This is the third part continued from here
EnoughAlready – at 17:45
Tom DVM – at 15:53
I understand, and agree with latent/innate immunity. (And hope I have inherited whatever kept my relatives from getting the previous flu’s.) However, about the waves… 2 questions. First, isn’t it possible to have waves of attack at various degrees something like on a bell curve, where intensity is greater at some point? (Where numbers of people infected vary in intensity, nmbers.) Second, are you saying there wouldn’t be periods of “hiding” or mutating or whatever is/might be happening? I guess I can see initial periods of low impact and retreat to regroup/strengthen, followed by a WHAM, and then another lower leveled attack… which would have to do with virulence of the “agent.” My intrique is that you “see” something else and “I” am not following what that is! I clearly saw what Barry saw… 3 waves… well, actually more than that because this thing didn’t really fizzle out as the book stated. But the major impact, I saw 3 waves. what am I missing? (Sorry to be so slow!)
BTW, I have been here. Not as much, and with breaks due to vacation, etc. Mostly lurking, ie- reading, or trying to help with the night time “bump” sessions. Also, I have been rabbit-hole-chasing info on threads to other stuff on other sites. And… been canning and dehydrating a bunch!
EnoughAlready – at 17:54
Never mind, TomDVM--- you really explained yourself (those waves) in the Let’s Talk CFR thread. Thanks!
I would like to clarify a couple of issues.
First, I don’t agree with the suggestion that we should tell people other than the unvarnished truth, even if it hurts. Frankly, I don’t even understand the logic of this. I am a scientist. It is my job to try to figure things out and then to report them as clearly as possible. I don’t understand other ways of doing things. One reason I could never succeeed as a politician ;-)
Scientists and engineers reported that New Orleans was not prepared for a category 3 or 4 hurricane. They said this very clearly. Should they not have? The meterologists who saw Katrina coming reported this. They suggested that it would likely be a category 3 or 4 storm. They explained what that would mean for New Orleans. Should they not have?
I’m sure the people of New Orleans were unhappy to be told these unpleasant truths, but most of them did leave when the government told them to. Some were not able to or chose not too. In the end, who experienced less trauma, the people who processed accurate, but scary information correctly and were able to leave, or the ones who stayed?
I’m not suggesting that I know the CFR for an H5N1 pandemic will be over 50%. And please note, this a worst case scenario, not an attempt at soothsaying. No-one knows for sure what will actually happen.
However, after reading a large number of scientific papers and thinking about the science alot, I have come to the conclusion that this is a distinct possibility. I have thought this for some time. Karo has reinforced this view. The kill rate did *not* go down in the first demonstrated H2H2H transmission chain. If anything, it went up.
I have personally observed viruses kill every single animal they infected. This happens. It is not science fiction.
My opinion is based on my interpretation of limited data, but it is not a gut hunch or other emotional response. I am not suggesting a worst case scenario of a pandemic with a 50% mortality rate because I am depressed or pessimistic or because I want to scare people.
My opinion that the worst case scenario is a pandemic of 50% CFR is my cold-eyed report of what I think. Period. Make of it what you will.
Monotreme. I agree completely except I don’t think a 50% CFR is the worst case scenario…
…I will deal with it after I get my head around the 10% CFR /:0)
The second issue I want to clarify is how to process bad news. This is perhaps a matter of personality. Some think it better not to wake the sleeping masses. Let them have their pleasant dreams If the worst case scenario occurs, we will all die anyways so why disturb them, goes one school of thought.
Not mine. I am not a fatalist. I do not think a CFR of 50% is the end of the world. What some people are forgetting is that you will not die if you are not infected. And we can stop people from getting infected if they stay put. Now, some people will ignore instructions to stay home - they will die. Unfortunate, but not the end of the world. If we supply everyone with food, if we keep the grid up, if we keep the water flowing, if we provide security, we can offer most people an excellent chance at survival. Even in the worst case scenario.
I assumed that the worst case scenario was actually the most likely scenario over a year ago. This did not make me dispair, it made me determined to fight to prepare people. This is why I’m here, at Flu Wiki.
Most of you are familiar with Preparedness Guides
Okieman and others provided valuable input which I implemented on this page:
There are concrete things we can do to prepare our communities. Let’s do them.
Regarding Monotreme’s post at 21:19: AND fellow fluwikians if that post did not scare you, nothing will. By “protesting” in an honest, inescapably frank way to those who have read his posts for many months he has removed all doubt that our surface impressions of him are dead-on accurate. Monotreme deserves the deference that I have always accorded him.
And he has fully and finally confirmed (to me at least) a true scientist’s objectivity with a compartmentalization that allows him to look the monster fully in the face and to tell it like it is He has no axe to grind other than what he has repeatedly stated.
And Monotreme I want no “thank you” for what I just said. Your “thank you” to me and to everybodyelse here at fluwiki is your continued and regular presence.
Monotreme – at 21:19 In my heart I know you are right, but a 50% CFR would result in total collapse of the Western world and revolution in almost every country in the world. Like Tom I am having a hard time with it. If I was one of the survivors of a situation where 90 to 95% of humanity was gone. That I would know how to handle. But if we only lost 30 to 50% then all bets are off. Only the strong and ruthless will survive and come out on top. I have seen those type of people and most are currently in prison. You are correct if the Governments of the World do not get their collect acts together, They will no longer exist, they will become one of the victims.
Medical Maven. Thank you /:0)
The third issue I want to address is what can we do beyond personal prepping to prepare our communities?
First, we can make ourselves pains in the butts for TPTB. Show up at town hall meetings. Ask the local government if they are prepared. It will be election season soon. Go to rallies, ask the candidates what they are doing to prepare for a pandemic. Send emails, write letters, call their offices. Do it like your life depends on it. Because it does.
Second, we need to inform the press. Write letters to editors. If you see a story that is wrong, write to the reporter and politely explain why they are wrong. We have to get the MSM on our side.
Of course, all of these efforts would be more effective if the WHO and the CDC would tell the truth about the real worst case scenario. Which brings me back to my first post tonight: The sleeping dreamers are TPTB and the MSM. It’s time to wake them up. If the truth makes them wet themselves, tough.
If they are too scared to think or plan, we’ll be happy to tell them what to do ;-)
we need names and emails that can be accessed by all fluwikians
moeb: Hi. Did you read the Time Magazine article (re: why Americans won’t prepare for disasters) that banshee linked to in the News Reports (8/21) thread?
I got a distinct feeling that Ms. Ripley’s research for this article left her in a mood to whack a few moles of the stupid variety. Would you consider adding her to the list? Perhaps your charming nature would convince her to join our cause.
p.s. Did you get the puppy?
Monotreme, I’ve lurked enough and feel it is time to throw in my two cents. First of all, thank you for your ongoing courage to get the whole truth out as opposed to pieces of it. Yes, we don’t know how bad a pandemic will be, but the collective information we have gathered these many months does not look good. That should be included in the truth telling.
Second, your call to activism is in my opinion a way to deal with fear. It is a call to confront the monster and get ready. I could put my head in the sand and not care about my own life, but I have a child. For his sake, I will continue to heed your call for action -always.
My ancestors were lighthouse keepers in Canada. Over the course of 100 years, they lit the lamp through thunderstorms, blizzards, illness, and death. They never missed a night; no ship ever ran aground - for 100 years. The truth that we may face a truly grim scenario that others feel may be impossible to deal with won’t stop me from trying to protect my child. It won’t stop me from calling on TPTB - from the WHO on down - to tell people that the truth is that a worst case scenario should be in the planning and everyone’s awareness. I owe it to the people I come from and to the people who may come in the future.
Three months ago I took on the project of pulling information together for a Freedom of Information Act request to get the CDC to release sequences. The information was sent on to an organization that has the ability to make that happen. They have not ruled out this project though I am discouraged with the passage of time. Was it all for not? Never. We must get people informed. At least those busy folks know more than they did before even if they lack the time and staff to act yet. Perhaps they will protect themselves and their loved ones better as a result of the information I provided, which included Monotreme’s opinion pieces on this Flu Wiki. Each of us can do something. Each of us can save lives. If we are a thousand, and we each touch ten people, then that is ten thousand, and they will inform thousands more. Don’t give up.
George Orwell: “In a time of universal deceit, telling the truth becomes a revolutionary act.”
Elizabeth Cady Stanton: “Reformers who are always compromising, have not yet grasped the idea that truth is the only safe ground to stand upon.”
late to bed early to rise, who can sleep? it’s very hard to predict the future, but I can tell you this place is going to be puppied! I go in 3 hours to put the deposit down on a brindle boxer, sweet dogs, mean looking dog… a very protective breed. The girlfriend is getting a golden lab (female) I assume it’ll make good back up.
that’ll make 4 dogs here for a short while as the oldest is on her way out (when she decides, she’s quite old)
activism: things seem bleak, that old fear slipped through my soul a couple of times. I shake that off as it’s a manifestation of ancient man clinging to a fire late at night, wolf howling somewhere near. I’m a gringo in Mexico, I am going to attempt to get the local paper to do a story on avian flu (it’s all spanish or tourism around here) I suppose I’ll push again with my mexican clients who I care about. (I can’t exactly say it’s good for business)
the flu pot is bubbling… in hurricane jargon, it’s time to rush to complete preparation. you could say we’ll go down fighting. you could suggest we tuck our heads between our legs and kiss our a** goodbye. Remember, not everyone will succumb… and I’ve got puppies.
moeb,
I consider you (along with Monotreme, Medical Maven, Tom DVM, FrenchieGirl and NS1) a “must read.”
anonymous – at 08:46 - Thank you. Shouldn’t you include so many others in your post as well? I’ve had delight reading everyone, even the toughest nuts or the softest fruits!
“George Orwell: “In a time of universal deceit, telling the truth becomes a revolutionary act.”
Elizabeth Cady Stanton: “Reformers who are always compromising, have not yet grasped the idea that truth is the only safe ground to stand upon.” “
Nightowl
I believe the first statement is accurate if you add the word ‘regulatory’ inbetween ‘universal’ and ‘deceit’.
Thanks. /:0)
It would be nice if there is a place on flu wiki we could save quotations like this and go there and read them once in a while.
Thanks, people; I needed that.
Monotreme, I really wish you were in my town…
FrenchieGirl – at 08:58 “I’ve had delight reading everyone, even the toughest nuts or the softest fruits!”
Trying to decide if I am a soft nut or a tough fruit. Or a nutty fruit . . . or a fruity nut . . . oh, never mind. :-)
The truth always should be provided to the people, whether it be good or bad. To say “peace, peace” when there is no peace, but only war and death approaches, or in this case disease and death, is a gross dis-service to the people. Think of the years leading up to the 2nd World War. It seems that only Churchill was able to look with a cold eye at what was developing and see the danger. He gave the warning, but he was ignored and those crying “peace, peace” ruled the day until Hitler invaded Poland. We all diserve the truth, whether rich or poor, educated or not. Without it wise decisions can not be made for our families or our country. Whether the news be good or bad, give me the truth.
As Monotreme so elegantly explained, science demands truth. Without truth, it is no longer science, but only opinion or lies. Good decision making must be based upon the availability of truth. This is true whether whether we are talking about decisions made by governments or by families.
Albert Schweitzer once said, “Truth has no special time of its own. Its hour is now - always.”
Speaking of Winston Churchill, a quote atributed to him, “When you’re going through hell, just keep on going.”
I’ll have a go at the question, it’s all coming from one plunge of the feather to the ink; I hope it makes some sense, but I find the subject very difficult and my chatting away is much disorganized, it’s a long time since I read philosophy! Feel free to point at the weaknesses of the argument! I’ll just post as is, before I’m in a mind of revising and never get to it again (as I have done with previous would-be posts)
Nightowl – at 03:07 — If we are a thousand, and we each touch ten people, then that is ten thousand, and they will inform thousands more.
I wish it was that easy. Different people need different strokes (as well illustrated on this forum).
Intellectually I already have a bad time coming to grips with a high CFR and I am not in denial. Emotionally, I just can’t, and I don’t think I’m in denial at that level either. Spiritually, its so impossible that I feel like just “remitting myself in the hand of G.d, for whatever design he/she has for me”. I’am a utopian as well as a realist. Besides, I have tree options: (a) trust myself, (b) trust TPTB, © trust G.d. I’d probably choose (a) and ©; I wouldn’t ever trust TPTB, not even if I managed to give them the message to build Noah’s Ark for the whole world and they agreed and did it. Some will choose differently.
Now then, how could I expect the majority people, be they in power or not, who are mostly knitted of one fiber only, to be able to come to terms with such awful thoughts, if I cannot? And I am not a defeatist. I just think most humans are not made to be able to fathom such possibilities. With respect to TPTB, they are like the mass in many ways (though not all) despite their responsibilities. They do not have better adaptation skills than the world at large, plus many are hungry for money and power which gives them opaque glasses on certain subjects. So we may consider that TPTB will cause the downfall, the loss, of many lives.
But let’s suppose for a moment that TPTB do react in our expected manner, listen to the Monotreme of this world, the Osterholsm, etc. and start prepping for the nations. Will they really save that many more lives?
You see, for TPTB to prep for a nation, yet alone for all nations (as groupings of nations), that requires a certain amount of transparency. If you agree that, after all, TPTB are at the top of a nation because they do possess certain skills that the common man does not have, let’s say organization skills, money, influence, whatever more than the man in the street, it means they will have to deliver a message of doom and despair to the masses.
And there you are going to be entering the debate of “are the masses capable of understanding without fear and to observe and practice whatever is being preached by TPTB to be prepped for the bigger catastrophe of humanity” (Not mentioning how condescending this attitude is). I read here and there about “risk communication”. Is the running of an ordinary individual’s life so complicated as to require books and books and books on how to pass on a difficult message to this person? I maintain that even though the man/woman in the street is capable of individual heroic behaviour on the spur of the moment, that it is impossible to give such a dire message to the whole world, to these masses, that it is impossible for humans to have a permanent, continued, heroic behaviour in prepping for months of uncertainty with the final knowledge that despite this fight, their loved ones are very likely to die.
Because that’s what we’re trying to do, across nations, cultures, religions, languages, etc. Try and tell your plumber, your electrician, your salesgirl, your typist, your jack-o-all-tools, your farmers’ hand, that in his/her family of four, at least two will die, his/her dear spouse and one of the children, and in their relatives and acquaintances, one grandma will be gone, three cousins also, 11 colleagues too, etc., and that they should prep for this… There will be panic, and deaths because of panic, bad planning, sheer stupidity, greed, etc. How can one do this as when even a doctor tells a person, of whatever intelligence or other emotional/spiritual level, that a loved one will die of cancer, aids, etc., it is impossible to be really prepared for that death. One death, one natural fated death.
I agree we do need to try and get TPTB to do more; I despair that’ll we’ll succeed to a big extent. Small steps might be possible. Perhaps a middle way? No I am not saying we should hide the truth, I am saying to deliver it in small chunks might go a longer way than antagonizing every PTB.
Denial of the worst case scenario? It’s not denial, I wouldn’t call this denial. It’s not denial that something really bad may happen. Not consciously, not subconsciously. One can only deny something which is seen as possible. They are not refusing to see a bad pandemic is possible; they do recognize it is possible. But the human mind is not constructed to encompass the total anihilation (or almost) of the human race. In order to function, humans need hope, even the stupidest kind of hope. If this hope is to say/think “There is nothing I can do, or little that I can do, therefore I won’t do, or I’ll do just the minimal necessary, and I just hope that it will not come to pass, or if it does, I’ll cope as best we can”, then these PTB are not in denial.
They are functioning the same as primal man, man hates change, likes certainty (which is why man/woman go to soothsayers by the way). And “It is easier to function with a bad system, than to change for a better system”.
Maybe this is where we need to punch: make use of the bad system instead of appearing to introduce a better one.
Okieman – at 09:38 — tell you what: I think I might make an effort to read my logic philosophers again, Kant, Critique of Pure Reason, to try and find a definition of truth. I remember vivid discussions in my youth as to what constituted truth.
(Well I AM a woman after all with all shades of truth, omitted truths, good truths, bad truths, truths that resemble lies, lies that resemble truth, lied truths and truthful lies… oh I give up!)
One thing that gets missed by those of you (myself included) who are in the choir, is that a basic trait of most creatures is to ignore a bad source of information. I think it’s called extinction conditioning: if a stimulus is repeatedly presented, with no adverse or pleasant event following, animals and humans tune the stimulus out. As the probability of a pandemic inches upwards, but no pandemic breaks out, the only people hearing “FIRE!!!!” are those in the choir singing it.
Thanks everyone for your kind words. Even more, thanks for not giving into fear and redoubling your efforts to make sure we do absolutely everything we can to get our families and our communities prepared.
Nightowl, I know how much you have done. It is deeply appreciated. You are carrying on the tradition of your family - warning people of the danger they are in.
moeb, I agree, the idea of going down fighting is infinitely preferable to curling up in the fetal position and giving up. Even better is fighting and not going down.
crfullmoon, I have read your posts for a long time. You know as much as I do about what needs to be done. I’m sure there are alot of people who wished they lived in your town.
Okieman, I have also thought of WWII as an analogy. The enemy is different, but total mobilization, total committement, and unflinching courage is necessary. Our grandparents and parents went through deprivation and in some cases, absolute hell. They feared no evil. Can we not do the same?
Each of us has no real choice other than to become leaders. We are too few to be followers. Because we see clearly the threat in front of us, it is our responsibility to do everything we can to prepare our families and our communities. We did not ask to know what we know, but we cannot unknow it or pretend that there is nothing we can do about it. We will be called alarmists, panic-mongers, and flakes. Some of us already have been. But so what? In the balance of life, how do some insults compare to millions of dead? There is no turning back.
Here is what we need form Regulators and Governments.
We understand that we are facing a monster and we know as well as you what that means…
…so give us and our communities the tools that we might have an even chance at surviving this. Set the societal structures in place to give us an even chance.
Tell us with exact words what you can do for our communities and what you can’t…
…and then get the hell out of the way and let us (communities) do what we do best.
We need public security…we need dispensed and stockpiled medications to treat our sick children…we need telephone or internet back-up when we are treating our own at home because we are well aware that hospitals will not be avaliable and we are okay with the knowledge.
We need heat, hydro, water and gasoline supplies…we need to have food avaliable in some form not for a few who can afford it BUT FOR THE WHOLE COMMUNITY.
You do this for us and then leave us alone…don’t interfere… WE WILL HANDLE THE REST PROUDLY.
And sometimes there is a Dunkirk. The news from Indonesia is ominous — but there seems to be some folks with cases surviving/recuperating (so far). I’ll keep talking and prepping but I also am hoping that a plant somewhere has what it takes to defeat this virus (English Ivy? Kudzu? Oil of fire ant?).
Keep on keepin’ on.
FrenchieGirl,
I am *still* not being clear. I do not think everyone in the world must die, even in the worst case scenario. The worst case refers to the CFR, *not* the number who will die. If we reduce the attack rate, ie, the number of people who get infected, we will drastically reduce the absolute number who will die even with a high CFR.
In the first world, I believe we can reduce the attack rate. With adequate planning. This is my point. Telling people what the real worst case scenario is critical to getting adequate resources allocated. The situation is *not* hopeless, even in the worst case scenario.
Tom DVM – at 10:19
Great post. I agree completely!
Monotreme – at 10:26 — Yes, yes, I do understand. But the worst case referring to the CFR still mean that so many would die that the number is unfathomable. I understand we would reduce, with appropriate measures, the number who get infected, therefore reducing the numbers. But even this number is mind-boggling for most… Neither do I believe the situation is hopeless. I debate on what is the most efficient way of getting maximum cooperation, taking account of human nature. Will come back tomorrow, have to go now, won’t be able to log in tonight (hahaha)
FrenchieGirl – at 10:36,
I can’t speak for Europeans, but the best way to get cooperation from North Americans to tell the truth, the whole truth and nothing but the truth. We don’t trust anyone who lies to us, no matter what they claim their motivation is.
Until a new thread is possibly started with quotes, sayings, etc., here is one we all need to put up on the wall where we will see it often:
LITANY OF FEAR
I must not fear. Fear is the mind-killer. Fear is the little-death that brings total obliteration. I will face my fear. I will permit it to pass over me and through me. And when it has gone past, I will turn the inner eye to see its path. Where the fear has gone there will be nothing. Only I will remain.
Monotreme. Thanks.
I just cannot get my head around a 50% CFR. That does not mean that more and more…it is looking like a distinct possibility…
…the potential to be a civilization buster similar to what I read about…land with no owners in Shakespeares time.
Anyway, if it more than a remote possiblility, maybe you could start a thread where we can specifically discuss the changes in infrastructure and preparedness that have to be made with respect to lowering the attack rate for H5N1 …masks gloves and children…etc. etc.
I’m going to jump back to a question by Weaver on the previous thread, sorry for the interuption. I have the complete set of Foxfire books, and they are great, but please remeber that the folks in the books grew up absorbing those skills from day one. Also, these are recollections and some steps of some skills/crafts are left out or assumed by the speaker that you know what they are talking about.
I would strongly recommend, first that you look at the FoxFire Cookbook. It focuses just on food, and food preparation. Its been pretty heavily edited, and while it retains the full flavour of the other books, it is easier to follow than the other books.
Sorry if this is off topic, but I feel these books can be a valuable survival tool.
MnEagle – at 10:46 Good quote, and another series of old friends that I need to hunt down for my SIP book stash. Thanks.
Someone said something about getting his mind around this was like trying to hug a ghost. Yup, that`s says it all to me.I sit and read, and shake my head. Then go to the stores, and buy more provisions.
Monotreme - Stealing a few minutes to reply. I am all for the truth and nothing but the truth. I differ in the way to deliver that truth. At any rate, the truth is “we do not know”. We are asking politicians to commit funds for an incalculable possibility. We cannot be certain of any scenario. Various models have been presented here, we don’t yet have a fuzzy or expert system model, and no model can give us much guidance, because there are as many models as proponents. Politicians are going to be caught in a catch-22 situation: if they do nothing and TSHTF, they’ll be blamed; if they do all they can and TSdoesnotHTF, or it does less than guesstimated, they’ll be blamed. Just as 30 years ago, TPTB acted for swine flu, and flopped… It is not easy to fight with utter conviction but be unable to give certainties. I’ll come back on this subject tomorrow, just now I can’t, Mr. Almost Right is arriving for a while and I must deliver him the perfect sequence: Aperitif/Dinner/Bed/Breakfast/08/2006, since he is a small PTB who could make the difference in his factory… and to my preps also, having both the brains and the means… (hence the “hahaha” above!)
Don’t bother counting them - there are 3750 stars.
(asterisks deleted anon_22)
This is the number of dead as a DIRECT result of the pandemic in your mid-size city of 500,000 in about eight weeks, assuming a 2.5% CFR and a 30% attack rate. The wiki would melt down if I tried to post such a representation at 10% or, God help us, Monotreme’s WCS of 50%.
Thus endeth the lesson. Any questions?
CRAP !
I made side scroll. Sincerest apologies to the mods, please remove.
I am sorry - I made side-scroll. Please delete my post at 12:44.
The Sarge
Frenchie, at 09:59 etc
Thank you for articulating so clearly and with such obvious anguish and sincerity the dilemmas. I feel these dilemmas exactly as you do. I am not in denial. I know exactly what we may be dealing with. I also know from long experiences of working with people that it is not a single simple step to move from knowing the truth to telling the truth.
If I believe that my shouting everything that I know from the rooftop will change people’s minds immediately and significantly, I will have no hesitation in doing so. Just as I have spent long hours and days and weeks ploughing through research and every bit of information, along the way I have agonized many times what are the best ways that I can make a difference. And I have come to the conclusion that shouting from the rooftops or at TPTB is not the most effective way of saving lives.
Those of you who say that TPTB should tell the whole truth (even assuming we agree that scenarios that we extrapolate from models can be depended upon as ‘truths’) may need to consider how many times you yourselves have tried to do that and what are the consequences/results. To say that well, I’m a nobody so people won’t believe me, but political leaders should tell cos they have the authority, is to ignore the widespread skepticism of our leaders in most countries. It doesn’t matter what are the reasons for such skepticism, whether the politicians should bear the responsibility or not, the effect is still the same.
I may be wrong but I also get a sense that those who shout loudest that TPTB should tell the truth are the same ones who most frequently (and shall I say sometimes in a kneejerk way) are the same ones who disbelieve almost everything that comes out of the mouths of officials.
Ah, much better! Thanks Anon_22. And again, my humble apologies.
Monotreme – at 10:26 FrenchieGirl,
“I am *still* not being clear. I do not think everyone in the world must die, even in the worst case scenario. The worst case refers to the CFR, *not* the number who will die. If we reduce the attack rate, ie, the number of people who get infected, we will drastically reduce the absolute number who will die even with a high CFR.
In the first world, I believe we can reduce the attack rate. With adequate planning. This is my point. Telling people what the real worst case scenario is critical to getting adequate resources allocated. The situation is *not* hopeless, even in the worst case scenario.”
Thanks, Mono. This is exactly what I am trying to do in the Efficacy of social distancing measures thread.
It is possible to
Where you and I differ is the ‘handle’ that allow us the voice to influence TPTB to get such policies going. :-)
come anon_22 come over to the dark side ;-)
moeb,
There is no dark side. Only competence, sincerity, courage, conviction, etc. Or lack thereof. And everything in between.
yes of course, but perhaps there is conviction and the will not to play the 2%/25 game. We can be as friendly as necessary yet stand up for our beliefs. we don’t have to irritate the PTB so much as remind them that we are watching and we don’t accept wrong figures
at this point, I believe a little panic could do some good, (in the general population)
the problem you exhibit is lack of conviction.. security and safety in the words scientific peers use. things being said here lend themselves to either you believe it’s going to happen or you don’t. no grey wishy washy. .maybe if (when it’s all too late)
pssst.. a discussion is not a discussion if you don’t reply :-)
a segment of fluwikians was bound to become activist beyond the medium. this activism does not issue marching orders to the whole. embracing and supporting this activism is not subversion of the message, it is an honorable endeavor. it’s a clarion call to believe knowing the facts support that belief. if you accept you act.. if not, then perhaps when you are ready
Everyone et al:
We are all right, but we will move in different directions to accomplish the goal be it one street, or an entire community. I have been on the verge of stomping on someone’s foot to prevent that “look”. The truth is hard to accept and I have given up on people who are too removed to even discuss it without an attitude. I don’t believe SIP will work due to length of time, however, if I had kids I would sip a year if I had to even if they hated me for it. The virus can’t spread without a human to infect. Anon 22′s thread is helpful in that regard. The panic in large cities or dorms when the first case appears will be a wild stampede if people haven’t thought it through, just what steps they will take.
I don’t think the emergency critical people will stay the course while everyone else SIPS if the CFR is high. (The health effects of the 911 workers is well known and everyone of the GC is aware that the death rate in NO is higher that when all the people where there prior to Katrina, and it’s not all due to stress). Will the SIP survivors make sure the critical workers or their families have compensation for the sacrifice of their life or health? Somehow I doubt the survivors will give a da**because they will be trying to move back to normal and forget about it. Critical workers aren’t stupid, they have seen too many examples of being discared after the difficult job is done.
Very few people will volunteer to risk their life for strangers who will shoot at them if they knock on the door. Most, not all, will want to wait it out and that’s why the panic will be worse than it should be. I won’t offer up any quotes to make anyone feel better, this is what I’ve been hearing from those who are expected to stay the course while everyone else is safely tucked away.
Monotreme: I agree with you in everything you say, but people are conditioned as ducksoup noted and I don’t know how you can get around it. TPTB know this and they will stay the course (as we have daily proof) unless citizens basically march in the streets over this…Do you see that happening?
Anon 22 is right in that we have all worked for some credibility on our jobs, me included, and you can hear credibility and trust whack the ground when AF is brought up for discussion.
Most peoples worst case, fall in my likely case scenarios. My worst case approaches when mankind faced extintion in the last ice age. Estimated human population 10,000.
My worst case takes the population down to a range of 1.5 billion to 500 million. Over half of it due to collapse of infrastructure and our dependance upon it.
annon 22. The WHO has repeatedly misrepresented the truth (or in other words lied repeatedly) …sovereign regulators use every false word regurgitated by various persons (talking points) at the WHO as absolute concrete evidence to rationalize doing nothing.
I’m afraid the time for quiet diplomacy is past.
They don’t get it, they didn’t get it and they are not going to get it…and they have to clearly understand that we clearly understand and they can no longer act with impunity…there will be consequences.
Over the past nine years as a whistleblower with respect to food safety, I have seen ‘every trick in the book’…so I can tell you with some expertise that the WHO is using every trick in the book with respect to their actions on lack thereof on H5N1…what they are doing in respect to other diseases…Lord knows.
WE HAVE APPEASED THE WHO FOR LONG ENOUGH…we are professionals, if we do not confront them…then we are in bed with them…and are part of the problem rather than part of the solution!!
I think we need to ignite a wikian grass roots movement within our own communities.If you tend the fire carefully, it will hopefully grow and catch the attention of the media. I have given up trying to talk to folks that do not or are not ready to hear about the pandemic. How do we foster awareness of the issues including the possibility of a high CFR? How do we promote awareness, knowledge about prepping, SIP and an overall understanding of the seriousness of the situation? My own simple step toward this began early this summer in my community. To begin, I made up several hundred small red ribbons and a fact sheet about pandemic flu. I listed some questions (things like what items should I prep? How do I store food? etc. I then listed some websites for answers. Wiki was on the top of my list. I also include web sites and telephone numbers for local,county, city and state government. People, out of curiousity, will visit these sites, I hope. In the process they may learn and share with others. The red ribbons stand for Pandemic Awareness. I seeded these over a 30 mile area. So far I have noticed a few women wearing them in separate grocery stores. I am also thinking of holding a 1 night discussion group at a local lbrary for Pandemic Q and A. I was involved in Nuclear Freeze group ages ago and it turned out to be an example of how powerful a grass roots movement can be. It is sad to see the MSM not doing a better job in getting useful information out to the public.
I, too would like for the PTB to tell the truth at all costs. I have been writing letters to as many as I can think of requesting this. Meanwhile, I am preparing to stay alive through SIP and trying to help others in my community do the same.
It seems to me that the WHO is like the police in most crimes. They seem to arrive after the damage is done. Generally, the police don’t prevent crimes,nor does the WHO seem to be able or willing to stop this pending pandemic.
Tom DVM @ 15:31- However, I agree that we should confront the WHO, because it is the ethical course of action. I wonder if that entity will still exist,post-pandemic.
The media is what defines reality for many people across the globe, IMHO. Perhaps,it would be productive to work through that avenue. Nothing gets an organization’s attention like the press.
If they can spin air, spinning the truth should be a piece of cake.
To clarify- I have ultimate respect for cops. I just mean that they typically only see crime after the victims call them for help.
Science Teacher at 15:42 - Wow, your red ribbon awareness campaign is a fantastic idea (and also the Q and A one). Thank you for sharing these ideas.
Science Teacher- How did you seed the ribbons and info?
Science Teacher - Would you consider starting a Red Ribbon Pandemic Awareness Campaign (or whatever you want to call it) thread?
Thanks, Nightowl!
Prepperbabe, I keep a box of ribbons and letters in my car. Whenever I come across a garage sale, craft fair, community event, I stop and ask if I can leave some; I haven’t been turned down yet. I visited some little league and soccer events and they let me leave them at the counter of the concessions stand. I am always looking for new opportunities.
moeb CFR6248 – at 14:05 “the problem you exhibit is lack of conviction.. security and safety in the words scientific peers use. things being said here lend themselves to either you believe it’s going to happen or you don’t. no grey wishy washy. .maybe if (when it’s all too late)”
Not true. There are lots of grey areas, lots of unknowns.
Just as we say that there is no science that says the CFR has to drop substantially, there is also no science that says the CFR has to stay high.
We just don’t know. No Data is No Data.
To step out and make pronoucements of conviction based on no data is a fast track to discrediting yourself and ruling yourself out of any possibility of making a difference, and giving ammunition to those who would much rather the public not know anything at all.
Leo7 is right in that there is no one right way of approaching this. We will all have to make our own judgements locally as to what is the best approach.
What Science Teacher has been doing is the best of ‘let’s get on with it’. Thank you.
Posted 8/22/2006 7:27 PM ET
USATODAY
“Only four in 10 Americans say they have a family emergency plan, though fewer than a third of those say they have all the needed elements in place.
For many, the cost of accumulating the extra food, water and supplies recommended by the Department of Health and Human Services and the Federal Emergency Management Agency is prohibitive. And then there’s the problem of storage space. “In urban areas, where are they supposed to store those supplies?” Redlener asks. “In New York City apartments, they literally don’t have the room.”
Yet, he says, “the details are not as important as the process. If you sit with your family and go through what you’d do in various scenarios, then when the unexpected happens your mind-set will be better prepared to deal with contingencies.”
Having thought about it ahead of time and made whatever preparations are possible — such as learning CPR, knowing the evacuation plan for your community, deciding a family meeting place or discussing who will pick up the children from school — will give you a head start, Redlener says, even if the reality of the situation is not what was planned for.
“Mental resiliency and the capacity to think on your feet is a skill that can be developed by talking through what you can think of, and reading about it,” he says. “The more you’ve practiced thinking about how you’d respond in unusual circumstances, the better you’ll respond when the unexpected circumstance arises.” (EXCERPT)
_________________
“… down the telegraph wires would come these almost unbelievable stories”. 1918 Pandemic (My dad was a survivor)
Tom DVM – at 15:31 wrote”
“Over the past nine years as a whistleblower with respect to food safety, I have seen ‘every trick in the book’…so I can tell you with some expertise that the WHO is using every trick in the book with respect to their actions on lack thereof on H5N1…what they are doing in respect to other diseases…Lord knows.”
Tom raises excellent points from my perspective . We’ve both walked down the same path. He could not have expressed himself more eloquently. If there are any doubts, seek out Sniffles and “Plan for the Pandemics”, a fellow comrade-in-arms. (just Google)
anon_22 and FrenchieGirl,
A couple of comments. First, the issue that I am raising is not what the final CFR will be, I agree we don’t know what that will be. The question is: Is 2% the worst case scenario? Is there any reason to beleive that that 2% is the biological limit for how lethal H5N1 could be as a pandemic strain? I believe to that answer is an unequivocal: NO!
There are no shades of grey on that one. Either you think 2% is the limit or you don’t. And anon_22, I believe you are with me in thinking 2% is not the worst case scenario.
Quite frankly, I think the people who suggest 2% is the worst case scenario are one or more of the following:
A. uninformed B. in denial C. intellectually lazy D. stupid E. liars
Sorry to be so harsh, but I that’s what I think.
WHO and CDC epidemiologists, pick which adjective applies to you.
Is there any way to even guess an upper bound CFR? I think the CFR from official data in Indonesia is about 3/4 (75%) and perhaps 2/3 (67%) world wide. Some still argue that a virus that “learns” to be transmitted more easily SHOULD become less lethal. I see the logic, but have not yet seen the virus agree with it. Could any scientists wigh in?
Next point. What is the best way to get TPTB to take the real worst case scenario seriously? It occurs to me that there may be cultural differences here. Americans are famous for their brashness and lack of subtlty. Consider me a type specimen. Europeans and Asians are more subtle, more diplomatic.
However, let me ask this question: FrenchieGirl, how much success have you had convincing the French government to prepare using subtle techniques? anon_22, same question with regard to the UK.
The US has had Michael Osterholm, who, diplomatically, has been shouting his lungs out warning the US government to get ready. My opinion, the US is better prepared than France or the UK as a result.
People tried to get the sequences released using diplomatic language. This approach failed miserably. But when the blogosphere rudely and insistently demanded that the sequences be released, a few journalists and scientists noticed (I think). There were then some polite, but blunt stories regarding the failure to release sequences.
Finally, many of the sequences were released. Co-incidence? I don’t think so.
It is my opinion that the only way we can get TPTB to prepare for the real worst case scenario is by making as much, and probably more noise as we made regarding the sequences. Those who prefer a more subtle approach are welcome to keep trying. I wish you luck.
Third point. CFR vs. Attack rate. This one is for you, The Sarge. Both these variables affect the final mortality rate. I believe we will not be able to do much about the CFR because we will not have enough Tamiflu or vaccines until long after the first wave is over. Bummer. But there is alot we can do about the attack rate. Theoretically, if the CFR was 100% and the attack rate was 0%, the number dead would be 0.
30–50% is often assumed to be the attack rate. This is a variable not a constant! We can reduce it. This is where we should focus our efforts. anon_22, I know this was your point with the Social Distancing thread. We should continue to pursue this. My point is that we will never, ever get the necessary resources for effective SIP without substantial investment from TPTB. And we won’t get that without extraordinary pressure from their constituents.
INFOMASS – at 21:38
I am a scientist, but not a virologist or epidemiologist. Below, I have copied a post from this thead:
[http://www.fluwikie2.com/pmwiki.php?n=Forum.MustAPanFluDecreaseInLethality|Must a Pandemic Strain of Influenza decrease in lethality?]]
which I started on May 1 2006. Hope it is helpful.
Must a Pandemic Strain of Influenza decrease in lethality?
This is a question that has been addressed several times on this forum, but new data prompts me to consider the question once again. We now know that H5N1 truly is a highly lethal virus in humans. The recent release of seroprevalence data has established this as fact. The arugment that a flu virus must avoid killing its host has been discussed extensively. My conclusion is that this is not true because virus is shed before the host becomes ill, so there is no selective pressure to spare the host. Additional recent evidence, and a rethinking of the genomic structure of influenza viruses provides additional reasons to think that H5N1 may be able to retain a very high level of lethality when/if it becomes a pandemic strain.
Influenza is an unusual virus in that its genes are separated into 8 distinct segments. The hemagluttin gene (HA) is responsible for entry of the virus into the host cell. It is also likely that this gene is important for initiating a pandemic as it must acquire the ability to infect the upper respiratory system in order to be transmitted efficiently between humans in respiratory droplets.
Viruses evolve via 3 mechanisms - random mutation, reassortment and recombination. Reassortment involves exchange of entire viral genomic segments while recombination involves exchange of subsegments. However, regardless of how H5N1 evolves, because of its segmented genome, HAs can change independently of other H5N1 genes. Recent studies demonstrate that this viral gene swapping occurs much more often in influenza viruses than was previously thought. Thus, H5N1 could acquire an HA adapted for efficient spread of virus without affecting the other genes in its genome. Thus, the question of which genes contribute to its virulence become key in understanding its potential lethality as a pandemic strain.
Both the polymerase gene complex and NS1 are thought to be major contributors to the high lethality of H5N1. They are not on the same genomic segment as HA. So, there is no reason to think that a change in the HA gene that permitted efficient human to human spread would affect the lethality of the virus, at least that part of the lethality that is due to genes other than HA.
There is still much we don’t understand about influenza viruses, so there may constraints in its behaviour that put an upper limit on its lethality in pandemic strains. But if so, we have no evidence of them that I am aware of. We have concrete reasons to think that the virus may be much more lethal than the 1918 virus. Yet, all our official planning is based on the assumption that a 2.5% fatality rate is the maximum. I would argue that, based on the available evidence, not only is a much higher fatality rate the true worst case scenario, it’s the most likely scenario if H5N1 becomes a panflu.
References
The polymerase complex genes contribute to the high virulence of the human H5N1 influenza virus isolate A/Vietnam/1203/04
Pathogenesis of Hong Kong H5N1 influenza virus NS gene reassortants in mice: the role of cytokines and B- and T-cell responses
The NS1 gene of H5N1 influenza viruses circumvents the host anti-viral cytokine responses
Whole-Genome Analysis of Human Influenza A Virus Reveals Multiple Persistent Lineages and Reassortment among Recent H3N2 Viruses
INFOMASS – at 21:38
I am a scientist, but not a virologist or epidemiologist. Below, I have copied a post from this thead:
Must a Pandemic Strain of Influenza decrease in lethality?
which I started on May 1 2006. Hope it is helpful.
Must a Pandemic Strain of Influenza decrease in lethality?
This is a question that has been addressed several times on this forum, but new data prompts me to consider the question once again. We now know that H5N1 truly is a highly lethal virus in humans. The recent release of seroprevalence data has established this as fact. The arugment that a flu virus must avoid killing its host has been discussed extensively. My conclusion is that this is not true because virus is shed before the host becomes ill, so there is no selective pressure to spare the host. Additional recent evidence, and a rethinking of the genomic structure of influenza viruses provides additional reasons to think that H5N1 may be able to retain a very high level of lethality when/if it becomes a pandemic strain.
Influenza is an unusual virus in that its genes are separated into 8 distinct segments. The hemagluttin gene (HA) is responsible for entry of the virus into the host cell. It is also likely that this gene is important for initiating a pandemic as it must acquire the ability to infect the upper respiratory system in order to be transmitted efficiently between humans in respiratory droplets.
Viruses evolve via 3 mechanisms - random mutation, reassortment and recombination. Reassortment involves exchange of entire viral genomic segments while recombination involves exchange of subsegments. However, regardless of how H5N1 evolves, because of its segmented genome, HAs can change independently of other H5N1 genes. Recent studies demonstrate that this viral gene swapping occurs much more often in influenza viruses than was previously thought. Thus, H5N1 could acquire an HA adapted for efficient spread of virus without affecting the other genes in its genome. Thus, the question of which genes contribute to its virulence become key in understanding its potential lethality as a pandemic strain.
Both the polymerase gene complex and NS1 are thought to be major contributors to the high lethality of H5N1. They are not on the same genomic segment as HA. So, there is no reason to think that a change in the HA gene that permitted efficient human to human spread would affect the lethality of the virus, at least that part of the lethality that is due to genes other than HA.
There is still much we don’t understand about influenza viruses, so there may constraints in its behaviour that put an upper limit on its lethality in pandemic strains. But if so, we have no evidence of them that I am aware of. We have concrete reasons to think that the virus may be much more lethal than the 1918 virus. Yet, all our official planning is based on the assumption that a 2.5% fatality rate is the maximum. I would argue that, based on the available evidence, not only is a much higher fatality rate the true worst case scenario, it’s the most likely scenario if H5N1 becomes a panflu.
References
The polymerase complex genes contribute to the high virulence of the human H5N1 influenza virus isolate A/Vietnam/1203/04
Pathogenesis of Hong Kong H5N1 influenza virus NS gene reassortants in mice: the role of cytokines and B- and T-cell responses
The NS1 gene of H5N1 influenza viruses circumvents the host anti-viral cytokine responses
Whole-Genome Analysis of Human Influenza A Virus Reveals Multiple Persistent Lineages and Reassortment among Recent H3N2 Viruses
Monotreme – at 21:41
“People tried to get the sequences released using diplomatic language. This approach failed miserably. But when the blogosphere rudely and insistently demanded that the sequences be released, a few journalists and scientists noticed (I think). There were then some polite, but blunt stories regarding the failure to release sequences.
Finally, many of the sequences were released. Co-incidence? I don’t think so.
The Indonesian government, when making the announcement for releasing the sequences, stated that “people were complaining, and we are trying to comply (or something to that effect)”.
It is my opinion that the only way we can get TPTB to prepare for the real worst case scenario is by making as much, and probably more noise as we made regarding the sequences.
Squeaking wheel does get the grease, especially when the case is so compelling. If people on this forum are shy or worry about consequences, think about the 8 Chinese scientists who submitted the story about the misdiagnosed SARS case to the New England Journal of Medicine, and stood by it.
The world is running out of time, and we cannot afford another tsunami, or Katrina to happen without at least Shouting at the Top of our Lungs. Think about the conscience you have to deal with when pandemic hits, or the what I could have done nightmare that you have to live with for the rest of your life, assuming you survive.
The scientists bound by contractual gag orders will be forever grateful to us. They won’t say we are usurping their authority. We are way past that point.
We don’t want our history to be written in the blood of the next pandemic victims. Do something about it.
Nightowl, I would be happy to share my ideas about a red ribbon Pandemic Awareness campaign. I will start a thread tomorrow.
Monotreme, I agree with your points also. Perhaps another petition like the free the sequence one to send to the PTB. Maybe looking into collecting funds to purchase a one page statement in a major paper. We could use the skills of a PR person to get the message out even if we have to pay for the space in the beginning. We need to learn how to harness group power on this site and someone like you to focus the action so that it will move from a thinking to doing mode of response. Would you have time for this role?
Monotreme@ 21:30 The true answer is… F. All the above. One of my favorite quotes…”The squeeky wheel always gets the oil.” gina
Klatu 20:34 Thank you for your kind comments. I did make a mistake in that post…I got my sevens and nines mixed up…I had my first direct involvement in food safety other than as a veterinarian in 1999 which would mean that my experience as a whistleblower has been seven rather than nine years. Thanks again.
Monotreme. Are we talking about another Worms of Weybridge…YaHoo!!
However, first we need to discuss something. You have probably already read my comments versus what I believe is an incorrect attack rate. If the world’s populace is an ‘immunologic virgin’ concerning H5N1, then I do not believe the attack rate will be 30% and I do not believe the attack rate in 1918 was 30%…but more likely 70%.
The fact that the first wave was mild in 1918 allowed a natural immunization of thirty percent of the population before the lethal wave hit…there is no garuntee that that will happen this time which means a realistic attack rate would be 70–85% as with small pox and other viruses in new populations.
I do not believe we can significantly change that attack rate when all of the preventative steps are being downplayed by regulators and it will be very difficult to get children to follow protocols.
I am with you…I just think we need to sort this one out.
ANON-YYZ, Science Teacher and Hurricane Alley RN,
We are all on the same page on this one.
I have just started a new thread called Community Preps for the Worst Case Scenario. My suggestion is that we all work on this for a while. Outline the problems and what we think the solutions are. Then we develop strategies to address each issue. Then we make some noise.
A multipronged approach was used to get the sequences released. I think this will also be necessary to get our communities prepared.
Tom DVM,
You may be right about a higher attack rate. If we do nothing. So, let’s figure out how to get that attack rate down. Which mostly means finding out how to allow people to SIP without starving, dying of thirst or freezing to death.
See you over at the Community Preps thread!
Monotreme and Science Teacher—Great ideas and I’m behind both of you!
Right on Lets go kick some ‘grgrgrgrgr’!!!!
anon_22 – at 20:13: “We just don’t know. No Data is No Data.”
No data is a lie.
Did I miss it or is 100% attack rate and 100% CFR the worst case? In that case you will find me flying a kite with my granddaughter.
As my DH so blatantly put it, there are too many stupid people in this world. There is no way to stop the attack rate. The world does not stop spinning. Monotreme, you are highly intelligent, as are most people here. However, you are greatly outnumbered by stupid people. They are not just ignorant and uninformed, they are just plain stupid.
I’m not saying give up. My instincts are to survive. My survival instincts are telling me what to do. I’m not going to count on anyone slowing or stopping the attack rate. If you can do it, more power to you. If we have a few more years, it might work. My feelings are that we don’t have that much time and you will never “get” to them in time.
Sorry to sound pessimistic, but I do feel that way lately.
I am reading the book “Black November” about the 1918 flu pandemic in New Zealand and, although I am only half way through, there are some significant points of note.
First, no-one was expecting the flu (compare with the warning we have now) so personal preparations were sparse (read nil). Communities rallied to ensure food and help was there for the sick. Special arrangements were made to care for children in households where parents or caregivers were unwell.
Second, the Armistice parades took place just as the flu hit so there was huge social interaction, which was recognised as the greatest source of flu spread. Towns that immediately enforced closures of theatres, schools etc, had a lower attack rate ongoing. Many cancelled community events, including church services. to achieve this. The then Minister of Health was against these moves as he insisted that low morale would be the real killer and people needed events (shows etc) to keep them busy and happy (he was severely criticised for this).
Third, towns and communities that introduced the ‘grid system’ for checking households for illness and obtaining medical assistance in a timely manner lowered the CFR and the attack rate. Moving the very sick to specially set up treatment centres gave them the best chance of survival and removed the infection source from the community. As soon as people showed any sign of illness, the ‘catch-cry’ was lots of fluids in, lots of fluids out. Home nursing care often involved giving a lot of boiled water and castor oil (keep the bowels open) and frequent spongeing to lower the temperature. No solid food was allowed and, as patients improved, broths and beef tea were given.
Fourth, it seems that, in most communities, the majority of people who were able, responded to the calls for volunteers to help with the sick and needy. Most helpers became sick with exhaustion than from the flu.
There are several books about experiences in the 1918 pandemic from which we can individually and collectively learn. What stands out to me is that the real effort came from grass roots level while TPTB procrastinated or made ineffective decisions. What I am seeing here at the Wiki is that nothing has changed - we are the grass roots level. So, we are the ones who can make the real effort.
Perhaps we could try a “Snowball Waltz” approach where each of us just helps one other person to prepare and they then go and help one more person and so on. If I am capable of infecting 2 or more people with the flu, am I also capable of stopping just one more person from not suffering with the flu?
Monotreme: Thank you for the CFR max citation and sorry to have missed the May 1st thread. By that reasoning, the fatality rate would depend on random genetic differences in those infected, but a very high percentage of the sick might very well die. I suppose that the particular strain(s) that evolve and infect would also make some difference. I agree that the best hope if the virus goes pandemic in the next flu season is staying at home and closing as many public venues as possible. While we tend to give up on government, the delivery of basic food rations on the front step or door might be one way to reduce exposure and this could be arranged locally or through churches. The delivery people might have some masks/gloves/goggles to help reduce their exposure. Of course, this assumes heat, power, water, phones, etc. would still work.
Monotreme at 21:48 -
Re: the attack rate. I am with you, and I am aware that the attack rate is a variable, just as is the CFR. I picked 30% because, like the CFR, we can only guess at what the attack rate may be in the coming pandemic. Sure, It could be much higher. I doubt it would be much lower - my guess is probably not less than about 20–25% as a lower limit.
However, I am pursuaded by, I believe it was Racter, that we haven’t previously seen the attack rate go much higher either. I would guess an upper limit of around 40–50%. I picked an intuitive median (IOW guessed). Still this is a fairly significant range when translated into the ultimate numbers of casualties.
I am in agreement with you, and probably with Tom DVM that old-fashioned infection comtrol measures such as distancing, hygeine and in some situations PPE can and must be applied to lower the attack rate, as we are unlikely to have effective interventions that will appreciably lower the CFR.
I am also in agreement with you that there is absolutely no reason to assume that the CFR will come down concurrent with the develoment of efficient H2H transmission. It would be good if that did happen, but to assume so is unwarranted wishful thinking. I do know that pandemic planning being conducted by government agencies is predicated on a CFR that is at or in some cases much lower than the 2.5% attrributed to the 1918 flu. That is in part based on the perception that 1918 was the most severe pandemic in modern history and; that beyond this figure, IMHO, the mind simply boggles and we are incapable of imagining measures for an effective response.
Yes, things could indeed be very much worse than TPTB portray. Their worst case scenario should rally be read as “the worst case that we can imagine we have even the remotest chance of dealing with”.
The Sarge. I agree with every word…with respect to estimates of CFR in 1918…I’m afraid that they were low and inaccurate as with the mortality estimates that now appear to have been out by more then a factor of ten.
My father was in the second world war…came home and never said one word about it…even when asked…
…I think the pandemic in 1918 was the same thing…I have known many people who lived through it and not one word was spoken…
…I think it was for the same reason…having survived it the last thing one would ever want to do is talk about it and bring back bad memories.
The point is that the attack rate in 1918 timeframe was probably 85 % not 25%.
Tom DVM -
It would seem to me that the attack rate is an elusive target, and depends greatly on a host of social and epidemilogical factors. In crowded group living conditions, like college dorms, long term care facilities, military barracks and prisons, I could easily imagine an 85% rate absent some drastic control measures. The same is true to an extent in heavily urbanized areas, especially with crowded and unsanitary housing, or heavy reliance on jam-packed public transit systems. Just look what happens with cholera, diptheria, novoviruses, c. difficile, Tuberculosis, MRSA and a plethora of other diseases. I would think that panflu would be like any other disease in that it thrives best in conditions of poverty, lack of education, war and famine.
As population density and interpersonal contacts decrease, so must attack rate, IMHO, or at least the attack is spread out over time. Thus, the aggregate drops. This is deceptive though, because the impact is very uneven. It may be slight to moderate in some places, and absolutely Old Testament catastrophic in others.
And, in addition to the social and epidemiological factors, there is the unknown quantity of how well our new ‘friend’ likes us as a host, and how well it spreads in airborne transmission - will it be through contact and fomites, droplets or; real true airborne with a low infective dose and a long and lingering half-life in air? I think we need some serious research in the area of airborne half-life and infectious dose. The problem is, there are precious few labs that can undertake this sort of study - it is just the sort of work that bioweaponeers do. Your average university lab is unlikely to have a toroid chamber inside of BSL 4 containment…
Sarge. If we are to conceptualize avoiding a ‘freak’ like H5N1 then we must conceptualize avoiding the many ‘cold’ viruses that circulate each year…sometimes I can get them in the afternoon after being out in the morning and have no idea how I was infected…now add children to the mix.
I believe that extended (more than a few weeks) SIP is not an option for 99.99% of the population. It would take a high degree of discipline to maintain it for any period of time…in some ways a heartless job.
I think we can live with this virus in our environment but we cannot do it without stockpiles of N 95 masks, gloves, and retrofitting public spaces to help in disease avoidance…
…What has the Government and my favorite regulator been doing for two years?…downplaying and not stockpiling masks because they are afraid what it might do to tourism or business or public confidence.
We can beat this thing…but they are going to have to smarten up!! and regulate and govern in the best interests of our children rather than for ‘the corporation’…and believe me, I have seven years of experience with regulators choosing trade and cooperations over health!!
Hi all. I won’t have time for a discourse today. Just a little question. Along the various discussions, some have pondered the fact that some particular individual genetic trait may afford some protection (as in malaria or HIV). How about if some particular genetic trait may increase susceptibility (as we’d discussed about the Karo ‘familial’ cluster or Turkey’s)? That’s possible, isn’t it? How could one integrate this variable in The Sarge’s list of arguments (poverty, promiscuity, etc.) for the calculation of a CFR figure (since many of us are in denial ;-) and need to be absolutely convinced of the worst possible CFR)?
On my way down the shore, and dropped in to see what is going on before leaving. I have always thought there was a genetic reason for some people getting the virus. I’ve said it before, in numerous ways. Reasoning is this. So many people have been culling infected birds without proper protection. Children playing with the discarded birds in Africa. Contact, contact, contact…. no avian flu. I also thought that blood relatives were disproportionaly affected. Non scientific, layman reasoning. Some common genetic trait seems most likely to predispose them to be a host to the virus.
Question to Monotreme, et al.
A link was posted to another thread with some estimates for the attack and CFR if an outbreak occurred in Michigan. The numbers work out to a 30% attack rate (roughly) and a CFR of 0.44% (0.0044 - forty four hundredths of a percent). I have seen this figure used repeatedly in pandemic estimates. Does anyone have any idea where this comes from? It seems a preety big stretch to expect a disease that is currently killing 60% or more of cases to drop down to that sort of level.
Reader – at 02:42 anon_22 – at 20:13: “We just don’t know. No Data is No Data.
No data is a lie.”
Really? Show me where you find data that tells you for sure what the CFR is going to be if we have a pandemic with H5N1.
Cos I want to know, if there is such data.
Absent of that, it is accurate to say “we don’t know”.
HOW one does that is entirely a matter of individual choice. I expect and respect such choices.
But it doesn’t take away the fact that we do not know whether the CFR is going to be 0.8%, 2% 50% or 80%. It is all guesswork. We can differ philosophically and strategically about how to make the best guesses and to deal with uncertainty.
As anonymous posters on the internet, you can say whatever you want and have few consequences. In real life, it is more important to be accurate in what you say, if you want to retain the ability to affect policy.
It is accurate to say the current CFR with H5N1 infections is 55%. There is no indication that if we have a pandemic the CFR has to drop. It may, it may not. We can’t say for sure.
No Data is No Data. I still stand by that.
Monotreme,
I don’t know which thread it was but I think you wrote something about Ferguson’s paper and how it’s been pulled or something. I didn’t post about it at the time now I can’t find that comment.
Anyway, what it was was Ferguson realized he made an important mistake in the Sep 2005 paper, which he corrected in his comments in his april 06 paper, saying that the attack rate should be 68% not 50%, so that the clinical attack rate at 50% of that should be 34%.
Which is weird way of correcting a mistake in a paper.
Just FYI.
I’m sorry but if you step in front of an oncoming bus, should I yell out “Hey Step Back” or say “have a nice trip” I mean we don’t know the driver might see you and stop?
(small wink) I follow your particular train of thought on this.. so
moeb ?
yes?
Don’t understand your comments. In case you were responding to my posts.
oh I’m sorry I guess I should have addressed that to you directly… I’m just teasing you anyway (politely)
you don’t? hmmmm double hmmmmm well there’s this big dark black beastly bus thing (an analogy of course) you are in it’s headlights and those it runs over
you know this stuff (sheese)
so?
we have to save the trains, farms and food processing plants… the rest will follow
agreed.
love your thought process :-) (processing that is)
anon_22 – at 20:17
But it doesn’t take away the fact that we do not know whether the CFR is going to be 0.8%, 2% 50% or 80%.
True, but that is not the point we are making on this thread. The question is: Is it appropriate to say that the worst case scenario is a 2% CFR and to tell people that this the worst they should plan for. My opinion is that the answer to this question is no.
The epidemiologists who say this are hacks, IMO. Dangerously stupid and/or in denial. And their incompetence may get a lot of people killed. Time we made this very clear.
Monotreme,
Who is saying the worst case scenario is 2%?
anon_22 – at 20:17
It is accurate to say the current CFR with H5N1 infections is 55%. There is no indication that if we have a pandemic the CFR has to drop. It may, it may not. We can’t say for sure.
Actually the CFR for 2003 to date is 58.5 total avg. The 2006 total avg. is 66.6666, an ominous number. And the CFR for Indonesia for 2006 (put on your peril sensitive sunglasses) is 81.4
We can look at the total to date number, but I think the 2006 numbers are better to use since you want to know what it is doing now.
Oremus,
Well, yes. Thanks for being so exact. I don’t know that I am capable of keeping such exact numbers.
I AM, however, watching the developing Indonesian situation with concern. I have a feeling something different is happening. But I haven’t gotten far enough to be sure what it might mean. In any case, its not good news.
Monotreme – at 21:41
“However, let me ask this question: FrenchieGirl, how much success have you had convincing the French government to prepare using subtle techniques? anon_22, same question with regard to the UK.”
You don’t know what else I do. And you don’t know who I talk to.
I will only say on a public forum that in the past few months I have spoken to many many people. And my opinions are partly based on the responses that I get.
But, as I have already said, we can agree to disagree, that each person has different ways of dealing with this.
We, or at least I, do not have a need to have everyone else behave the way I do.
The worst case scenario certainly is not 2% (it’s worse). We don’t know what it is, when or even if it will happen.
It is therefore prudent to plan the way we do and the way we are. We will all feel we didn’t do enough should such a catastophe hit, no matter what we have tried to do beforehand. But we are not unanimous about much of the above and never have been.
Just saying… sometimes it seems there are no contrary voices heard. ;-)
From the WHO itself:
“7. Large numbers of deaths will occur.
Historically, the number of deaths during a pandemic has varied greatly. Death rates are largely determined by four factors: the number of people who become infected, the virulence of the virus, the underlying characteristics and vulnerability of affected populations, and the effectiveness of preventive measures. Accurate predictions of mortality cannot be made before the pandemic virus emerges and begins to spread. All estimates of the number of deaths are purely speculative.
WHO has used a relatively conservative estimate – from 2 million to 7.4 million deaths – because it provides a useful and plausible planning target. This estimate is based on the comparatively mild 1957 pandemic. Estimates based on a more virulent virus, closer to the one seen in 1918, have been made and are much higher. However, the 1918 pandemic was considered exceptional.”
It is my view that this information is what is firmly entrenched in the minds of many as “the worst case.” Shocking and frightening to me that WHO is peddling this when so many people, organizations, and governments are relying on them.
Hi everyone. Probably for the first time, I can’t figure out what you guys are up to but that won’t stop me from commmenting anyway /:0)
I would like to discuss this no data is no data stuff. Data only becomes avaliable after the fact so unless we are planning to prep after the event I think a good deal of science and health requires accurate prediction…
…and as Oremus has clearly demonstrated, we actually have ten years of solid data as well as circumstancial evidence on which to make some preditions.
There is a thunder storm on the horizon…we have no data…we know that thunderstorms have done in the past although we only have to recent mild ones with real accurate data…so I guess this one that is coming is going to be mild like the rest…of course we heard of that bad thunderstorm a long time ago but it was a long time ago and our forecasting has improved significantly…so as the clouds look more and more ominous I am standing outside my house with no data…PARALYSED.
Nope, We have lots of data…lets get the best scientists in the world, stick them in a room and make them give us solid numbers (See gs I have been listening to you)(come back come back wherever you are)
Thats how you sell prepping to the public!!
anon_22 – at 21:35
Who is saying the worst case scenario is 2%?
Um, the US government. This is the official worst case scenario.
DemFromCT – at 22:14
The worst case scenario certainly is not 2% (it’s worse). We don’t know what it is, when or even if it will happen.
This all I have been trying to say. Unfortunately, all planning in the US is based on the 2% number.
Monotreme. I respectfully disagree with you…wasn’t the planning based on the .44% CFR based on that Jan 2005 2–7 million stinker they tried to pass off.
anon_22 – at 22:02
You don’t know what else I do. And you don’t know who I talk to.
All I know is what you say on FluWiki, and sometimes you say things like this;
I will only say on a public forum that in the past few months I have spoken to many many people. And my opinions are partly based on the responses that I get.
Which leads me to think that you think a subtle approach is the most effective. And I would suggest that that is not borne out by the results. The UK does not have a Michael Osterholm equivalent, ie, someone who is very loud about the need to prepare. The UK is in even worse shape, much worse shape in terms of preparation than the US. I think you have said that yourself. I would suggest that these two facts are not coincidences.
Monotreme – at 23:37 anon_22 – at 21:35
“Who is saying the worst case scenario is 2%?
Um, the US government. This is the official worst case scenario.”
OK, just as long as you didn’t think I was saying that. :-)
Nightowl – at 22:33,
Exactly right.
Tom DVM,the .44% is the number the CDC used to use. They told all the states to plan based on this number. Early in 2006, they started giving out new instructions. They told the states to plan for a 2% CFR. They portrayed this as planning for the absolute worst, something very unlikely. Some state health departments are still using the old number for planning purposes. Mostly out of confusion, I suspect.
I don’t know what the situation is like in Canada.
anon_22 – at 23:44,
I know you don’t think the worst case is 2%. The problem is every state and locality in the US believes that 2% is the worst case because that is what the CDC is telling them.
Monotreme. Thanks. I stand corrected.
Here in Canada you ask?
Oh, we have to take a unique approach to everything…I will let you use your imagination.
Monotreme. I think part of the problem is that 1) they still think it won’t happen or 2) it is not going to happen for ten years or 1)&2) it won’t happen while I am in a position of authority!!
Sorry, should have said or 1) and 2) it won’t happen while I am in a postion of responsibility!!
What we can observe at this point is that the CFR appeasrs to be increasing. Does this tell us anything? It does me, and I am acting accordingly, I am revising plans. I don’t think history will be unkind to those who choose to err on the side of saving lives. Somebody has to take a stand.
Monotreme,
This is just an aside. Officials are confused about many things, and the CFR is only one of many things that cause the confusion. Some of the planning scenarios are so far off the mark that it makes me want to bang my head against the wall in frustration. And I am talking about the US. Sorry can’t get more specific on this.
The biggest obstacle at the moment IMHO is the disconnectedness of the efforts. The most frequently expressed comment I have heard is “no one is telling us what to do”. And frankly most are working on this on top of whatever their normal workload is, which means even those with the best will find it hard to find the time to do it properly. And if you are pushing it earnestly, you still need other people to be on the same page, which seems to be the exception rather than the rule.
Monotreme,
You are assuming the US being where it is is due to Osterholm going public with worst case scenarios. I like the guy, I admire the things that he does. But I doubt that your president would have been convinced about anything without Katrina.
You raise a good point about the UK being in worse shape. But you were not there to read the headlines when BF was first discovered there. There were more headlines about scaremongering than about what the problem was. So giving the numbers that you give is a non-starter. My observations there is the major reason why I suggest caution when using worst case scenarios.
(BTW suggesting caution doesn’t mean I’m against what other folks are suggesting. I am only suggesting caution.)
Plus the UK has a unique set of political circumstances currently that makes anything to do with pandemic prep particularly hard to get through - the waning power of Tony Blair, the ambitions of Gordon Brown who is in great fear of being discredited because of his disastrous policies of increasing NHS funding by 1/3 with almost no improvement in results, so anything that may include more money or scrutiny of the state of the NHS gets blocked from the very top.
It is never as straight-forward as how we want it to be.
anon_22, I agree about the disjointedness of the effort in the US. This is partly due to ignorance, most politicians know nothing of science, and partly due to the normal focus on short term political objectives.
However, this problem is made infinitely worse by the low-ball worst case scenario put out by the WHO and the CDC. If they had the brains and/or courage to point out the real worst case scenario, it would provide cover for the politicians to allocate resources and to take planning seriously.
I can’t tell you how many times I have spoken to a local official/medico who responds to my concerns by replying: “But the CDC says…” And who am I to question the wisdom of the CDC.
Perhaps if we break it down into numbers people can deal with, not in terms of the whole population. I have a little more luck when I tell someone to think of their 10 closest family and friends. Out of those 10 people, 5 will get very sick (that’s a 50% attack rate). Out of those 5 people, 3 will die (that’s about a 62% CFR). The likelihood of those 3 being in the age group of 1 to 30 is great, so pick 3 out of your 10 closest family and friends in that age group. It has to relate to the individual or it will always be someone else.
anon_22 – at 20:17, there is a lot of data we don’t get privy to. Just a while back, they released a study where !1! out of 50 or more possible combinations was having a hard time combining with everyday viruses (or is it viri). I would certainly think that we should get all the results, but we got !1!. I’m talking about all the data that is not released, I’m pretty sure there is a lot and the worse it is, the less likely we are to hear about it.
Monotreme – at 00:45
“who am I to question the wisdom of the CDC. “
It’s “what argument it is that challenges the wisdom of the CDC?”
It’s publishing the flaws of he basis (or lack) of the wisdom of the CDC.
I had made my guess earlier in this thread about the possible death rate, attack rate etc. Today went into the largest hospital in Las Vagas to visit a brother-in-law that is in serious condition due to blood aspirated from a surgegal procedure on his throat and he has pneumonia now bad. ALthough I was a medic (at an earlier time in my fire service career), and was around hospitals at that time, of course I was not thinking of a flu pandemic, but seeing this man in the hospital, and most of the ICU unit full of all aspects of sickness (heart attacks, strokes, accidents etc), my wife and I talked about what would happen in the Las Vegas hospitals with even a low attack rate of 5%,,,,,,and believe me even at that low number (and for the life of me I cannot understand how it could go that low dealing with the history of the avian flu), the hospitals will be a mess and will become a “zone of death” so much worse. Brother in law is lucky that they had a ventilator to use,,,,but if he did not have it,,he would have NO CHANCE and that is the way it will be with most of the serious infections of the avian flu. Wish I did have a crystal ball though, to check what the attack rate will be and the death rate will be, but all we can do is speculate,,,but I would speculate on the higher side of 5% and above, and even with that scenario the cities will fall apart.
I look at the latest news out of Indonesia, both with awareness and with speculation, due to the amount of live stock (birds - chickens, geese, ducks, etc) that the population has in their hands. As the news that more and more people are getting infected, I try to pay particular attention on the hows that the diease is transmitted to them but it does seem that the some of the latest news carring this information, “Cities in Indonesia are falling like dominos to bird flu: Garut in West Java, then Kendari in Southeast Sulawesi, then Dairi, Serang, and finally Simalungun in North Sumatra….”, that I am keeping a close eye on any news I can find. On the ABC evening news, not a word was mentioned about the spreading flu in Indonesia but they did mention New Orleans again. The American media again seems to be asleep at the desk, and is waiting for what a REAL PANDEMIC? Go figure!
Gary Near Death Valley,
I have also noticed the quiteness of the MSM on the Indonesian situation. It’s surreal.
Gary in DV: my wife and I talked about what would happen in the Las Vegas hospitals with even a low attack rate of 5%,,,,,,and believe me even at that low number (and for the life of me I cannot understand how it could go that low dealing with the history of the avian flu), the hospitals will be a mess and will become a “zone of death” so much worse.
“Modern” medicine will devolve back to 1918 (or beyond) for strictly pallative care.
There is no way around it.
It’s just how it’s going to be. We’re not going to be ready.
The faster we can make that adjustment reaction NOW, the better off we will be if/when a pandemic hits.
It’s also a teachable moment that shouldn’t be lost.
Strict quarantine SIP is going to be the ONLY way you MAY dodge this beast. Notice I said MAY, not WILL.
Reader – at 01:11
Thanks for the “breakdown”, that is just really simplistic and on target! And… you are correct about the data, IMHO.
Gary Near Death Valley & Monotreme: sleep & quiteness???? It’s beyond that. What would you call the willful withholding of pertinent information (by the very people who are supposedly the info pipeline) that would benefit citizens? And “why” would it be done (on several tiers)? It’s de ja vu - ish.
About surreal… I find it very “surreal” to be someone who seems to “see” this. There are times, or days, that this surreality overwhelms me and I want so badly to be “like them.” Most of the time, I know I must work diligently to prepare for this… not just for myself.
BirdGuano – at 00:03 Yes I agree with you that “modern medicine” will devert backwards quite a spell. One reason I watch and read what is happening world wide, is that my wife and I can and will SIP for as long as needed. Right now we could stay put for at least 2 years on our little section of desert near Death Valley (2 acres),and we have basically everything in place, and could even take in a few others (family and or friends if needed, but most do not live here). Having been in the fire service and serving in many functions from firefighter, medic, public relations, fire marshal, hazardous material officer, etc., I know how dangerous this world is in normal times and what is coming is not going to be normal in any sense of the word. At least out here, I do not expect any rioting or civil disturbance to take place.
EnoughAlready – at 00:06 One thing it is very difficult to do is see a rolling rock heading down a mountain and warning others when it seems everyone else has blinders on. Those of us here at Fluwikie, do try to warn others (I sent a comment to a Salem, Oregon newspaper yesterday), but all we can do is try to warn. And to take care of ourselves and loved ones as best as possible and not wait for any government enity to drive up the road to save us. Can you say New Orleans.
Thanks, EnoughAlready.
Monotreme – at 21:32: “Now, some people will ignore instructions to stay home - they will die.” I’m sorry, I don’t agree that they will all die. My DH suggested that, as Americans, we will have a hard time enforcing any kind of mass quarantine. People will resist it, no matter how much sense it makes, no matter how strong the military forces are. From some statistics he quoted, there are 6 civilians to every 1 military/police/enforcement personnel as it stands now. While I am quite certain that 4–5 of those civilians are law abiding citizens, I am also quite certain that the other 1–2 will form a black market, sneaky, disease spreading sub-culture. Even only 1–2 will give the enforcement teams a run for their money. These are the ones we are all afraid of, the home invasions and such. They will have the same worst case CFR, so they won’t all die. As a matter of fact, they will thrive because they will stop at nothing to get food and water, and so they will get it, while the rest of us exist meagerly, poor and hungry, especially those who did not prepare.
I do totally agree with Monotreme otherwise, and even if upping the numbers results with only 1% more preparing, that’s good.
But what I’m most afraid of, as I have said many times, is a light first wave and then we get whammied with a second and third one. They will base all percentages and procedures on that first wave and then we are done for. Monotreme, what shall we do about the waves?
Reader. Most expect the pattern to follow that of H1N1 in 1918. Nature never throws the same ‘pitch at you twice’ in a row.
Let me give you sort of an analogy. Remember the tsunami in Dec. 2004. The last large tsunami was in 1830 (if you are interested in patterns, the second last serious pandemic was in 1830 as well - go figure!)…
…The mortality from the 19830 tsunami was estimated at between 25 and 50,000 people. That was taken as the historical precedent and was thought to be a one-off event (same argument on the possibility of a pandemic in Jan 2005). They did not take into account population changes and the concentrations of population on the Ocean’s edge…
…as warning system wasn’t put in place because as a one-off, it wouldn’t happen again (same complacency around H1N1 1918).
tsunami hits unprotected east asian countries in 2004 killing 150 - 100,000 people.
Moral of the story…records are meant to be broken…nature is more often unpredictable than predictable…ignore this pattern at you peril!!
Sorry, I missed the point of my response to Reader.
The 1918 had a pattern of mile first wave, virulent second wave and milder third waves etc.
Having seen this pattern once in the history of the world, many scientists are convinced that this pattern will repeat itself where I would think that because this pattern was just followed…that is exactly why it won’t happen next time.
The mile first wave in 1918 was a blessing for the following reason. Thirty percent of the population was affected and developed some level of immunologic resistance which means when the next virulent wave started in the fall of 1918, a significant level of the population was at least partially protected decreasing the severity of infections and the mortality rate.
If our next serious pandemic follows two mild waves and then a virulent wave, we will even be better off.
However, if the ‘Monster comes to the Door’ with a virulent first wave, the nightmare scenario occurs in my opinion.
The moral of this is we must understand natures patterns for what they are…disasters do repeat themselves on a fairly regular and predictable basis…but the subtle factors within the natural disaster, with serious effects, change each time.
Reader – at 03:12
You’re right that not everyone who disobeys orders to SIP will all die of H5N1, even in a worst case scenario. I should have said, many will die. My hope is that martial law will be imposed in the worst case scenario and that law enforcement will have back-up from National Guard and the regular military, if needed. I am assuming that they will have PPE to decrease their risk but we all know that may not be true. Neighborhoods could create their own security patrols, if necessary.
I am hoping that we will have effective vaccines for the later waves, but I’m not sure about this. We will need to work as hard as possible in between waves to brace for subsequent waves. Eventually, I expect that H5N1 will become a mild flu virus after it has infected enough people. The reason is that once that happens, selective pressure to evade the immune system usually results in a strain that causes less pathology. Certainly this was true of the 1918 strain. Also, the longer you delay exposure, the better. Australians tried to keep H1N1 out in 1918. Ultimately they failed, but, because they delayed its appearance in their country, their mortality rate was lower than elsewhere because virus had weakened by the time it got in.
Closed for length and continued here
Last relevant post copied to new thread