gut feel):
When it’s all over, can your community function without cities and still keep a semblance of modern society? IMHO, we have become so inter-dependent that rural and cities need each other.
The battle at the local community level cannot be sustained if cities collapse. Don’t forget this thing will last 18 months or so, in maybe 3 waves.
Melanie@19:13. “…I have been worried for sometime so getting the reveres on board is no small thing.”
So you’ve recently changed your stance a bit about the liklihood of pandemic? May I ask why? Is it due to empirical info of some kind, or more intuitive?
ANON - YYZ. In the end a city is a community of communities…the battle will still end up being fought on a communtity level…
…If I was Government, federal or local, it might be wise to break a city into areas served by individual hospitals and then break the services down on that basis…it would allow communtities to organize for themselves.
There is one thing that is indisputable…if they try and run this thing with established hospital and health procedures…it will all fall like a ‘house of cards’ in the first ten days.
We have become so interdependent that the whole world needs each other.
John Deere brings in from overseas 17.000 machine parts crucial to the operation of all of their farm and industrial machines. And, of course, it is “just in time”. We could through some miracle sustain the United States and still collapse into a heap of incoherence.
ANON-YYZ,
I agree about needing cities to sustain civilization. However, I don’t think TPTB believe we need all the cities. [New Orleans will never be the city that it was. This is due to decisions at the federal level.] My point is that resources may not be evenly distributed to every city during a pandemic. Certain cities may be chosen to save, others may be triaged.
If you have 20 million doses of vaccine, do you distribute it evenly across the US or do you pick 10 cities of 2 million each and vaccinate everyone there? Which course of action is more likely to result in preservation of civilisation? Even in the cities that are triaged, what is truly necessary to preserve for the sake of civilisation, the people or key infrastructure? Look at the issue from the viewpoint of a cold-eyed government planner and see what you conclude.
Okieman – at 22:59
Thanks, and I think that’s exactly right re politics and the wiki. I do not and can not know the answer as to whether the approach would be different with a Republican vs Dem president (i.e, is small government philosophy involved), yet the do-it-youself, don’t-depend-on-others approach makes sense whoever says it.
NYC has one of the finest public health departments in the country, yet it is also an example of this being beyond what public health alone can do. I still haven’t read their entire plan or compared it to Seattle’s or San Francisco’s. But it’s a nightmare any way you slice it for the cities.
Montreme,
Interesting point except for one thing. Who would raise our food? I think they better not just take care of the cities and avoid the farmers. As for cities, I think NY would be the first to get the vaccination and medication. Got to keep the stock exchange going ya know. Second would be Washington D.C., which is obvious. AFter that it would depend on which areas are more important from a security standpoint.
Montreme,
I brought this thread up yesterday because of a number of recent events unfolding.
I am copying a few points below for your review from my post yesterday ANON-YYZ – at 18:43
5. Indonesia new Karo clusters turned out to be false positives
6. Thailand has 2 deaths with unclear sources of infection
7. Laos has bird flu outbreak
8. Vietnam has suspected human case
9. Malaysia is on high alert on bird flu
Do these events affect your thinking how it’s going to play out? Is it still going to be the unknown mammalian reservoir in these countries, or is it more likely to break out in South China?
Montreme- unfortunately, pandemic flu isn’t going to be like some sci-fi movie where a perfectly functioning city is left standing, just missing all the people. I would assume that between acts of deseperation, acts of violence acts of vandalism and just plain accidents there would be much damage including widespread fires.
(I will refer to the Philadelphia MOVE incident where in an attempt to break a deadlock with a dangerous group of squatters, the city of Philadelphia droped a bomb on the house they were occupying, which resulted in a massive fire which levelled several city blocks and displaced hundreds of residents.)
Any thought to the preservation of a city because of its infrastructure had better include the preservation of people. We have a symbiotic relationship with our technology. While we cannot long exist without it, neither can it exist without us there to care for it.
DemFromCT – at 08:49 The problem is that this is not a Health issue but a social one. However; almost all of TPTB have determined it to be a health issue and have washed their hands of it. When it all fails they can then blame the HCW’s for not doing enough and being ready for it.
boneman – at 09:10 They would not try to save the entire city. Only selected individuals would receive the treatments. Major players in the stock markets, bankers, political leaders etc. The thinking would be that everyone else could be replaced if they do not survive and if the old folks (50 and over)go then less Socical Security they would have to pay. So no they would not save a few key cities, they would break up what they have, save those that they feel are important and let the rest spin in the wind (I have my rope on so I can stay in one place while spinning).
With the current 5% CFR from the normal Flu in Thailand (already discussed in news thread) I have a feeling that H5N1 has moved into the human base. It has just not made the final jump for easy transmission. It is getting lots of chances and I think sooner rather than later it will make the jump.
Treatment and infrastructure realities of an H5N1 pandemic at any time within the next ten years are bad enough…
…on top of everything else, H5N1 will be an ethical disaster…an ethical black-hole that will trap every person in authority.
Anon_451 – at 11:19
Other than what’s happening in Thailand now, have we seen any other ‘dual out breaks’ where both regular seasonal flu and H5N1 result in human deaths concurrently? This seems to be the first time.
I wonder how many of the suspected cases in Thailand turn out to be H1N1, and how many H5N1. Then the nasty question, how many have both.
boneman – at 09:10
Who would raise our food? I think they better not just take care of the cities and avoid the farmers.
How many farmers do we really need to grow our food? In the US, food production is heavily industrialized. Food processing and transportation is another matter entirely.
As for cities, I think NY would be the first to get the vaccination and medication. Got to keep the stock exchange going ya know.
How many people are absolutely necessary to keep the financial markets going? Cantor Fitzgerald lost 2/3′s of their employees and their New York office in 9/11. They were back in business within one week. I suspect most of the financial institutions in NYC have contingency plans for continued operation assuming total decimation of NYC.
Second would be Washington D.C., which is obvious.
Not necessarily. My hunch is that most of the residents in DC are not considered high-priority. Facilities and procedures for continuence of government fucntions at other locations are well-established.
AFter that it would depend on which areas are more important from a security standpoint.
Actually, I think certain military installations will be the top priority.
ANON-YYZ – at 11:05
Do these events affect your thinking how it’s going to play out? Is it still going to be the unknown mammalian reservoir in these countries, or is it more likely to break out in South China?
No, these events don’t suprise me or change my thinking. There is definitely something weird going on with the adaptation of H5N1 to humans. More sequences will make this clearer. I still think the action is in China. There are odd things going on there. However, a pandemic could at least appear to start in any of the affected countries.
ANON-YYZ – at 11:27
Re:”I wonder how many of the suspected cases in Thailand turn out to be H1N1, and how many H5N1. Then the nasty question, how many have both.”
How ironic is that? That we worry about the next severe pandemic being formed from the remnents of the last severe one?
Tom DVM at 11:27: At the extreme you throw ethics out the window and let pure logic rule. Those in authority will be faulted no matter what they do, so they might as well get results that further the continuance of society. And as in 1918 we can conveniently bury and repress the horrors that necessity required.
Eccles – at 11:12
…unfortunately, pandemic flu isn’t going to be like some sci-fi movie where a perfectly functioning city is left standing, just missing all the people. I would assume that between acts of deseperation, acts of violence acts of vandalism and just plain accidents there would be much damage including widespread fires.
I think there will be plans to preserve some people. ie, the people who know how to run the utilities. I expect widespread destruction of many businesses and homes. However, I expect that nuclear power plants and other key utilities will be protected. Sewer and water pipes will still exist even if the stores above them have been burned to the ground. Not that hard to rebuild or repopulate a city, assuming that there are outside cities still intact.
Any thought to the preservation of a city because of its infrastructure had better include the preservation of people. We have a symbiotic relationship with our technology. While we cannot long exist without it, neither can it exist without us there to care for it.
I agree, to a point. The question is: How many people do we need? Which people? There are many consumers of technology and utilities, very few producers and operators.
Monotreme – at 11:38
As far as sequences go, are enough samples being collected? Are we missing key data? What can be done?
I posted in the News Thread a couple of days ago:
ANON-YYZ – at 11:06 Closer study of H5N1 strains needed, expert says
However, some hope that such a disaster might be averted if the disease can be effectively controlled in birds. Peiris said it was paramount now for Thailand to sequence the H5N1 virus that has recently re-emerged in the country’s north and northeast after a nine-month hiatus.
“If this virus is still the same old virus, it means you have to think of additional things to do to completely keep it under control. But if it is a Qinghai-like virus, then it means it comes from wild birds,” he said, referring to Qinghai Lake in China, a breeding spot of a strain of H5N1 that has since spread to parts of Europe, Africa and India via migratory birds.
Peiris said genetic sequencing was badly lacking in parts of Asia, but declined to say where. H5N1 is endemic in Indonesia, where it has killed 42 people, and has flared up in Laos. Vietnam fears a comeback of the virus — which killed 42 people there — after many months without cases in people or poultry.
Monotreme – at 11:33
“Actually, I think certain military installations will be the top priority. “
I agree and they will be the ones that bring the most lethal powwer to bare (SF, Rangers, 82d Airborne) It may be worth watching when the cream of those units are brought home and put in their barracks, It may be significant (saying we are still fighting in Iraq and Afganastan (sp).
Grace RN – at 11:40
“How ironic is that? That we worry about the next severe pandemic being formed from the remnents of the last severe one?”
That MAY be a good thing in that we MAY have some resistance to that.
Anon_451 – at 11:49
I agree and they will be the ones that bring the most lethal powwer to bare (SF, Rangers, 82d Airborne) It may be worth watching when the cream of those units are brought home and put in their barracks, It may be significant (saying we are still fighting in Iraq and Afganastan (sp).
I agree. This is one of the signals I am looking for that the US government thinks something is about to happen. Of course, they may guess wrong and have to bring these people back after it’s started. But these units, and Boomer crews and combat pilots and people who control ICBM’s will be the top priority, IMO.
Monotreme – at 11:56
Do you know the name of the town that would be the ‘standby’ for Washington DC? I saw it on TV recently, but forgot the name of the place. Watch for construction of warehouses (to store food etc) there?
I will be participating in a meeting with a concerned county official this week, and am looking for a post made in the last few days (I think by anon_22) that had a quick bare-bones analysis of tamiflu availability and dosage. Can anyone direct me to the correct thread, or some similar information? Thanks!
ANON-YYZ – at 11:46
As far as sequences go, are enough samples being collected?
No, definitely not. We especially need more samples from mammals.
Are we missing key data? What can be done?
Yes, we’re missing lots of key data. What we need is complete, searchable database of information on all human cases, including sequences, pathology, treatment, location, relationship to other patients, etc. Dude and I are working on creating such a database with the currently available information.
The place where we need the most information is China. This is where H5N1 developed and where it continues to evolve. The best way to get information from China is to block Margaret Chan from becoming Director-General of the WHO and to apply financial pressure to get China to release the human sequences and to fess up about all vaccine efforts, legal or illegal. Threatening MFN status would be a good start. I have little hope that either of these things will occur.
Monotreme. I think the pressure point…achilles heel for ethics in China may be the Olympics in 2008…that may be where to apply the pressure.
ANON-YYZ – at 11:59
Do you know the name of the town that would be the ‘standby’ for Washington DC? I saw it on TV recently, but forgot the name of the place. Watch for construction of warehouses (to store food etc) there?
Yes, but I won’t tell or everyone in the country would want to live here ;-)
Just kidding.
I suspect there is more than one town and the one on TV may not be the real one. It’s possible that the US government would want everyone in the world to know this information ;-)
Tom DVM,
I think the Chinese government would fear loss of MFN status more than loss of the Olympics, but you bring up a good point. Average people can’t influence MFN trading status, but we can decide not to go to the Olympics. How about this: Start a campaign to boycott the Olympics unless China releases all H5N1 information?
Monotreme – at 12:04
What about ‘low hanging fruit’ from countries that are more cooperative, in the immediate future? I am thinking Thailand, Indonesia. Do they have enough resources and are they collectin mammal samples? Malik Peiris comments about ‘molecular detective work’ in Thailand seem to be doable, without too much political resistance.
ANON-YYZ – at 12:11
What about ‘low hanging fruit’ from countries that are more cooperative, in the immediate future? I am thinking Thailand, Indonesia. Do they have enough resources and are they collectin mammal samples? Malik Peiris comments about ‘molecular detective work’ in Thailand seem to be doable, without too much political resistance.
I agree. If we could make these countries understand that it is in their interest to understand what is going on in China and that the best way to do this is to deposit all sequences as quickly as possible, we may get alot of answers to our questions. We need to encourage them to start taking samples from pigs and other mammals.
There was a national security exercise held on June 19th of this year involving 4,000 employees from virtually all of the federal agencies in which they did a “bug-out” exercise to dozen of facilities/bunkers. These classified facilities were located in Maryland, the Virginia suburbs, and the foothills of the Alleghenies. It was the largest “continuity of government” exercise ever conducted. These type of exercises were revived and expanded after 9/11 by the Bush administration.
Monotreme – at 11:56
You mentioned the movement of the military forces as being one of your signals that something was up. Some of my signals: 1. Movement of large volumes of cash to main banks around the country to cover the checking and pass book savings accounts. 2. Total news black outs in this area. 3. CDC high ranking officials going on “unexpected vacations” and not reachable. 4. Very senior members of the administration or congress going home or on conference that had not been announced. 5. Notification to TSA and customs at the airports to be more vigilant on flights coming in from “certain countries” no specifics just a heightened awareness factor. 6. Hospital overcrowding that is reported (meaning very bad) in certain countries (Currently on going with “Dengue Fever” in Vietnam) 7. Most of the Navy and all of the boomers putting to sea with a full pantry and fuel stores and escorts going with them to keep them out for longer then six months. 8. Selected military units sent on training missions where they would have no physical contact with anyone not in the unit. 9. Multiple nuclear power plants shutting down for “routine maintainment” all at the same time.
What to list a few more? Alone they would mean nothing, together they would mean a lot.
Monotreme, we need to encourage ourcountry to do the same.
A question on signals. How would you know about those signals? A total news black out would be observable but not likely, even under the worst of situations. Number 5 has already happened.
glo – at 13:00
“A question on signals. How would you know about those signals? A total news black out would be observable but not likely, even under the worst of situations. Number 5 has already happened.”
This is one of the problems with our news thread. We all (I am just as guilty) concentrate on the Health Issues and do not pay enough attention to the side issues that may really give us a heads up.
What I know of my signals is from friends around the country and from being a news junkie. So I never have anything I can post and link, ego I do not post if I can link or if it has not already been posted on the Wikie.
Melanie – at 19:13
“What we have are news stories. What we don’t have is scientific data. The judgement of the mods after our conference call on Sunday for threat assessment is that even the reveres, who are sceptics, are worried. Dem, anon_22 and I have been worried for sometime so getting the reveres on board is no small thing.”
Melanie, what bit of information or data has gotten the reveres worrying? I would be interested in their take on the matter.
For whoever asked about what is the probable backup site for Washington DC, for some reason Lincoln, Nebraska comes to mind. In all likelyhood there are multiple locations identified for various contingencies.
I tried the above link for Dr. Bob Gleeson and got an “URL not found” message. Here he is (this isn’t too long, so I won’t try the tinyurl): http://drbobgleeson.typepad.com/bird_flu/
I do check it a couple of times a month. He doesn’t post all that often.
I don’t think you understand my question. It’s not a rhetorical question. I really want to know. I read what might be indicators, and wonder how I would know. Most of the indicators you’ve listed wouldn’t neccessarily be public information, nor newsworthy. Hence, my question. I want to be educated if there’s some means to find out these kinds of information.
1. Movement of large volumes of cash to main banks. Not a visible occurence.
2. Total news black outs in this area. There will always be some kind of news.
3 and 4. CDC high ranking officials going on “unexpected vacations”; very senior members of the administration or congress going home or on conference that had not been announced. Not public information, no one would know.
5. TSA and customs - a non-specific heightened awareness factor on flights coming in from certain countries.’ Already implemented; part of US pandemic planning.
6. Hospital overcrowding in certain countries Already happened. Not particulary meaningful without context.
7 and 8. Naval offshore deployment - full pantry, fuel, escorts; military training exercise deployment. Not public information. Homeland Security.
9. Multiple nuclear power plants shutting down for “routine maintainment” simultaneously. Wouldn’t be publicized.
Some of us on this site have inside sources that would open up if things were truly progressing to “ground zero”. I would hope those persons would provide some veiled comments that others could read between the lines on. Enough said.
Medical Maven, that’s actually the primary reason I read here.
glo – at 14:23
None of us will be able to put it all together as an individual. A good newpaper would be able to aquire all of the data if they were watching for it. There should be other indicators as well hence the real reason for my post. Many newpapers come here for information If we had a good list of things to look for, with the resources that they have they would be able to track the data. With good data they could write good stories. But there is other more fun things to cover, sex drugs and war.
That is why I have always held that I would know when it is happening when the people in my town came down with it and the local press started to report it.
Melanie at 1913 - Would you please elaborate on what specifics have resulted in this change of attitude on the part of the reveres, and the seeming increase in your own risk assessment?
I’m not the first person to ask, but I haven’t seen it answered. I know my own anxiety level is up appreciably, but I think it’s far more relevant that you and the reveres are exhibiting increased concern. I’m living in that state of perpetually increased awareness - hypervigilance, perhaps.
Please ignore my request for information posted at 12:03, as I have located the thread that contains it.
Monotreme – at 11:38
There’s been much expression about observing events in the U.S. as early signs. Wouldn’t that be downstream? I would rather watch events in countries where the virus may gradually or suddenly change to pandemic strain. Up to now, we react to news and say ‘this is not a good sign’ but not sure how to quantify in a actionable way what that statement means. It’s even harder to understand it in the heat of the moment and we either over react or discount it too quickly.
The only actionable assessment is how many more and what kind of steps if it’s a gradual model, or how many and what kind of missing conditions surrounding the virus supporting a sudden shift to pandemic strain. Time scale estimates will make it even more clear.
Better clarity will encourage more individuals and corporations to take action.
We as a group are more informed from each other and these posts than the average John. Everyday we see movement in our own communities. Dr.s offices now have hand santizers on the WALLS in the offices, wet wipes for the carts at all the stores. BIG bags of rice in the front of the stores. These are the tiny threads that eventually will help sew the quilt which everyone will observe. We are just lucky to the ones that are preparing ahead of schedule. We may end up in the same quilt square as everyone else but we will have that piece of mind we prepared and did the best and are knowledgable about the situation.
Melanie – at 22:07 I’m pretty much with anon_22, waiting for an anomolous mutation in Indon, which is just about the worst case scenario.
Ditto. I’m sure it took a while to go from stage 1 to stage 3; my fear is that we can go from stage 3 to stage 6 in a exceptionally short period of time. So short that anyone who thought they had time to prep, or write a pandemic plan for their workplace will be S.O.O.L. [Shit Out Of Luck]
I seem to be missing something. “Melanie – at 22:07″ is absent from my view of this thread?
glo,
It was a July 6 post by Melanie.
Okieman – at 14:09
We have these out of season cases. That has all of us paying attention.
Thailand has concurrent human bird flu and seasonal flu deaths.
Indonesia has human seasonal flu cases with dead confirmed bird flu inflicted chicken in the neighborhood.
People in both countries question the tests.
bump
Bump
ANON-YYZ – at 20:19
There’s been much expression about observing events in the U.S. as early signs. Wouldn’t that be downstream? I would rather watch events in countries where the virus may gradually or suddenly change to pandemic strain.
The ideal situation would be know what is going on in China and other locations where H5N1 is evolving, but the lack of transparency in some of these countries means we may not see the upstream events. And some people do have inside information. For example, Dr. Webster has access to sequences from countries that have not yet admitted that they have H5N1 outbreaks. Hence, we parse his sentences and the utterances of other people who may have privlildged access to information quite carefully. Recent comments by Laurie Garrett and Dr. Peiris make me suspect that the conventional wisdom is now more pessimistic than a month ago, for reasons that are not stated.
Once the pandemic starts, there will be leaks before the general public is notified. We all hope someone leaks this information to us, first. If not, crude signs like disappearing rice may be all the warning we have. Note, due to JIT delivery, even a very small leak of information will result in a big effect on supplies in the region where someone has inside information. Hence, we should not expect supplies to be depleted universally when a leak occurs.
Monotreme – at 01:09
“The ideal situation would be know what is going on in China and other locations where H5N1 is evolving, but the lack of transparency in some of these countries means we may not see the upstream events. And some people do have inside information.
Once the pandemic starts, there will be leaks before the general public is notified. We all hope someone leaks this information to us, first. “
I certainly share your hope for hearing the leaks here first. But is something beyond our control and at best treated as a bonus.
Some of the ‘upstream events’ may be hidden from our views, but human nature will betray the people who try to ‘hide the secrets’, so there will be some leaks ahead of the pandemic, sometimes not by what is said, but by what is not said, or illogical action etc.
Seeking out these ‘hidden upstream events’, however, requires an understanding of how according to the conventional science and wisdom events SHOULD playout. This understanding will help us identify anomalies.
While I am in support of pressing for more transparency, the success of such pushing also depends on our abilities to uncover some of those ‘hidden upstream events’ without waiting for the mercy of TPTB to decide to be more open.
Once the pandemic starts, it will be mostly too late, even if we hear ‘leaks’ shortly ahead of the masses.
Ah, that was me. Sorry
ANON-YYZ – at 01:23
Some of the ‘upstream events’ may be hidden from our views, but human nature will betray the people who try to ‘hide the secrets’, so there will be some leaks ahead of the pandemic, sometimes not by what is said, but by what is not said, or illogical action etc.
Seeking out these ‘hidden upstream events’, however, requires an understanding of how according to the conventional science and wisdom events SHOULD playout. This understanding will help us identify anomalies.
In my opinion, anomalous behaviour is already occuring, especially in China. Retracted sequences, attempts to prevent publication of a paper, failure to provide sequence information, etc.
Monotreme – at 01:33
In addition to China, have you noticed any anomalous behaviour and can you cite and/or interpret them? I am particularly interested in Thailand and Indonesia where there are current out breaks.
the most anomalous behavior IMO is the experts refusing to give numbers and discussion for probability estimates, but give unclear threat assessment statements instead.
This leads to the currently absurd situation that the well informed members of flu-forums like this one have a much higher pandemic fear-level than what is communicated by the media and perceived by the average population.
The experts in average seem to be between these two groups with their fear-level.
ANON-YYZ,
No. I don’t think the Thais or Indonesians are doing anything unusual. The Thai government always tries to hide outbreaks and the Thai scientists always push for full disclosure. Sometimes the government wins, sometimes the scientists win. This seesaw has been going on for years. The Indonesian government has no idea what H5N1 really is or how much of a threat it is. Indonesian science is much weaker, in several ways, than Thai science. If the pandemic begins in Indonesia, the government there will figure it out only slightly before the rest of us.
beehiver – at 12:03 “I will be participating in a meeting with a concerned county official this week, and am looking for a post made in the last few days (I think by anon_22) that had a quick bare-bones analysis of tamiflu availability and dosage. Can anyone direct me to the correct thread, or some similar information? Thanks!”
I am working on this Everything Tamiflu page on the Wiki.
Tamiflu availability in the context of community or hospital planning was discussed on this thread CDC hospitalization and mortality estimates
the Indonesians can’t find the source, where the humans in Java are infected from
anonymous – at 01:46
If people were to look closely at sequences from other countries, they would find that the bird-to-human transmittal dogma is not always true in countries other than Indonesia.
(posts deleted per writers’ request)
monotreme, which countries ? I think Indonesia (Java) is quite special here.
To the Thai/Indonesians-Where is the pig/cat/dog testing? We KNOW it’s endemic in birds, look elsewhere-think out of the box!! Ask the FAO for help!
Closed due to length. Discussion continued here
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