A Severe Pandemic is Likely, part 2
Based on input from the part 1 of this thread I have modified my opening post.
In reviewing the US State Plans, I have come to the conclusion that there are many, including public health officials, who are apparently unaware of the facts pertaining to the risk of a severe pandemic. Since planning is heavily dependent on the assumptions made, it’s important that decision-makers, which includes the general public, understand why a severe pandemic is likely.
Although we don’t know what the kill rate of a pandemic strain of H5N1 will be, there is no reason to think that it will be less than the 1918 pandemic strain and many reasons to think that it will be worse, much worse. Historical arguments are non-scientific and ignore basic virology. Risk assessments of the likely severity of an H5N1 pandemic should be based on the very substantial data that has been collected on this strain and not based on what has happened in previous pandemics.
Given the available facts, failing to prepare for a severe pandemic is irresponsible and likely to result in the deaths of hundreds of millions of people.
Additional References
Evolution and adaptation of H5N1 influenza virus in avian and human hosts in Indonesia and Vietnam
The viral polymerase mediates adaptation of an avian influenza virus to a mammalian host
Structure and receptor specificity of the hemagglutinin from an H5N1 influenza virus
The sentence from with the screwed up link should read:
H5N1 is an influenza A virus. Like all flu A viruses, it mutates at a very rapid rate.
And now it does.
I have posted an Opinion with the content in the first post here. Anyone may link to it who wishes to. Anyone is free to use the content for encouraging preparedness. Because it’s not on the forum, access time should be shorter. By using the edit function, you can get the urls. Please feel free to repackage the content in whatever way works best for you.
And thanks to everyone who found it useful.
Thanks DemFromCT.
Have the clusters become more numerous and larger over time?
I think browsers allow to “print with urls” so that urls get printed at the end of the page. Or if there’s enough demand we might place the urls at the end - though I guess it works as is, as an online resource - which people can “save as” a full html page.
when it meets a nonimmunized group. There was an Influenza A pandemic about 3–4 times per century in the past, in which case 20–40% of the entire world population was infected.
As usual, challenging each and every piece of data/opinion is most welcome. If it can’t be successfully challenged, we might be in for a very rough ride.
It’s true that we don’t decide how poisonous the next gift from Nature will be. But not being able to challenge this would mean …
Monotreme - that’s really excellent. I have never seen a better summary of the situation.
There has been a lot of good discussion on the first part of this thread. I’ll try to address some of the issues that came up there.
First, I want to make this clear, I really think a severe pandemic is likely. Actually, I expect a very severe pandemic. I’m not trying to make the risk sound scarier than it is. Based on my understanding of the science, I think the risk of a very severe pandemic is quite high. I also don’t think Drs. Osterholm, Webster and Nabarro are using scare tactics to achieve some other end. I think they really believe what they say.
The reason I think the risk is so high is based on my understanding of viral evolution. I think H5N1 is being passaged in a hidden mammalian reservoir right now. There is lots of evidence for this, such as:
Serial passage of H5N1 in mammals would shorten the evolutionary distance it has to travel to full adaptation and sustained transmission in humans. The currently circulating H5N1 strain in Indonesia already has the ability to transmit human to human to human. One or two more generations of transmission may be all that’s need to start a pandemic. The coming flu season will provide this strain of H5N1 many additional opportunities to make this final leap.
It would be very helpful to policy-makers and the general public for professional virologists to describe the risk of a severe H5N1 pandemic in the context of mainstream virology. I really wish they would do this.
the opinion-wikipage now has links to forum threads (in reverse order, in case this grows)
Dude – at 13:50
There have been clusters from the first reported human cases from mainland China in 2003. However, starting in January 2006, larger clusters have been reported in Turkey, Azerbaijan and Indonesia. The well documented human to human to human transmission in Indonesia (Karo) is particularly dangerous, IMO.
maybe one of the admins might put a link to the wikipage at the top of the threads? thanks!
done - DemFromCT
lugon – at 13:59
As usual, challenging each and every piece of data/opinion is most welcome.
I agree. As I have said before, I’d like to be wrong. But I need to be proven wrong based on the science, not based on “That outcome is too extreme, therefore it is unlikely to happen.”
My brain automatically rejects those sorts of arguments. I provide specific mechanisms for my arguements. In order to believe I’m wrong, I need specific mechanisms to stop the adaptation of the virus in humans.
I’m not a virologist, so I could be wrong. I’ve just not heard any virologist give a clear explanation on why a severe pandemic won’t occur. Please remember, Dr. Webster is probably one of the most qualified people on the planet to give an opinion, and his is quite dire.
Thanks Pixie.
Someone please explain “novel cleavage site”. New to all this, Thanks.
Folks, my reptilian brain needs another thread to balance this one off: what to do if A “it hits soon” and B “people have no time to prep”. Given that, in any case, A is more likely than B, then we need that thread. I’m writing this because I guess such a thread exists already. Thanks.
Monotreme, is it your understanding that the last two pandemics were relatively mild because some of the population had partial immunity due to exposure from an H or an N that their immune systems had “seen” before? And why is it in your opinion that the H5N1 victims’ immune systems couldn’t recognize the “N1″ part of the virus in time? Is it a different kind of N1 from the H1N1 virus?
Monotreme – at 13:30
I am not a virologist nor a scientist, but I think you stated your case exceptionaly well. Wish we could get anon_22, Webster or Osterholm to review it and proffer an opinion.
I think you have read many of our minds on what we feel lies ahead for H5N1 and the human race.
Dude – at 13:50
Here is a thread about epidemiology I started that explains about epidemeiology and clusters.
The real question is not if there are more and larger clusters. The answer to that is yes… absolutely.
The real question is Does WHO acknowledge there are more and larger clusters. Techincally, yes. But, (I don’t believe) Not to the extent they are actually occurring. (hence, the genogram you posted for me).
Because of the increased amount and size of clusters (real, unverified, or other) that have begun to surface, the WHO began revising their description of when they want to move to phase 4. (Began last fall?, is that right).
If I am not mistaken, The wording has been changed 3 times. I do understand their relunctance in moving to Phase 4, because of the economic repercussions they have tied to phase 4. (Theirs and other countries). But, at the same time, Their new definitions leave very little room between phase 4 and phase 5… and then phase 6.
Watching and tracking the clusters by epidemiologic methods through foriegn newspaper accounts leave much to be desired. But, since this is the only method available to the vast majority of us… Those who contribute their time in looking for and posting the articles, can help decipher the unfolding events.
Still, all of this needs to be looked at objectively. There is no subsitute for actually being there and able to follow through on the numerous questions that arise.
My thought on the topic of this thread…… ???
I see a pattern emerging that did not exist when I started watching (closely) a year and a half ago. This is definitely progressing towards something occuring…. What that will be, is the million dollar question.
And frankly, the CFR staying above 50% is the most concerning part of this. That, and the fact that all the strains that have developed from the original have a high CFR.
But, JMO….
thanks dem (for the link at the top)
Monotreme
fantastic. You summarized the whole thing in one short Bullet pointed post. I commend you.
i am so proud of all of us. Everyone who hunts the news from far off places and seemingly unrelated events. All who question the news and TPTB. All who offer advice or comfort… or thanks. All who ask tough questions… and those who ask “what is the all about”
The old timers and the new comers. The professionals and the amatuers - we are all trying to understand and come to terms with the unthinkable. a potential horror the world has seen before.
I have gone to the cemetery. i have seen the gravestones from Oct 1918 with brothers and sisters ages 1–35 standing in silent testimony to what has been. I have wept at them fearing my child’s name will be on one.
IT is coming again. Please let us be ready this time.
Grace RN – at 15:09
Wish we could get anon_22, Webster or Osterholm to review it and proffer an opinion.
I’d like to think with all humility that your putting my name next to these eminent scientists is just an accident.
That said, my post on the first part of the thread is what I am thinking. If our extrapolations are valid, then Monotreme is absolutely right. But the comforting as well as disturbing thing is finding out how much of what we hold as the holy grail of flu virology is built on very flimsy or almost non-existent foundations. And that’s not out of any disrespect to scientists, just that there is so little research done on influenza for decades.
A few examples:
1 Did you know that the theory of pig as the mixing vessel is built on very little evidence? The biggest one being they carry both receptors.
2 If pigs were the mixing vessels and humans catch flu from them, how come we are seeing so very few human isolates that belong to swine clades? 1976 was famous when that happened, but it also tells you how very rarely that happens.
3 If we are not finding swine viruses in humans, we certainly are finding humans flu viruses in swines. Perhaps humans are the mixing vessels for swine flu?
4 We can’t interpret what HPAI means in chickens because there is no large scale surveillance of healthy chickens to find out what the flu virus normally does in chickens.
5 It is said that the flu virus in aquatic birds aka ducks live in ‘evolutionary stasis’. Well, actually, flu viruses by their very nature mutate constantly. It is not possible for them to be in stasis. What is more likely is there is some mechanism by which change is actively selected out. What that mechanism is, we have no idea.
6 We talk about ducks as natural reservoirs, but we don’t know whether other species of birds also carry flu viruses, and what the viruses do in them. Somebody told me there is this American joke about a bank-robber who was arrested. When he was asked why did he rob a bank, the answer was “cos that’s where the money is.” Well, they went and took samples from ducks cos that’s where the flu viruses are. Not because you can’t find it anywhere else, cos nobody ever looked anywhere else.
These are just a few examples of how flimsy our understanding of how flu viruses evolve is.
I talk to someone like JKT and I always end up with more questions.
What I don’t understand is the “Third Generation” theory/statement. Once it gets to the Third Generation it has gone pandemic. Seems to me if 3 generations are living among eachother, they can get it just as easily as any group living closely together. I don’t see why the 3rd generation is so important. I know I’m missing it completely!!!
De jure – at 14:38
Monotreme, is it your understanding that the last two pandemics were relatively mild because some of the population had partial immunity due to exposure from an H or an N that their immune systems had “seen” before?
This is one explanation that I have seen. I also suspect that the viruses that caused the two minor pandemics were simply not that virulent which is different than transmisibility. There were no reports that those viruses killed millions of birds prior to pandemic onset.
And why is it in your opinion that the H5N1 victims’ immune systems couldn’t recognize the “N1″ part of the virus in time? Is it a different kind of N1 from the H1N1 virus?
Yes. Because of flu A’s high mutation rate, the N1 from H5N1 is very different from the N1 of the currently circulating H1N1. That being said, it is possible that people who have been exposed to many flu A viruses will have an advantage over people who haven’t. This is one reason for encouraging people to get vaccinated with the regular flu vaccine. No-one can promise that it will do any good, but it might.
Monotreme – at 17:31
Agree with every word.
Grace RN and Goju, thanks. We all contribute what we can.
I try not to think about it anymore. I got my tamiflu and have some food aside but beyond that what can any of us do? Worry just makes life a nightmare and right now my life is filled with many other more mundane worries. God willing this terrible scourge won’t be visited upon us any time soon. As for the long haul history is replete with endless stories and rcords of great plagues and the calamities they brought about.
This morning, while on the Indonesia Outbreak thread, I got reminded of the ‘truth’ of the current situation. On Sept 11, I made a post about an outbreak of H5N1 in poultry in a new region in Indonesia and added the comment “I wonder how long until we see cases in people here too”. Sadly, 11 days later, reports are now coming in of suspected cases in people … if that doesn’t send shivers down your spine and make you want to get people informed and prepared then what does it take??
Monotreme at 17:31: Thank you, as always. You indicated that it is possible that the regular flu vaccine might add a small advantage against H5N1. For what it’s worth, my physician indicated that the flu mist vaccine would provide a bit more advantage over the flu shot regarding this scenario, since flu mist is based on a live virus and the shot isn’t. Thanks again.
Barry writes: “The great influenza” (title) The Epic Story of the deadliest plague in history. So we would hardly expect 1890 or 1830 were even remotely as severe as 1918
anon0628. 11:54
I just had a chance to catch up on the thread. anon0628, I am quite sure that you would not say that the 1918 was…” the deadliest plague in history”…and I don’t think John Barry believed it either…but it is a heck of a title for a book.
As of Jan. 2005, the World Health Organization had made two separate statements…1) the range of mortality from a h5N1 pandemic would be 2–7 million worldwide…2) the 1967 extremely mild pandemic was the norm upon which these predictions were based…and 3) the 1918 pandemic was a ‘freak of nature’, never to be repeated.
“…and although its severity is often considered anomalous, the pandemic of 1830 through 1832 was similarily severe…” Dr. Osterholm
“…the 1889–90 influenza pandemic - with the exception of 1918–19, the most severe influenza pandemic of the last three centuries…” John Barry.
The Reference you sited stated that until the 1700′s reports of pandemics were unreliable.
Therefore, even with the lack of accurate evidence to determine reliable conclusions, in the past two centuries we have had six pandemics…
three of the six pandemics were of comparable ferocity to the 1918 pandemic… and two pandemics were comparably mild…and one pandemic was extremely mild.
I am not trying to convince anyone other than myself…but the strong circumstancia evidence provided by at least two authorities who ahve studied influenza in much more detail than me…have indicated that
…1918 was not an outlier, 50% of all pandemics are at least similar…
…the outlier was 1968…and it was 1968 that the World Health Organization used to produce their estimates…
…considering the fact that my government and my regulatory health agencies are still using those WHO documents as the reason we don’t need to worry or prepare, I think our discussion of this information essential to correcting the record for Dick Thompson because he has no intention of doing it himself…Thanks.
Commonground – at 17:24
The key about third generation and H5N1 transmission is not that three generations within a family are infected, it’s that the virus has gone human to human to human. In the Karo cluster, the people who were infected were related to each other. That might be significant in terms of genetic susceptibility to currently circulating strains, but is different point than H2H2H.
Transmission from individual to another is an example of serial passage. In the laboratory, a foreign virus can be adapted to a new host by injecting high levels of the virus into an animal. Most of the viruses will die. A very small number will replicate to a limited degree. One can collect these weakly adapted viruses and inject into another animal of the same species. Now, more of the virus will survive and it will be able to replicate a bit better. Continue this process and you will eventually get a virus that infects the foreign animal very well. The newly adapted virus is typically much more lethal to it’s new host than when this process began.
H2H2H gives the virus a chance to adapt to humans. The Karo cluster was very dangerous. Every time one of these types of clusters occur, the risk of pandemic onset is severe.
Monotreme - that was a great explanation. I never knew that. Hmmmm. We will have to watch the “possible” family of 5 that was reported about 2–3 hours ago in the Outbreak thread. How do you interpret the line is the article. It says “One family suspect….”. We are all trying to figure out if all 5 patients are related. Let us know over there how you interpret it, please? Thanks for helping me understand.
De jure – at 17:39
You’re welcome.
I got FluMist last season for the same reason and plan to again. I think it’s important to point out that making live vaccines requires much more care than inactivated vaccines. The worst that can happen with an improperly made live H3N2 vaccine is that you get the regular flu. The worst that can happen with an improperly made live H5N1 vaccine is…
I don’t want to hijack my own thread, but, while I think it’s a good idea to get FluMist for H3N2 and H1N1, I would want to see very good studies on a live H5N1 vaccine before I took that. It may be the way to go, but we need to make sure that the appropriate safety trials have been done.
Commonground – at 17:51
You’re welcome.
I’ll take a look at that thread later. It will probably take a while to sort through it. The only way to be absolutely sure of H2H or H2H2H is with sequence information. Fat chance of getting that from cases that the WHO hasn’t even acknowledged yet. Sigh.
I think the sleuthing on the Indonesia Outbreak thread is great. Looking for gaps in onset dates consistent with H2H2H… may be the only warning we get.
anon 22 17:21 You voiced my frustration with the World Health Organization perfectly…Thanks…it was beautifully said.
Anon_22 at 17:21-Great review of what we don’t know. You know things are bad when you have to take comfort in the fact that a discipline (virology) that should have been given the highest priority was allowed to wallow in the backwaters of science. We won’t get to Mars in twenty years because some damn virus will drag us back into the mud.
OK, going to try this one more time
Birdie – at 14:19 Someone please explain “novel cleavage site”. New to all this, Thanks.
Commonground – at 17:51
We are all trying to figure out if all 5 patients are related. Let us know over there how you interpret it, please?
I’m afraid I’m no better at interpreting toggletext than anyone else. Hopefully a native speaker will do a proper translation. The key issue is onset dates. If several people become infected at the same time, it’s probably not H2H. If the gap is longer, then the odds of H2H go up. So, getting onset dates of illness is the most important priority, IMO.
Birdie – at 18:19
Someone please explain “novel cleavage site”. New to all this, Thanks.
I’m guessing you’re getting this phrase from Dr. Niman’s commentary. Is that correct? If so, you may wish to talk to him directly. He participates on the Flu Trackers website.
If I’m not correct, could you describe in what context you are asking the question? Did you read this in a paper or see it mentioned in a news story? If so, please provide a link and I’ll take a lood at it later.
Thanks.
Monotreme, I researched the link (Univ St Louis) you provided for adaption and selection as it is performed in a lab for a virus to acquire, select and adapt to a new host. I noticed that the data supports that once we achieve 10 to the 9th and 10 to the 14th exposure the lab results guarentee that the virus will indeed select the host…others have similar findings of course. My question is this, does 10 to the 9th represent individual infection per species ( 1 billion birds, or mammals for instance)or does the 10 to the 9th represent actul viral replication (copies)? For if it is the former it could be argued that the virus wil take some time before adapting and selecting the mamalian species effeciently, but if it is the latter, it appears are though we are on borrowed miracle time, if you will. Quite an eye opener and thanks for the research link.
Monotreme – at 14:05 FloridaGirl – at 15:18 Yes, I understand the basics. I had graduate level courses in Epidemiology and worked for the Mass. Dept of Public Health in Infectious disease followup. My question is this: If the virus is showing an adaptation to humans, it will be in the data. Has anyone a graph of X=time, y=number of cases in a cluster? Does this graph show a trend of more clusters in short intervals of time and larger cluster sizes. (I would not just accept the WHO data, but a logical extrapolation of cases to include what any rational person would define as a positive i.e. index cases dies and no tests.) This picture would be worth millions of lives.
HistoriographerLou – at 19:30
Laboratory experiments can’t be used to predict how quickly H5N1 will adapt to humans. Every virus has a different relationship to a novel host. Some viruses are “closer” to adaptation than others. There are many viruses are so far away from human adaptation that they are unlikely ever to adapt to humans. The key idea to take away from the lab studies is that adaptation is a process. If you can get it started and the conditions are right, it is highly likely to reach completion.
My reading of the current situation is that H5N1 is already almost completely adapted to humans. The fact that it can replicate in humans very efficiently and cause severe pathology supports this idea. The final step in the process of adaptation is sustained transmission. I can’t think of one reason why this final step won’t happen, possibly very soon. Indeed, I think expecting this to happen is the more conservative position, from a scientific perspective, than expecting it won’t happen.
The only way I can think of to stop the process is to keep people away from infected animals. I don’t think there is much chance of being successful in that.
Dude @19:59 that should read: “…more clusters in shorter intervals of time…”
Dude – at 19:59
I would like to have the graph you mention, but I think we have too few data points. If we had complete information on all the clusters, we’d have a better idea of where we are. Unfortunately, I think we are only seeing a fraction of all the clusters. I suspect China, in particular, has not released information on their scary clusters. We only have rumors of massive “clean-up” operations.
This lack of information is why we spend so much time analyzing the statements of various experts that we think have access to information that we don’t have.
Hmm…but we can put together a graph of what we do have. I think we have between 30 and 50 data points over 2003 to today. Would that alone not provide an indication of this trend?
Monotreme – at 18:26 Birdie – at 18:19
Someone please explain “novel cleavage site”. New to all this, Thanks.
I’m guessing you’re getting this phrase from Dr. Niman’s commentary. Is that correct? If so, you may wish to talk to him directly. He participates on the Flu Trackers website.
If I’m not correct, could you describe in what context you are asking the question? Did you read this in a paper or see it mentioned in a news story? If so, please provide a link and I’ll take a lood at it later.
Thank you Monotreme, here is the link.
http://www.recombinomics.com/News/09240601/H5N1_South_Jakarta.html
Snip: All but one human H5N1 bird flu isolate from the Jakarta area have a novel cleavage site. This novel cleavage site has not been reported in any poultry from the Jakarta area, even though human cases have been reported for well over a year, beginning in July, 2005. The only Java bird isolate with the cleavage site was from Indramyu, but that isolate match a very small subset of human isolates
Adding to Monotreme’s assumption that we may be a lot closer to a pandemic originating with the H5N1 virus, than not, in my mind the possibility is only increased, when I consider what I have learned about H5N1 and it’s similarities to H1N1. (The Spanish Flu from 1918.) When they recreated the virus from gathering frozen lung tissues from still available samples, they determined that the H1N1 pandemic was caused by a purely avian strain of flu. It didn’t appear to have had any “mixing vessel” with any other mammals (i.e., pigs, etc.) in order to create this devastating pandemic. (Since there were not any recorded die offs of birds that I have been able to find reference to in 1918, I am leaning towards thinking that possibly it was asymptomatic in birds at this time?)
My understanding from what I have read regarding H5N1 (please correct me if I am wrong), is that there is a very real possibility that this virus needs only a few minor adaptations in its protein receptors in order to turn pandemic. H5N1, although it has the ability to cross over to many mammalian sources, does not necessarily need a “mixing vessel” to make the pandemic jump. Perhaps, in my limited understanding of virology, it might be beneficial if it did mix with the common human flu, as the CFR might actually be reduced if the HA factor changed to something that we had a little resistance to, say binding with another more common flu. (Not sure of that point, just conjecture, on my behalf.) Also from Mike Davis, “researchers believe that these hemagglutininss contain extra amino acids at their cleavage sites that amplify virulence by allowing viruses to invade a broader variety of tissues and possibly, species.” Perhaps H5N1 will only make the necessary changes in “each” mammal, and will have a unique propensity for each type of mammal it infects vs. what we think of “mixing vessels.” It could have a unique affect and effect on each type of mammal that it is able to infect. It may not make a difference to us humans necessarily about what is occurring in pigs or chickens, once it makes the adaptations that it needs for humans…My wording my be somewhat incoherent, but I wonder if the premise may be accurate.
If H5N1 doesn’t make any changes in its HA or NA, it will become pandemic in its current state and with its current CFR. That will be the worst case scenario. Upon reading “The Monster at our Door,” by Mike Davis, he presented the worst case of CFR with H5N1, at a whopping worldwide death toll of 325 million dead using the 1918 as the base! (He came to this number by extrapolating the worst case numbers from 1918 into today’s population.) If you extrapolate using the current CFR of H5N1 (roughly 72%) the true worst case scenario would be closer to 1 billion!!!!!! (P. 125 and p.126 of The Monster at our Door) I can only hope that H5N1 does mix with some other form of flu and the CFR will be reduced. It if manages to make the jump, on its own, with no changes in its basic structure, we will all be in a world of hurt, and possibly a lot of other species might be wiped out as well.
PLEASE, correct me if I am wrong!
Dr Robert Webster said on Nightline last year that there was a 50% chance of the pandemic starting at that time and if it did, 1/2 the world’s population could die… last time i looked, that was 3,250,000,000
He did not qualify that statement.
he may have included collateral deaths.
H5N1 is a monster with the potential to change the world as we know it.
There is nothing anyone can do to stop it. If it comes, duck under the wave until it passes. The only way to do that is to SIP before you become infected. When you emerge 8–12 weeks later, pray that the infrastructure is intact and there are enough of us to kick start it back up. Hope that it is not winter and we can grow our own crops. Hope that the next wave will be less virulent or non existant or far enough in the future to resupply for ducking under again.
This is a nightmare.
And then again, H5N1 may turn into a puppy dog and just lick our faces.
It can make you insane!
Dude – at 19:59
To my knowledge, there is not such a graph. But, Thinking back… There were clusters in vietNam in Feb (?)(I think) of 2005, Is that right? and then there were the occassional patients here and there until about September of last year, where everyone thought there might have been clusters (unofficially, of course).
This trend waxed and waned until about December, when it started cooling off…
Then near the end of Jan of this year, we began to have clusters again… The most publicized is the Karo cluster in Indonesia. This is the cluster that WHO acknowledges Human to Human transmission.
This spring / summer has been off and on again….. until about early July, than we started having clusters again… Which is when I started trying to keep a record.
Hopefully, I did not get too much of this wrong…. Forgive me if it is… It is from memory.
Additional support. Here’s what Mayo Clinic says:
“(A) H5N1: Prelude to a pandemic? Fifteen known subtypes of influenza A virus can affect birds. Although some strains are more deadly than others, even mild forms can quickly mutate into highly pathogenic types.
In the current epidemic, two influenza subtypes have proved especially dangerous — (A) H7N7, which sickened poultry workers in the Netherlands, and (A) H5N1, which has been responsible for the majority of human and avian deaths in Asia. Of these, (A) H5N1 is of particular concern for several reasons:
“But the greatest complication of bird flu is still hypothetical — the emergence of a new viral strain that spreads easily from person to person. If a person were simultaneously infected with human and bird flu viruses, the reassortment of genetic material could produce an entirely new subtype with a preponderance of human genes. This could make the virus highly contagious and, with no natural immunity among the world population, especially lethal.” http://tinyurl.com/l3uyx
Dude – at 19:59
Tell me something…. What kind of graph would you like to see?
The criteria I am using for the excel “Order of Patient symptoms” & “Genogram of clusters” is pretty much what I can find in the news articles. If they have symptoms and have had contact with Chicken which tested postive and died…. or if they had contact with a confirmed patient… and I try to include those patients who are being treated with Tamiflu. (Of course, the excel document, has just about every patient mentioned, but only to keep track.)
Going forward, and using the information I (really, Michelle, Okieman, pugmom,commonground & Influencia) have already collected…. We could make whatever kind of graph you like. From about Early July forward.
This is a horrible thought, but some undetermined high level of CFR as opposed to some undetermined CFR less than that HIGH level might result in fewer deaths overall over the longterm and provide a better chance for civilization to jumpstart itself. Once the Grid goes down for good a critical point of no return has been reached. Once that nexus occurs the more humans that are left, the more chaos that will ensue, and the more the collateral damage and secondary damage to infrastructure.
Maybe under the first alternative we would avoid the worst of the civilizational “cytokine storm” in which “the body” attacks itself (becomes disregulated). I fear collateral deaths exceeding deaths via panflu under the unluckiest of scenarios.
Separation and spacing of individuals and families would be achieved by a high CAR and a high CFR.
This conjecture is, of course, a moot point. And I would never want to run the “parallel universe” experiment. But I do think once we cross the Rubicon of semi-permanent Grid collapse something like the above may come into play as to whether our civilization ever gets going again.
MM- I agree with you, and have been thinking the same thing for several weeks now. Timing is a key issue, too, and the rapidity of the spread of the pandemic. The biggest issue would be the availability of food.
Do the math- Rapid onset 50% CAR 50% CFR means 75 million dead spread more or less equally throughout the USA. Slower onset 50% CAR 5% to 10% CFR means 270 million dead primarily in the cities and immediate environment if the grid goes down. This excludes any deliberate intervention by government or outsiders, which is another possibility to consider.
I also do hope somebody is thinking about what to do with all those nuclear plants and nuclear weapons if things fall apart…..
FloridaGirl – at 22:14 It is a plot of the x axis being time in some scale. The y axis is a bar chart. The height of the bar is the number of cases in the cluster. The width covers the date of the first case of the cluster to the date of the last case of the cluster. This visual representation would tell us if the limited data we have is pointing to an adaptaion of H5N1 in humans over time. The higher the bar and the closer together the clusters are over time is what we are looking for.
OK Dude….. Bar chart it is… I will start work on it tomorrow…. Give me a couple of days to pull the data together.
Last week of freedom… I am back to work next week, and back to school the week after. Might as well make the most of it.
:)
Thank you FloridaGirl. I am not worthy.
Goju, Webster later said that no one can predict the likelyhood or severety of a pandemic (which is nonsense IMO) and that his views were not appropriately reported. AFAIK, he has not repeated that night-line statement.
TomDVM, you can almost always find some author who supports a controversial view. But picking just what you like and ignoring the other sources is unscientific and biased. Also your attitude here that Tamiflu or vaccine is useless. Also with the Chinese pigs. You are just ignoring some sources instead of addressing them and weighting the arguments. Also with your prednisolene earlier. Also with your earlier expressed view that we all here would expect a 50%or higher probability for a pandemic this year. I also doubt that “you like me” while most others here don’t. This is all non-credible. You are an alarmist here. And yes I would have formulated Barry’s title differently. It’s misleading and tricky.But it might be correct, I assume he has researched that the 1918–1919 pandemic probably caused more deaths than the 1348–1350 black death _in absolute numbers_. Maybe without some recurrent later outbreaks years or decades later, which could be tricky to set an exact timeline for the 1350 pandemic. You could also save Osterholm’s statement about 1830, if you view it locally and not globally. Osterholm is tricking his audience.
>Is a pandemic going to happen
95%
>when will it happen
50% for the next 5 years
>where will it start
70% for China
>will it be a mild one and
60% for mild
>which previous pandemic would you expect it will be similar to
not sure. Maybe 1957 since H5 is similar to H2
> what will be the attack rate
25%
>and the CFR.
60% that it’s < 1% 20% for 1%−10% 20% for >10%
this is for the next pandemic. There could be several. This is written “ad hoc”, how I feel ATM . Maybe I can think (I know, I should !) about it later a little more. We should also distinguish the waves of a pandemic
anonymous. If I only liked those that agreed with me, life would be pretty boring wouldn’t it. I will go through a few of the things you mentioned in your post at 2:11 and then you can have the last word…
My conclusions about each aspect of pandemic flu are from as much circumstancial evidence and as many authors as possible. The evidence is circumstancial in my opinion because no one knows anything much about influenza than I do…as a result the experts have to dissect and mine information like we do. Just because I fundamentally disagree with an author doesn’t mean I ignored them.
My readings and assesments have lead to some I guess startling conclusions to you…they are not to me…I have seen many instances like this in my professional life…just because someone in authority says it is true…does not make it true.
1) I believe antivirals and vaccines are useless not only because they are archaic in design but also because they can’t be produced in enough dosages to influence a pandemic statistically at all…if the pandemic is twenty years from now, they may if we don’t go back to sleep again.
I see that other ‘experts’ feel the same way…and by the way, as my previous post indicates, I did read your source cited from 2000…it was an interesting read Thanks.
2) Chinese pigs…the serology indicates H5N1 is in pigs asymptomatically…that’s all I need to know…doesn’t matter whether the current outbreak in pigs is H5N1 or not…other than for timing of the pandemic.
3) prednisolone is the only effective treatment for the ‘cytokine storm’ at the moment…this may change in the future if an ‘antitoxin can be produced…those who don’t want to use prednisolone may try other things but they won’t work…period.
4) 50% of us think pandemic this year…I think we just had a thread on this and much more than 50% believe it will be this year…but you are right, I shouldn’t have surmised this and stated it as fact before we had the thread to back it up.
5) Osterholms quote was not his alone…it was taken from other scientific sources and was peer reviewed as well…
6) the facts are that 1918 was not a ‘freak of nature’…analyzing the scattered information…as bad as it is…indicates again that three of the six pandemics were of comparable ferocity to 1918…two were mild and one was an outlier…the World Health Organization’s greatest friend…and crutch…and ‘spin’ mechanism…1968.
7) I don’t believe I am alarmist…I am just telling the whole truth as I see it…as if I was sitting in a boardroom with the leaders of the world or in the same way that I would discuss things with Dr.’s Osterholm, Webster or Osterhaus…or the way I would talk to other veterinarians…
…I have great respect for you and my other colleagues on flu wiki…why should I spin myself or mince words.
8) I do really like you…you are intelligent and when you get over these personal conspiracy theories…we will have some great conversations…
…you have to be consistent gs…if you use your own name on another board then you should use your own name here.
gs. by the way…your assesment at 2:15 is wrong /:0) but it shows how intelligent you really are…so lets get back on track…I don’t see evidence that anyone dislikes you on flu wiki…it is not about personalities…it is all about the information.
anon~ at 2:03. Webster has repeated his sentiments in the international press since the ABC interview; I’ve read them. I remember when that interview ran - I saved it for my spouse, but it wasn’t available on the ABC website later that day. I predicted he would come out with an “apology” or a “retraction” and sure enough, the next day he did produce a “clarification.” It retracts nothing, only states that no one can know, no one can predict when a pandemic will happen.
It was patently obvious to me he was told to put a sock in it.
anonymous, your risk assessments ignore everything we know about the biology of H5N1. However, I agree it would be nice to get an update from Dr. Webster on his current risk assessment. I would be surprised if human to human to human spread of H5N1 caused him to downgrade his risk assessment.
northstar, basically he made some statements and then said that nobody could know that. So that seems to include himself and thus that his prior statements were meaningless.
the risk assessments, well I’m not yet very comfortable with them either. Recently I’ve been wondering about the likelyhood of more than one pandemic in the next 5 years. And the number of waves and their CFRs of one H5N1 pandemic. When one pandemic with 50% CFR is possible, then why not two or three and that with several waves ? We didn’t see it before, but then H5N1 is different, mutates much more has much diversity. I would like to discuss about monotreme’s numbers…
Tom, thanks for addressing the points.
This looks like a special situation. Your earlier experiences
might not so well apply.
1)as I remember you doubted that Tamiflu would be useful for normal
flu too and you won’t take vaccine, even if available
2) looks a bit towards an “all-clear-signal” for PHFD while
the other problem persists (as before)
4)that’s for the species of “common flubies” on BF-boards. Most of
the mods, most of the experts put it lower AFAIK
5) didn’t they all refer to the same source ?
Another one:
http://whqlibdoc.who.int/bulletin/1999/Vol77-No10/bulletin_1999_77(10)_820–828.pdf
The 1918±20pandemic, also with three successive waves, was unequalled in recorded history
Crosby AW.Epidemic and peace 1918. Westport,CT,Greenwood Press,1976
correct link is [[http://whqlibdoc.who.int/bulletin/1999/Vol77-No10/bulletin_1999_77(10)_820–828.pdf|this]
see also table 5 and consider that the average age in 1892 was
about 25.
gs. The link still doesn’t work.
I couldn’t agree more with your worry about multiple pandemics.
Given that we know that in 1918, infection in earlier waves did not confer protection from infection in later waves, it implies that very different viral variants were responsible for each pandemic wave.
We have seen that H5N1 exists in multiple different substrains and clades at present, such that it is doubtful that there would be much cross immunity in vaccines targetted for one type against another. The WHO has therefore released 6 (I think) different substrains for early vaccine development work,
Therefore, I wonder if each substrain of H5N1 has the potential to become a pandemic wave by itself, and, that if one H5N1 variant acquires h2h capability, how likely is it that that capability could then be transferred to other substrain variants in dual infections of a host. If this were the case, we could be in for an awful lot of pandemic waves, given the very large genetic diversity of H5N1 in the global environment.
I have not seen any data on cross immunity generated by vaccines deisgned for one specific sub strain to another - does anyone know of any? Also I would like to be wrong, so please feel free to destroy this hypothesis!
Goju – at 16:56 I have gone to the cemetery. i have seen the gravestones from Oct 1918 with brothers and sisters ages 1–35 standing in silent testimony to what has been. I have wept at them fearing my child’s name will be on one.
Goju,
I had a similar experience a number of years ago. I was visiting a friend at work (a large cemetery) and I commented on the huge vault in the main building. It’s for storing the cemeteries records. He opened the vault, (and it was big), and he said “Do you want to see something amazing?” Naturally I said yes. He got the 1918 book out and I immediately saw it was thicker than the rest, but at the time I had no idea why. (I miss my days of viral innocence and bliss!) He opened it to October which was actually more in the center of the book. He said “Check out how many people died from the Spanish flu.”
It was heartbreaking to read real names of children. A 5 year old boy here, his 8 year old sister two days later followed by their mother the next day. Dozens of handwritten entries like that. When you have physical evidence in your hands that these things happen, it just blows your mind! And what really added to the chill was the fact that these people where buried all around me. It freaked me out!
“First, they confirmed what they had suspected: the lethal fall disease was a second wave of the same disease that had hit in the spring. They based their conclusion on the fact that those exposed to the spring wave had substantial immunity to the later one.”…”In October, influenza “scarcely touched” the old troops but decimated the recruits”. The Great Influenza John M Barry…page 408–09.
Flumonitor. I also read some where in the book but couldn’t find it that the immunity from wave one didn’t necessarily protect from wave three or wave four…meaning the immunity from waves one and two did later drift to maintain infectivity.
There is also information that the waves in the 1830 pandemic continued for 5–6 years as the 1918 pandemic also continued for several years…
…it seems that there are multiple waves with these pandemics that probably blend in together over a decade.
I think we can assume some immunity occurs with any infection…but it should also be remembered that the influenza virus is the most effective at causing problems for humans specifically because better than any other bug…it has the unique ability to drift from vaccines within the time period to produce those vaccines and that is why the vaccines typically don’t work using antiquated producton methods.
What we don’t want is for the lethal wave to be first in line and I am afraid that is what we might get this time…because just when you think you have nature worked out…it throws a curve at you…and this would be the best/worst curve ball in its arsenal…considering the fact that nobody is considering the fact.
If the lethal wave comes first we will not have the partial immunity limiting losses mentioned above.
Tom DVM: 3) prednisolone is the only effective treatment for the ‘cytokine storm’ at the moment…this may change in the future if an ‘antitoxin can be produced…those who don’t want to use prednisolone may try other things but they won’t work…period.
Tom, could you maybe talk a little more about this, or please point me in the general direction of the thread that possibly discusses this matter. Thank you.
Birdie. There is a thread from last winter that I believe starts with the title: Predniolone…
If you go back through the threads you might find it and if not…just ask one of the moderators and they will be able to direct you to it…and if you have any questions afterwords, I will be happy to answer them. Thanks.
Tom DVM – at 13:37
Thank you :o)
Birdie. I just went down through the threads and searched the site and couldn’t find the thread in question…actually there were two or three that encompassed the discussion but none are in the records…
…a few weeks back, demfromct did give the thread to someone who asked so ask on the moderator thread…
…if we can’t find it we can start a new thread…you should not that the subject is a little contentious on flu wiki. /:0)
I also gave the thread awhile back. I’ll try to find it again.
Tom DVM – at 13:37
“Predniolone” ?
spok. oops!!
Flumonitor 12:54. I found the other quotes from The Great Influenza pertaining to you post.
“But the virus, even as it lost some of its virulence, was not yet finished. Only weeks after the disease seemed to have dissipated, when town after town had congratulated itself on surviving it - and in some places where people had had the hubris to believe they had defeated it - after health boards and emergency councils had canceled orders to close theaters, schoolcs, and churches and to wear masks, a third wave broke over the earth.
The virus had mutated again. It had not become radically different. People who had gotten sick in the second wave had a fair amount of immunity to another attack, just as people sickened in the first wave had fared better than others in the second wave. But it mutated enough, its antigens drifted enough, to rekindle the epidemic.” page 373.
“The virus was still not finished. All through the spring of 1919 a kind of rolling thunder moved above the earth, intermittent, unleashing sometimes a sudden localized storm, sometimes even a lightning bolt, and sometimes passing over with only a rumbe of threatened violence in the distant and dark sky.” page 377
“The year 1920 would see either (sources differ) the second or third most deaths from influenza and pneumonia in the twentieth century. lAnd it continued to strike cities sporadically. AS late as January 1922, for example, Washington State’s health director, Dr. Paul Turner, while refusing to admit the return of influenza, declared, “The severe respiratory infection which is epidemic at this time throughout the state is to be dealth with the same as influenza…Enforce absolute quatantine.”
Only in the next few years did it finally fade away in both the United States and the world. It did not disappear. It continued to attack, but with far less virulence, partly because the virus mutated further toward its mean, toward the behavior of most influenza viruses, partly because people’s immune systems adjusted. But it left a legacy.” Page 391
and if I could, I would like to add one other comment from Page 409 of The Great Influenza by John M Barry…
“I think that this epidemic is likely to pass away and we are no more familiar with the control of the disease than we were in the epidemic of 1889. It is humiliating, but true.”
Dr. William Henry Welch, Father of Modern Medicine in the United States.
Let’s hope we do not have to say the same thing in the near future…again.
Monotreme, That was very informative and well verse. Thankyou very much for the work you have put into A Severe Pandemic is Likely Part 2. You left nothing out. And if the public can’t understand whats ahead after reading your writings. I give up.
It was put so well we should copy it and hand it out to everyone we know. Is it okay to make copies and hand it out to the public????+
Tom DVM : thanks for all your work. Your quotes from Barry illustrate how much of a problem a single evolving viral strain was. Your insights and work are much appreciated.
Tom DVM – at 16:24 Monotreme
Check out the Indo Thread, MadamSpinners posts. Some very interesting comments which can not be proved at the moment but I find highly likely,
flumonitor. Each time a question is asked…we reach a new level of understanding…and without the question…there is no reorganization to answer the question…in other words…on flu wiki, our relationships are symbiotic…I know I have learned a lot by being here…Thanks Again!!
Anon 451. I read MadamSpinners posts…it seems her nephew is saying that there is a new H-H-H etc. cluster they are having trouble containing…makes sense to me…I am expecting more and bigger clusters this winter…actually, I am expecting a pandemic this winter.
It will be interesting to hear what Monotreme thinks about it.
I have one area of the world that I am currently worried about…North Korea…
…North Korea is a neighbour and very close ally of China…North Korea has a food problem and recieves food aid from China…which means foods rejected in China are shipped to North Korea…
…we know what has repeatedly happened to China’s neighbours Thailand and Vietnam…we can only imagine the results of their close relationship with North Korea…
…at least in Indonesia there is some reporting as to what is going on.
Tom DVM - I really enjoy the intelligence and reason of your posts, but I can’t get a handle on whether you are serious or not.
If you are, one understandably has trouble believing it.
You believe a pandemic is coming this winter and yet you haven’t prepped. How is that possible?
I’m starting to believe that you are an agent provacteur of some sort.
<smiles> I haven’t figured out your game, but I want you to know that <said in best Robert Deniro “Meet the Parents” voice> I’ll be watching you, Focker. : )
anonymous – at 19:33 After reading Toms post for a while now, Tom is ready in a different way then we are. Where he lives, he intends to live off of the land. Also I think he is a closet prepper and does not want to tell us because he is a nutjob just like the rest of us. /;−0
Anon_451
LOL. Tom DVM come out of the closet! : )
anonymous: Congratulations! I have gritted my teeth for the first time today.
Medical Maven:
Laughing that hard, eh?
; )
Naw, just choking on some heavy gruel that is being dished out.
Tom, stay in your closet, close to your preps. The world must not know that you have cornered the market on peanut butter. Muhahaha!
Just read the Indo thread. Am feeling unnerved and worried—I am so busy working to get everyone else ‘planned, prepped nad exercised’ that I have not had time to prep as much as I should (enza confesses). I need someone to tell me I still have time —anonymous perhaps?
enza. You still have time…because if you don’t…I am in big trouble!! /:0)
enza – at 19:54 While I have prepped for 6 months, in my very humble opinion, 6–8 weeks may be more then enough to get through the first wave. Timing is everything and while I said September or October, I have been so wrong on this so many times that I don’t trust myself. Listen to Tom DVM and DemFromCt. Tom is watching it like a hawk and I read all of his post. If Dem starts to get worried then it is time to get worried, and Dem is not sounding the alarm bell yet.
We wouldn’t starve, but our meals would be very boring— I need to add more than the basics. Some posters sound like they really have put thought into the vairety of meals, I’m trying to catch up. I keep the fluwikie page up on my computer, even when I can’t get to read it for a few days, just to check the wikieswan’s feet once a day.
birdwatcher – at 17:10
Is it okay to make copies and hand it out to the public????
Yes! Please do.
And thanks.
Anon_451 and Tom DVM,
I saw Madame Spinner’s posts. If they are accurate we’re obviously in a lot of trouble. At this point, I think we have to regard them as rumor until we got another source saying the same thing.
Anyone want to go to fly to Indonesia and find out? Only problem is, if the rumor checks out, you can’t come back ;-)
Monotreme. Sorry, I am planning on going to China and North Korea…want to come with me?
Monotreme – at 21:10 Concur. Confirmation is needed, as I once saw somewhat the same about 4 months ago but the person, on another site, was talking about China. Nothing came of it so until we see something that is linked and confirmed we do need to treat it as rumor only,
Tom DVM – at 21:14
I’d really like to, but Gulag’s are bad for my health. However, gs would be happy to go with you ;-)
I’m thinking Hope and Crosby, only with less comedy.
“Road to Bandung”
“Road to Pyongyang”
“Road to Qinghai”
Oh that’s a good one…I haven’t laughed that hard since Bronco Bill and gs had that set to a month ago…and gs thinks we don’t like him…Oh well…
You and me meeting the border agents going into China…now that would be something to see. /:0)
I have recently met a gentleman who works with the CDC and gov’t planning in Washington DC. He assures us that he will give us a signal when “it’s on” and we have limited time to really make that last run. He will knwo when it is formally declared, in another country as well as in the US. He was very surprised to know we were actively following this and seemed overwhelmingly relieved to hear that. He also said he would need us. Probably pretty soon, as he wants to also “do something” very locally. He couldn’t really talk more about that as someone walked in the hall. He said he would be back real soon. He was flying back up to DC. He makes the trip at least once a week. In fact,lately he has spent more time there than here.
I swear, if I get the nod from him, I will immediately let y’all know too.
I totally trust and believe this guy is in the know. He is an old man now and was retired military/civil servant. He is a consultant I believe now, but still a very active, full-time worker even though I know he’s got to be in his late 60′s (at least).
I’m sorry I can’t give my name right now. I wouldn’t want to compromise him in any way shape or form.
“I swear, if I get the nod from him, I will immediately let y’all know too.”
Anonymous, if you should get that nod, it be very much appreciated if you would start a new thread and make the thread title clear to catch attention. I wish I had time to read all the threads here but I don’t.
An appropriate thread title, for example, might be “Finish Your Prepping NOW!”
anonymous. Thank you…we would be grateful for any information no matter how unrelated it may seem…we are going to put this thing together one seemingly unrelated dot at a time until we get a clear picture…and we will get a clear picture before it happens.
I’m going to have the opportunity to meet John Barry in a few weeks time. If I have one question what should it be?—suggestions please.
Are you sure that the 1890 outbreak was not worse than 1918?
Thanks enza. /:0)
By the way, when we are done…you will need a couple of hours with him.
If Madam Spinner is right and we have H to H to H, is there anyway to calculate the present R0 (degree of efficient transmission) from the data available? Should we be looking for reports of health care workers getting sick as an indication of a high transmissivity? I would like to move from “a serious epidemic is inevitable” to some means of monitoring the spread - even if it gives us only a week or two of warning. I realize that this is what the heroic Indonesian thread efforts have been doing (if only China were more open!) but wonder if there is some mathemtatical model that could massage the data we have to extract more information. Or are the data so bad and understated that we should simply expect something bad sooner rather than later?
If Madam Spinner is right and we have H to H to H, is there anyway to calculate the present R0 (degree of efficient transmission) from the data available? Should we be looking for reports of health care workers getting sick as an indication of a high transmissivity? I would like to move from “a serious epidemic is inevitable” to some means of monitoring the spread - even if it gives us only a week or two of warning. I realize that this is what the heroic Indonesian thread efforts have been doing (if only China were more open!) but wonder if there is some mathemtatical model that could massage the data we have to extract more information. Or are the data so bad and understated that we should simply expect something bad sooner rather than later? (PS: Is there any basis for 664 cases being a tipping point?)
(Been out for a while). Okay, we have a Madam Sprinner and maybe something “hot” brewing in Indonesia. We also have a new “anonymous” (which I did not realize earlier) who promises to give us a “heads up”. Are these two posters connected? I hope not.
But, the “anonymous” formerly know as gs needs to get a handle We can’t have any confusion at this point. “Playtime” may be over. (Or maybe not).
Do you always check the Wiki every day?
I have gone as much as three days without checking.
I don’t know if posting to the wiki is fast enough. We may want to look at an automated method of getting the word out even faster. Most of us have cell phones. You can send emails to most cell phones by putting in something like.
8031234567@mycingular.com (Nextel, Virison etc have different email addresses.)
The message will then appear as a text message on the phone.
Any ideas about how to set this up without giving away our phone numbers? Possibly by setting up an extra email address and redirecting emails at X@yahoo.com to 8031234567@mycingular.com
Sort of like a fluwikie ‘reverse 911′?
Sort of like a fluwikie ‘reverse 911′?
This should probably be on the rumors thread, but.. A couple of weeks ago a client mentioned a “lady from church” who’s son was military and going overseas. He/she told his family that they couldn’t “talk about work” but that the family should prepare NOW cause they have NO IDEA of what’s coming soon. All this is third/fourth/fifth? hand which is why I didn’t post it before. I didn’t talk with the mother or the soldier/sailor so don’t know if he/she was puffing up or blowing steam. I believe my client told the story she thinks she heard, but… I don’t know the players. I asked the client to find out more if they could. I just hope this monster holds off till after the holidays. We need more time.
mj. For what it’s worth which is absolutely nothing…I have been visualizing between Christmas and New Years…a bit similar to the tsunami on Boxing Day…because at that point of the year for several weeks…we have our guard down…
…lets continue to hope it is either never or 15 years from now.
“he intends to live off of the land”
I wonder how many other people have the same idea.
So, once you have this information,at the speed of light, how will you use it? Would you be better off if you read it on the wiki? Some here state that they will SIP at first sign of a pandemic. How long can you do that and how do you expect anything to be there for you when you emerge? I am self sufficent to a degree that most here can only dream of. When this starts I will be in my clinic treating patients. I will judge whwen to hide my ass by what is going down. Til then I will be there to treat cuts, breaks, dehydration and babies. Kelly
One thing we all need to be wary of is people having fun at our expense or claiming to have super-duper inside info. Not naming any names, or lack of names, but certain recent posts do not ring true to me. Of course, sometimes people really do talk like bad thriller novels.
Most of the Rumors on the rumor thread (hint, hint) never were confirmed by a trusted source.
Which doesn’t mean we shouldn’t collect them. But they belong on the Rumors thread.
The actual message would be something like.
TIME TO CHECK THE WIKI! If it gave me 24hrs extra I might be able to get my daughter home.
Np1 (Kelly) I actually think you are right. It wont flare up as quick as we think. We will probably have 7–10 days from the first cluster that hits 100 before it arrives in the states. The trouble is I cant count on that.
I have allways been amazed at medical workers. They place their lives on the line every day. You have the right mind set.
I work out of my house or I am out of town. SIP for a few days to see if its a real problem is not a big deal. If its a false alarm I wont lose anything.
I have not gotten to the point of preping yet but I am woried.
For people who want to post rumors, can I suggest that you post them here?
enza – at 22:20
I am very interested in knowing more about Dr. William Henry Welch’s survival methods during the pandemic. He not only contracted the pandemic strain, but survived it w/o going bonkers. I know he took homeopathic medicines and staunchly believed in resting to recuberate. I’d really like to more about his life during his illness. I think it potentially could help so many.
Closed and continued here.