From Flu Wiki 2

Forum: A Severe Pandemic is Likely Part 4

27 September 2006

Monotreme – at 22:39

Part 3

note, please feel free to print out or link to this post

A Severe Pandemic is Likely, Part 4

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.

Definitions

I am defining a severe pandemic as a case fatality rate of at least 2%. I use the term very severe to mean a case fatality rate of at least 5%. I am only referring to virus, not to effect of the pandemic on society. I believe it is possible for society to survive a very severe pandemic, if adequate planning is done.

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 virus and not based on what has happened in previous pandemics with different viruses.

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

Monotreme – at 22:42

DennisC – at 20:42

Not exactly a survey of “experts” but as close as I could find.

US workers believe avian flu outbreak “likely”

US workers are worried about avian flu, finds a Kimberly-Clark Professional survey, and their workplaces are unprepared.

“Seventy percent of respondents said they believed avian flu was likely to hit North America, but only 25 percent responded “yes” when asked, “Has your company engaged in building a plan in the event of an actual outbreak of the avian flu?” Forty percent expressed concern about an avian flu outbreak in their workplace. …”

“The national, online survey was conducted in May and polled employees in health care, science, manufacturing, office buildings, lodging and other industries. Kimberly-Clark Professional issued the voluntary, nonrandom survey using its own industry e-newsletter and received 379 responses.”

http://tinyurl.com/g2a7c

Tom DVM – at 20:46

Hi seacoast. Having had a fair bit of experience with regulators trying to get the damn horse to drink…including shoving its head under water…I will try and put this in perspective.

Back in 1996, a few people got the message, not least of which Dr. Webster. But many didn’t. They were convinced that H5N1 was never going to cause a problem…they ignored the neon signs flashing in their faces from 1996 until last fall. If you noticed that article about my friend Dick Thompson from the WHO (I wish I knew how to do the URL thingy) he was still downplaying everything in Sept 2005.

All the seriousness began for three reasons. Q. Lake when it became apparent that infected birds could actually fly and spread it around the Middle East, Europe and Africa…then there was the cluster in Turkey…and then there was the cluster in Karo…and there must have been something about that cluster we were not told because it was specifically at that point that they seemed to collectively get the point that there was no way we could escape an H5N1 pandemic…and it was at that time that the USA made a point of announcing publically the release of their Tamiflu reserve to Indonesia.

At that time they found themselves up the creek without a paddle…now four months later, their canoe is on the bottom and they are frantically dog paddling against the current with the faint hope of escaping the inevitable…

…it was all laughing at the ‘fear mongerers’ before…and now they are at the head of the parade…

…next time you see a press conference about this subject…tape it and play it back with the sound turned off…just look at their eyes and their body language…that’s what I do because their words mean nothing anyway.

I am sorry to say that these jobs appear to attract a certain type of person…and then once in a while you run into a Dr. Nabarro…but they don’t last long because the fight takes too much out of them.

Monotreme – at 22:47

An article from the November/December issue of AARP contains an interview with Dr. Webster. Gilmore has excerpted a small sample the Flu Clinic.

Q. If H5N1 mutates, what could readers do to protect themselves?

Webster: You mean if they can’t get a vaccine? I’d say: If they have a house in the hills, then go to it-and stay there for 3 months. And have enough food there already so that you can stay as far away from neighbors as possible.

Q. So you advocating people stockpiling food and medicine

Webster: Absolutley. Most of us can afford dry food for 3 months. One bottle of clorox is enough to purify all the water you need out of local rivers.

Q. Why get the standard flu shot?

Webster: It may do a little bit against bird flu. A little bit. Another thing: Tamiflu or Relenza, have them on hand. . . I keep a supply myself. I always take it with me when I travel-just in case I get exposed.


Anyone think Dr. Webster is expecting a mild pandemic?

Monotreme – at 23:11

From Speaker details dangers of avian flu

For people who doubt the looming danger, Osterholm said, “I wouldn’t bet my family’s life that it’s not going to happen.”

[snip]

When the pandemic hits, what will it be like?

“Imagine a 12-to-18-month global blizzard,” he said.

[snip]

“We will see bodies pile up right here in Ventura County. You’ve got to start planning, locally, now.”

Individuals and families should stockpile a six- to 12-week supply of food and water in their homes, he said. Business and education areas must prepare to protect employees and students.


Anyone think Dr. Osterholm is expecting a mild pandemic?

anonymous – at 23:35

anyone expecting to catch the flu just because he gets a flu-shot ? You should be prepared, even when the probability is only 20%.


Why doesn’t the government prepare a national strategic stockpile of food then ? As they did during cold war. As they still do with oil and some other things. Wouldn’t that be more appropriate i.e. in the towns ?

Monotreme – at 23:40

From the US gvoernment http://pandemicflu.gov/plan/pandplan.html?

1.1.3. The clinical disease attack rate will likely be 30% or higher in the overall population during the pandemic. Illness rates will be highest among school-aged children (about 40%) and decline with age. Among working adults, an average of 20% will become ill during a community outbreak.

[snip]

1.1.5. The number of hospitalizations and deaths will depend on the virulence of the pandemic virus. Estimates differ about 10-fold between more and less severe scenarios. Two scenarios are presented based on extrapolation of past pandemic experience (Table 1). Planning should include the more severe scenario.

[Number of deaths in the US indicated for a severe (1918-like) pandemic: 1,903,000]


Anyone think the US government is expecting a mild pandemic?

Monotreme – at 23:41

Correct link for the US government Pandemic Planning Assumptions.

Monotreme – at 23:43

anonymous – at 23:35

Why doesn’t the government prepare a national strategic stockpile of food then ? As they did during cold war. As they still do with oil and some other things. Wouldn’t that be more appropriate i.e. in the towns ?

I think they should. I wish they would.

cactus – at 23:47

Maybe,because they can`t?

And, they are telling you that,repeatably. Your on your own. YOYO. What about that can`t you understand?

Responding to a diaster be it terrorists(ie 9–11)or natural(ie Katrina),is a one place deal. A pandemic is a country wide event. No way government will be remotely be able to help everyone.Remember, those fresh faced Army fellers are among those that H5N1 seems to like best.

Cold War..1950`s. Our population was a wee bit lower than currently.

And, as to the oil. Did you know that it is crude? Just what are they going to do with that when the grid goes down?

28 September 2006

Monotreme – at 00:01

cactus – at 23:47

There is no reason the federal government couldn’t stockpile food now. This would be pre-positioned near the mega-cities now. There is no way that everyone in the megacites, or even a significant fraction, will stockpile 6 weeks of food. If this is not done, in a very severe pandemic, the megacities will burn. And if that happens, the Grid will go down everywhere.

In New York City, the Commissioner for Health & Mental Hygiene, Thomas Frieden said that he thinks a flu pandemic is unlikely. For 1 dollar, you can hear him say it here. He has sent this message to the public and essential workers of NYC. There is a specific reason New Yorkers aren’t prepared for a pandemic: Thomas Frieden.

econ101 – at 00:05

I also saw Thomas Frieden on Charly Rose and heard him make that statrment. Not only was I shocked but Charly Rose seemed shocked also. Where is the fallout form this kind of irresbonsible cccomment? Damn

Hurricane Alley RN – at 00:09

Where has the government repeated YOYO? I have only heard it once and that was when the President said it in his speach after the movie. We seem to be the only ones keeping YOYO alive. gina

Monotreme – at 00:10

econ101 – at 00:05

As near as I can tell, no consequences. His idea of preparing for a pandemic is rearrange bus schedules and tell New Yorkers to store 3 days of food and water.

This is in direct violation of the HHS directive to store at least 2 weeks of food and to prepare for a severe pandemic.

Sadly, most New Yorkers don’t know this. The local media can’t be bothered to tell New Yorkers that their Commissioner for Health & Mental Hygiene is deliberately ignoring federal guidelines. And putting their lives in peril as a result.

Tom DVM – at 00:15

What exactly is mental hygiene…I have never heard of this term before…is it doublespeak for a synonym for brain washing?

Hurricane Alley RN – at 00:19

Monotreme - What happens to people on Welfare and those on limited incomes who can’t afford to prep? More Body bags? gina

Monotreme – at 00:19

Tom DVM – at 00:15

What exactly is mental hygiene?

New York City is very old. The name of the Health Department there comes from a time when mental illness was separated from physical illness. Frankly, I think they should change the name to represent 21st century understanding of mental illness, but then again, they’ve got a commissioner who would embarass the citizens of 17th century New York.

Monotreme – at 00:21

Hurricane Alley RN – at 00:19

What happens to people on Welfare and those on limited incomes who can’t afford to prep? More Body bags?

No, the body bags will be for the middle-class, if they’re lucky. For the poor, hungry rats will do the clean-up.

Dark Horse – at 00:22

I think it’s beyond the resources of the federal government alone to provide food, water and essential medicines for 300 million people for 3 months. If, however, the public was repeated told by Bush, Leavitt, Cheney, on national television that this threat is real and start stocking food, many people would do it. This message could be reinforced by public service announcements and posters in post offices, supermarkets and drug stores. A public campaign would also help galvanize churches, community groups and charities to get in gear to help those who cannot do this on their own. Storage of food & meds would be local and immediate.

I was in New York City for 3 days this week and it gave me a very surrealistic feeling of how these millions of people will be completely panicked when TSHTF. Walking down Broadway, I realized how few major food stores there were and how difficult it would be to carry enough food home without a car. I can’t even count the times I’ve loaded up my SUV with preps.

One of the most serious failures of the government (US and others) is not impressing upon people the seriousness of the threat and what they must do to survive it whenever it comes, even if it is 3–4 years away. When I try to impress the threat on my relatives, they keep telling me that there’s nothing in the local papers, nothing on the local news, and so they think I’m nuts. Same thing with the mega company I work for in New York. And this is so unnecessary. Many people have the chance to be educated about this, to prepare and to help others in their communities to prepare. I’m pissed.

Anon_451 – at 00:23

Hurricane Alley RN – at 00:09

While your government will do much to prepare for a pandemic, individual action and individual responsibility are necessary for the success of any measures. Not only should you take action to protect yourself and your families, you should also take action to prevent the spread of influenza if you or anyone in your family becomes ill.

GEORGE W. BUSH THE WHITE HOUSE

http://www.whitehouse.gov/homeland/pandemic-influenza.html

Eyeswideopen – at 00:23

Monotreme at 22:47:

Everyone and their chicken are talking about the Robin Williams AARP Magazine issue w/ Dr. Webster. Everyone attributes it to a different “reliable” source.

I have yet to see a post here, at CE, Flu Trackers, etc. where someone has seen this interview first hand.

There is no such article on the AARP web site, so obviously you can’t link to it.

I would caution posting info from an article you yourself have never read.

econ101 – at 00:26

Before, i thought maybe Bloomberg was on top of this since Bloomberg T.V. is now the only T.V. scroll where you can still see H5N1 mentioned. Only silence at Fox, CNN, and others. Someday I hope to write about the 200 Trillion ( yes, Trillion) dollar derivative market and why this makes it nearly impossible to move food into the mega-cities but my health will not allow it now. Hopefully I can soon.

Monotreme – at 00:30

Eyeswideopen – at 00:23

AARP Table of Contents: November & December 2006

The interview clearly took place. But you’re right, I haven’t been able to find a copy of the article. I will retract if it turns out be wrong, but the general tone is consistent with past statements of Dr. Webster. As soon as anyone gets a copy of the article, please let us know if the quotes from the Flu Clinic are accurate.

Hurricane Alley RN – at 00:49

Anon_451 - While our government prepares. Surely you jest. You must have ment - As each politian preps. Watch what they do not what they say. Watch for the politians leaving town in a mass exodus. They are not even telling the military of the lower ranks. Not even those stationed overseas. How do they prepare on their Welfare level saleries? gina

Anon_451 – at 00:53

Hurricane Alley RN – at 00:49

The Link I provide will take you to that quote. It was in GW’s letter.

I expect nothing from any level of government, I can only hope that they will not come to my door and take what I have stocked up on. Now that would make me very angry.

enza – at 00:54

Hurrricane Alley RN—YOYO has been stated by Dr. Levitt in his March and June/06 “Report on Pandemic Planning”.

heddiecalifornia – at 01:02

“News Secretive Biodefense Legislation Moves Forward 09/26/2006 The House and Senate are nearing a vote on legislation to authorize a new federal agency, the Biomedical Advanced Research and Development Agency (BARDA), within the Department of Health and Human Services (HHS). The agency would oversee “advanced research and development” of countermeasures to bioterrorism threats, epidemics, and pandemics, and would have broad authority to exempt information from public disclosure under the Freedom of Information Act (FOIA). “ from website below

http://www.ombwatch.org/article/archive/1?TopicID=1

The information at the OMB Watch web site has much additional information on the nature of the two bills up before both the Senate and the House, as well as links to the proposed bills in their entirety.

It’s up for a vote later this week, but since they are ready to go on break this weekend, it may get moved off. If they believe it is important, and they do find time to vote for it, I think my PPF will go through the roof and I’ll be ready to SIP next Monday.

From my quick reading of it all, the bills may restrict any information on pandemic or epidemic or any other illnesses, for that matter, to only a few agencies in the U.S. government, and a few select research organizations, and drug companies. Publication of such information could become a crime. Forbids the government from buying generic medicines. IMO it would make it even more impossible for CIDRAP, WHO, the UN and anyone else to give us details, or the truth as we need it.

The whole biological/medical research industry could end up being put under a blanket of secrecy thicker than the one over the aerospace industry in the ‘60’s. I fear we are joining the same league as China.

Pixie – at 01:08

The BARDA legislation was also up for consideration around this time last year and it went nowhere then.

Hurricane Alley RN – at 01:10

enza - Thank you for the update. Must not have been a big news maker.

Anon_451 = Don’t forget State and Local govs. And the hoards of hungery people in search of. Preps well hidden and guns loaded? gina

heddiecalifornia – at 01:14

Pixie at 1:08

Last time they didn’t have co-sponsors from the other party . This time Kennedy Mass in the Senate, and Eschoo in California have signed on. I don’t think that any of the changes they wanted last year have been incorporated.

Like I said, if they DO pass it right away in a hurry with everything else on the agenda at the last minute, it might indicate that there is something really really bad in the wind. Or not. Maybe they have better lobbyists this year than last.

enza – at 01:22

Gina— March 13 and June 29 in News Archive at pandemicflu.gov Don’t remember what happened March 13 but June 29 was just before the July 4th holiday w/end and the MSM had BBQs to report on ;-) I remember thinking OMG nobody is going to be aware of this.

Hurricane Alley RN – at 01:27

heddiecalifornia - Will we even know what the vote is? Could they also see that as: They don’t need to know. gina

highdesetAZ – at 01:33

Eyeswideopen: Just got my AARP issue and the Robert Webster quotes above are quoted exactly from the interview. He further states how “if this killer virus hits, the country’s infrastructure will fall apart. The hospitals will be overloaded. Most of us don’t realize how interdependent we are for food. In a pandemic, people would get sick, the gas supply would stop, food would not be there.”

Hurricane Alley RN – at 01:34

enza - OMG you were absolutly correct. No wonder people are clueless. gina

anonymous – at 02:22

people, why do you insist to paint the picture darker than it is ?
Why are positive factors being suppressed here ?
Is this a competition who can sound most alarming ?
Why the title of this thread ? Why the summary by Monotreme
above on each new part which gives
This is Osterholm-like agenda. Let’s figure out the risk by considering
all aspects. In the end we will be more trustworthy when we are honest
and not alarmistic.


> 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

of course, there are some reasons.

> and many reasons to think that it will be worse, much worse.

name them. The only reason that I can see is historical too :
We have experience that these pandemics do happen with influenza A
and H5N1 happens to be influenza A. And it has high CFR.

> Historical arguments are non-scientific

ahh, no.

> 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 virus and not based on what has happened in
> previous pandemics with different viruses.

just because you say so ?

RMS: 20% that the next pandemic will be worse than 1918.
Show me one expert who says that he considers it larger than 50%.

Yes, a severe pandemic is likely by your definition of “severe”.
But in which timeframe ?
Next 3 years , then no, I think it’s less than 50%.
Next 300 years, then yes, I think it’s more than 50% (and thus “likely”).

anonymous – at 04:09

Monotreme – at 00:21

I priced body bags: about fifty dollars each. For my family, it looks like plastic drop-cloths and duct tape.

anonymous – at 04:25

anonymous – at 02:22

You think a pandemic unlikely anytime soon; Monotreme has a differing view. Why should your opinion hold more water than his? What are your credentials?

Oremus – at 04:26

anonymous at 4:09 and 4:25 were me.

anonymous – at 05:14

because I give references. See the RMS-quote. Monotreme has provided no expert-quotes to back the statements. Only unclear opinions which can be interpreted as you wish. Rarely experts do give numbers, but those who did were Webster: “about even odds at this time for the virus to learn how to transmit human to human,” although later he felt misinterpreted by the press and switched to “no one knows”. Salzberg: 10% that H5N1 will go pandemic, 30%−50% that a reassorted H5N1 goes pandemic\\revere:30% for a pandemic in 2 years


Fischhoff study: Question: what is the probability that H5N1 will become an efficient human-to-human transmitter (capable of being propagated through at least two epidemiological generations of affected humans) sometime during the next 3 years ?

Experts:1%(4),10%(5),20%(2),30%(1),50%(1),60%(2),70%(2),80%(1) “Experts”:30%(2),40%(2),50%(1),60%(3),70%(4)


Question: If there is an outbreak of H5N1 or a similar virus among humans in the next 3 years,(…),how many people in the world will die of H5N1 over the next 3 years ?

Experts:25–165 million “Experts”:6.25–200 million _________________


A national survey of 656 physicians revealed that more than half of physicians (56%) believe that the Avian Bird Flu will achieve human transmission within four years in the U.S.

anonymous – at 05:41

monotreme, the Karo quote: “This cluster likely represents the first documented instance of human to human to human spread of H5N1.” this was because they apparantly had identified a mutation which was given from the son to the father. The sequences were later released by Indonesia and the mutation wasn’t there. WHO had probably used wrong data to come up with the h2h conclusion. I wouldn’t count this as the “first documented instance of human to human to human spread of H5N1

moeb – at 06:04

takes a seat and pulls out some popcorn… carryon mous~ I find this very interesting. I’ve been following along for some time and I don’t think you have a hope in hell of being right, but I’ll listen. It’d sure be nice if you were.

Let’s make some valid points though…. your assumption as a mous~ that there was no H2H2H in Indonesia lacks total credibility. In fact until you put up reasons we should believe anything you say (often a string of coherent, correct statements based on true data), perhaps you should consider the alternatives..

moeb – at 06:26

anonymous – at 02:22

looking at your entire post here.. I’m tempted to ridicule and even sink so low as to question your basic intelligence. We try to not do that around here. I see no argument on your side concerning the current CFR, you don’t even mention it. Do you even know what it means? And prancing around “Historical Reference” and lack of public statements “as to a severe pandemic” by leading experts in the MSM (main stream media) don’t cut it. Facts cut it. Facts that explain what is going on. It’s already been broadly discussed why we don’t see more of the so called experts speaking up.

We don’t know exactly when H5N1 will show it’s hand but the data shows the game began some time ago. What information we do have, what facts and data that has been learned tell us this is not a ten year down the road problem. To hope it is three years down the road is a silly hope that will kill you if you hang your preparations on that time frame. What we fear is out there already, it’s at the door trying keys to get in. It has a billion keys and many of them will can unlock that door. It’s coming to kill me, kill you and kill anyone it can infect. You should consider catching up to speed.

crfullmoon – at 07:46

Saying don’t make it so; “public perception” may be enough “reality” for some politicians, but, Nature & Death don’t care what humans think, or know, or think they know.

“Historical” in the general human attention span is useless;

if someone points to a past volcanic eruption they know about, and tries to reassure the public about the volcano they are living on,

I’d bet my life on listening to the ethical vulcanologists who have been saying this is *not* a dormant volcano, it is giving evey measurable indication of imminent eruption,

no, they can’t give a time, (but why are we living on a volcano in the first place??) and some eruptions *are* just small slow lava flows, but some are poisonous gas clouds, and some instantly shatter the entire mountainsides off! Or, all of the above!

And, once the public and politicians are sure the volcano *is* erupting, it is too late to do anything about it, except become casualties. And, a volcaon is usually a localized event; no area will be unaffected and able to send help in a influenza pandemic.

I’m just a person who reads and thinks and pays attention, and the whose scientist I read about H5N1 2 or 3 years ago, and following the news myself and then with the help of other at the ‘Wiki - well, we are way past being willing to risk our and our regions lives and futures on irrational reassurances.

High impact events are worth preparing against, even if the risk is low, let alone moderate; that is why people buckle their seat belts, or buy insurance; impossible to act protectively after impact.

“Dark Horse – at 00:22, …”If, however, the public was repeated told by Bush, Leavitt, Cheney, on national television that this threat is real and start stocking food, many people would do it.

This message could be reinforced by public service announcements and posters in post offices, supermarkets and drug stores. A public campaign would also help galvanize churches, community groups and charities to get in gear to help those who cannot do this on their own. Storage of food & meds would be local and immediate.”…

As far as I can see, officials are *choosing* not to do this, and should have to be responsible for the consequences. (Not that that will help those impacted.)

crfullmoon – at 07:48

(I’m also not a typist, and in a hurry, because I am supposed to be offline and out the door right now -bye)

Phase 7 – at 07:54

20:46 “I am sorry to say that these jobs appear to attract a certain type of person…”

The quintessence of our situation.

JWB – at 08:30

moeb -Ditto

moeb – at 09:12

hey crfullmoon, I know what you mean about those late night visits to the forum… don’t worry about the syntax we get you ;-)

anonymous – at 09:55

Anonymous at 02:00

When the ill start showing up at emergency rooms, coughing and gasping, I say we give you one of those crappy masks that have been stockpiled in Ontario, and let you go first. How’s that? I want to see the sweat beading on your brow. That’s what policies based on opinions such as yours has gotten us.

Want to know what I am doing today? I am attending the funeral of my BIL who died of an pneumonia caused by a super-infection.

Since my temper is short, I want to say “Idiot!”.

anonymous – at 09:56

sorry, that was me, Jody.

Torange – at 10:17

I think that there is a point that needs to be addressed. What if secret computer simulations show that the best choice is to let certaqin areas burn to the ground. New York, south east Florida, and Dallas Fort Worth are examples.

The day after tomorrow – at 10:43

anonymous – at 05:41

I am not 100% on this but from what I understand in the Karo cluster it was suspected that it was human to human transmission because the girl had no known contact with the sick poultry that indeed she had avoided them. However I only remember reading this and don’t know the source.

LMWatBullRunat 10:55

Anonymous (troll) at 02:22

I cannot speak for others, but the reasons I am concerned about the present situation with regard to H5N1 and the potential of a pandemic have nothing to do with what so-called experts are saying or not saying.

It has much more to do with the following facts-

- H5N1 has demonstrated an accelerated infection of humans;

-H5N1 has (contrary to what the ‘experts’ said beforehand) demonstrated not only that it can infect humans but that it is now capable of human to human transmission, and that in the course of doing so it is capable of progressive adaptation.

- The present Case Fatality Rate for H5N1 infection in Indonesia is around 75% or better. Lest you think the US would do better, I remind you that we have only around 4 million treatment courses of Tamiflu available in our stockpile.

- At least 3 of the last 6 influenza pandemics we know of were reputed to be as bad or worse than 1918.

-At present, the US can produce only 10–20 million doses of vaccine per year once the strain is known, and there will be a 4–6 month delay in releasing vaccine, if one can be produced. Presently H5N1 is killing the chicken eggs before vaccines can be produced.

There are no “experts” on this, and I hope that there never will be! Hope, however, is not a plan, and what the FACTS tell me is that I face a very serious potential threat to me, my family and my friends. If you wish, for reasons of your own, to disregard these facts, feel free. Don’t expect your “head fixed firmly in the sand” attitude to get much support from the rational members of this community, however.

Monotreme and his cohorts are doing an invaluable service in bringing this potential threat to our attention, and I do not welcome or appreciate craven mudslinging from an anonymous troll.

OKbirdwatcherat 11:00

heddiecalifornia at 01:02 -

Well what the h***???? Thanks for the informative post.

LMWatBullRunat 11:03

And as regards the behaviour of the various PTB, I again refer you all to Pournelle’s Iron Law of Bureaucracy, and to Kipling’s “Gods of the Copybook Headings”. Nobody should be surprised when govenrmental organizations act with the preservation of the government as their first priority.

Accept it and find a way to cope.

OKbirdwatcherat 11:35

Monotreme at 22:47 -

Webster:

“Another thing: Tamiflu or Relenza…have them on hand…”

Is he kidding? How many people on the FW have posted concerning their failed attempts to get those scripts from their doctors? Is he unaware how things work in our world?

Scaredy Cat – at 12:20

anonymous at 05:14 - Webster: “about even odds at this time for the virus to learn how to transmit human to human,” although later he felt misinterpreted by the press and switched to “no one knows”.

It seems to me that on this thread you are demanding exactitude from others while relying on assumptions in your own thinking to make your own point. You say Webster switched to “no one knows” because he “felt misinterpreted by the press.” But how can you be sure that Webster doesn’t still think the odds are quite high for pandemic? How can you be sure that there aren’t other, perhaps hidden, motives for his backtracking? We’ve seen this backtracking with others: Nabarro, right? Blurted out some naughty numbers and Big Daddy assured us we wouldn’t be hearing those sorts of predictions again.

Also, I think that if we look only to the numbers you seek (that is the numbers we do have; even most of the “experts” have indicated they lack sufficient data to make an accurate prediction) in assessing the likelihood of a pandemic, we might very well miss the gestalt of the situation.

First of all, while numbers and probabilities are very important, most people—even scientists and mathematicians—operate under additional, relatively messy, influences, so to take everything a person says without consideration of complicating factors such as outside pressures, emotions and personal agendas, could lead to faulty (and perhaps tragic) conclusions.

Not only that, but to rely only on the analytical left side of the brain in assessing probabilities, while perhaps offering (the illusion of?) some sense of certainty and security, might, in disregarding other contributions of the brain such as that of intuition, be dangerously misleading.

Northstar – at 13:11

Webster has never, to my knowledge, ever backtracked from the numbers he stated, and I’ve read his carefully worded “clarification” that read to me that he’d been muzzled. He has in fact repeated his “half the people on the planet could die” assertion in the New Zealand press after the “clarification” to the US press. I’ve never read him to be saying that he’d been misinterpreted, and I try to follow what he says as best I can.

Tom DVM – at 13:16

Northstar. I completely agree with you. He may have clarified minor details but he didn’t retract one thing he said.

ducksoup – at 13:23

I have to come to the defence of anonymous, accused by others of being a troll. I think contrarian views are the most important, and should be accepted with respect. Notice that EVERYBODY is jumping on him/her, even though we all have to acknowledge that we know way too little to be able to make strong predictions. Aside from the merits of his arguments, I think the bigger point that this person is trying to make is that participants here suffer from groupthink. The way everyone jumped on him/her bears this out, and really should give the most convinced some pause. Keep your minds open, and listen to EVERYONE.

Tom DVM – at 13:28

ducksoup. I agree with you too. If anonymous has a shred of evidence to back up his position that the next pandemic is going to be a mild one…then he should put it on the table for discussion.

He has criticized others for failing to produce irrefutable evidence while not producing a ‘shred’ on the other side…

…so far we have nothing to debate.

moeb – at 13:28

just the facts ma’am.. just the facts please

JWB – at 13:30

I have a theory. It is this.

Monotreme and anonymous are one and the same. He is actually a brilliant but insane patient in a mental institution and he has secretly found access to the internet. Or perhaps they let him post as part of his therapy.

(Just like mine!)

8-D

P.S. DON’t asked what eight - d is! And a pencil it is not!

Tom DVM – at 13:32

/:0)

DennisCat 13:39

JWB – at 13:30 8D…. I always was partial to 5D Kaluza Klein theories of EM and GR myself pun intended but I wonder how many understand it.

Back to my therapy.

heddiecalifornia – at 13:43

Gina: The Rogers bill passed the house on a voice vote yesterday. This makes me really concerned; we have to look for what’s happening in the Senate.

More information here:

http://www.ombwatch.org/article/archive/1?TopicID=1

this site has links to the actual bills.

I think we need a thread on this; I will be gone until late this evening and would hope that someone with more insite and knowledge can pick this up and explain more about it for us; I am very concerned this might be another indicator that flu is nigh, but I may be wrong about these tea leaves —

JWB – at 13:45

LOL DennisC

moeb – at 13:57

let me shout for a moment: “FOR THE LOVE OF GOD IF YOU CAN REFUTE THIS THREAD PLEASE DO SO” I think we’d like that as long as you base it on facts and not your mental wishes

when I first saw the mous~ speak with a bit of authority in his voice I thought “Okay, here we go” but then it became insinuation, ignoring of known facts and plainly not coherent conversation… so enough of that :-)

what I am not sure of is if we will really face collapse of civilization. the government’s main goal seems to be continuity of said government. I’ve seen the numbers of probable dead and I’ve heard a great deal of speculation that humanity will crack under the strain. but will it really?

Medical Maven – at 14:35

moeb at 13:57-“I’ve seen the numbers of probable dead and I’ve heard a great deal of speculation that humanity will crack under the strain, but will it really?”

H5N1 vs. Humanity-Which is the unthinking, unrelenting juggernaut? Who is debilitated by fear, indecision, and incompetence? Who will attack its own kind? Who needs a regular supply of water, food, and shelter? Which feeds on ever ready flesh and flies on the wind? Who adapts slowly on the evolutionary scale? Which mutates at hyperspeed to meet the environmental demands?

We are a rabble (even under the best of circumstances) as compared to H5N1.

moeb – at 15:02

mutters something about compassion, the natural tendency to bind together in the face of adversity and the will to do what must be done regardless of probable death

LMWatBullRunat 15:17

moeb-

If the next pandemic is as bad as 1918 civilization may crumble.

If the next pandemic is significantly worse than 1918, then civilization WILL crumble.

How likely is that? I don’t know, but the probability isn’t zero. Given that it could happen, I try as best I can to prepare for the threat I face.

JWB – at 15:24

Well written Medical Maven. All we need is Morgan Freeman to recite those words and we got the beginning of a horror movie. (i.e. War of the Worlds)

I guess its Panflu dream city tonight!

Hillbilly Bill – at 15:32

A very wise and elder fluwikian once remarked that some who post here have a flawed view of what a pandemic will be like. They have made plans for staying at home for 6 months or so, and after that they will turn on the TV, watch their favorite show, and later go out to Starbucks for coffee. It will be bittersweet, because some of their friends will be gone but then again they won’t have to wait in a long line.

The actual reality of a pandemic that even starts to approach the CAR and CFR numbers we so easily toss about is beyond comprehension.

Tom DVM – at 15:44

Medical Maven.

Okay…enough is enough…I have just been deputized into the Word Police and I have been ordered to pull you over for speeding…

…our background information indicates that you are a philosopher/scientist who works or worked in the healthcare industry…

… You have been red-lighted because it appears that no one with that training could write and have a command of the English language the way you do…

…so I am going to have to ask for you to step away from the computer and provide me with you license and qualifications…and yes…keep your hands on the computer at all times!!

Thank you.

anonymous – at 15:51

JWB – at 15:24

“All we need is Morgan Freeman to recite those words and we got the beginning of a horror movie.”

Or

We get Samuel L. Jackson and satrt with “We’ve gotta get this Mutha F*@#ing Bird Flu off this Mutha F*@#ing planet!”

: )

lugon – at 15:58

I wonder what we can learn from this: http://www.sustainer.org/pubs/Dancing.html

I copy just the summary:

Dancing With Systems by Donella Meadows

Versions of this piece have been published in Whole Earth, winter 2001 and The Systems Thinker, Vol. 13, No. 2 (March 2002).

The Dance

  1. Get the beat
  2. Listen to the wisdom of the system
  3. Expose your mental models to the open air
  4. Stay humble. Stay a learner
  5. Honor and protect information
  6. Locate responsibility in the system
  7. Make feedback policies for feedback systems
  8. Pay attention to what is important, not just what is quantifiable
  9. Go for the good of the whole
  10. Expand time horizons
  11. Expand thought horizons
  12. Expand the boundary of caring
  13. Celebrate complexity
  14. Hold fast to the goal of goodness

People who are raised in the industrial world and who get enthused about systems thinking are likely to make a terrible mistake. They are likely to assume that here, in systems analysis, in interconnection and complication, in the power of the computer, here at last, is the key to prediction and control. This mistake is likely because the mindset of the industrial world assumes that there is a key to prediction and control.

But self-organizing, nonlinear, feedback systems are inherently unpredictable. They are not controllable. They are understandable only in the most general way. The goal of foreseeing the future exactly and preparing for it perfectly is unrealizable. The idea of making a complex system do just what you want it to do can be achieved only temporarily, at best. We can never fully understand our world, not in the way our reductionistic science has led us to expect. Our science itself, from quantum theory to the mathematics of chaos, leads us into irreducible uncertainty. For any objective other than the most trivial, we can’t optimize; we don’t even know what to optimize. We can’t keep track of everything. We can’t find a proper, sustainable relationship to nature, each other, or the institutions we create, if we try to do it from the role of omniscient conqueror.

We can’t control systems or figure them out. But we can dance with them!

DennisCat 15:58

Most of you will remember Dr. Bob. He is not exactly known as an alarmist but notice his recent post: “Two more recent deaths from H5N1--one in Thailand and one in Indonesia. The Indonesia death has all of the markings of another family cluster: a brother who died last week and was buried without testing and a sister hospitalized with respiratory problems. The local officials say this is not a cluster, but if it barks like a dog and looks like a dog. . . .”

http://drbobgleeson.typepad.com/bird_flu/

LMWatBullRunat 16:00

HBB-

You are spot on. We cannot, at the present time, truly comprehend such an event. I hope and pray we never do. But hoping doesn’t help make a plan, and prayer is not preparation.

There may be divine forgivness for those who do not prepare for this threat because they don’t know or have never been told. But there can be no hellfire hot enough, no agony too excruciating for the person who knows, who is *told*, and who fails to prepare his family for what may lie ahead.

That may sound a bit too “Old testament” for some, but I’m definitely more of an Old testament sort of person. Turning the other cheek isn’t in my nature.

OKbirdwatcherat 16:42

Tom DVM at 15:44 - L O L!!!

ducksoup – at 17:07

In an effort to find straws that might support a bit more weight, what about the speculation that H5N1 will become less virulent before H2H really kicks in? I don’t believe this as a steady-state outcome, but I do think that a first, less lethal wave may be in the cards. The logic is this: a less lethal strain with low transmissibility will (despite low transmissibility) find its way to more human hosts, since the carriers will survive and shed virus freely. This less lethal strain would thus be more likely to undergo mutations that would make it better suited to its human host, which could then break out as a highly transmissible, low lethal strain. The problem is, sooner or later this strain will coinfect with the low-transmissible, high lethality strain of the virus, which creates conditions for the emergence of that which we all fear. I believe that in 1918, a less lethal wave preceded the killer wave. Moral of the story: if BF shows up, and it doesn’t kill as many as it might have been expected to, it might make sense to get sick, and get some immunity to this new strain of virus. I’d have to be pretty desperate to go that route, but then I am. For all we know this split may have already occurred: there may be a cohort of asymptomatic H5N1 patients in Indo. Because the high-path strain is there too, the blending may happen before breakout of the first wave occurs.

LMWatBullRunat 17:22

Duck soup-

Interesting and plausible speculation. Might be.

Try this alternate scenario-

H5N1 acquires structure needed to become highly infectious while resident in (pick your bridge species, pigs, dogs, cats, whatever,) and hits the ground running with a 30% CAR and a 80% CFR. (for the first wave) By the time the nature and severity of the infection are understood in Indonesia, tens of thousands of people have already been infected in the US, each of whom is busily and unknowingly spreading the disease nationwide. [curtain closes for the sake of decorum]

That is my waking nightmare.

BTW, what Indonesian seroprevalence studies have been done, (there aren’t many) suggest that in those locals with human cases that there is no asymptomatic infection. fun, huh?

And the worse news is, that it really doesn’t have to be much worse than 1918, (which we know could happen because it has already at least 3 times we know of), to cause a breakdown of the fabric of civilization.

bgw in MT – at 17:29

Ducksoup, Perhaps you have not been here the whole time and seen the endless amount of time our best posters have spent answering the same questions Anonymous has kept posting over and over. This has happened not only here but on every flu forum I have visited. We lose patience after awhile. If you want to hear more from Anonymous he has his own website and you may go visit him there. We have heard enough. He does not respect our opinions so it’s a stretch to respect him. He has insulted many here, many times.

Anonymous prides himself on his logic and rational thinking, but in my opinion he indulges in magical thinking. He seems to think that if he can convince everybody else that that the pandemic will not be severe, then it won’t be.

I understand your fear of group think and that we don’t want to allow ourselves to indulge in that, but I have made up my own mind on the subject. I am nothing if not an independent thinker. Please do not encourage him any further. I have a son who is a high-functioning autistic and I am familiar with this type of personality.

Prepper_Utah – at 17:36

I believe the pandemic will not be the end of human civilization, HOWEVER, I believe we will be thrown back to an economic and agricultural system pre-1940′s. The Just-In-Time delivery systems we enjoy will be put out of business. The real problem with the new/old system is that it cannot support the current number of people on the earth. More people will die from the lack of accessable food and services than from H5N1. Then you take into consideration the ‘want it now pay - later economy’ now at work and there is no way to avoid a major economic crash. Just a thought.

enza – at 17:37

Need to vent a little. We have tried to engage someone who is involved with preparedness for a segment of our population. I was told they “Don’t do bird flu”.

Huh??!!Ok then.

I felt like sending a reply to the effect of “Yeah? Well bird flu does us”. But I’ll be nice: Monotreme, with your above stated permisssion, I will send your analyis to them.

anon_22 – at 17:51

Ducksoup,

Just to respond to that one point about virulence and transmissibility. For a pandemic to happen, the virus to achieve a reproductive ration R0 (the number of people infected per patient) of >1. For a disease that is very infectious before onset of symptoms, and certainly before people are too ill to move around, we do not need a high survival rate in the patients to propagate the virus. Currently those who are admitted to hospital (and presumably too sick to go around infecting others, although they can still infect those in hospital) do so around day 6 or 7, and those who die do so around the second week. For a virus with a generation time tg of only about 3–4 days (Ferguson 2006) , it becomes obvious that a virus can be lethal, ie kills the index patient, and at the same time highly transmissible, ie being passed to >1 person before the patient dies.

LMWatBUllRunat 17:55

Enza-

I respond to that by saying, “neither do I. The problem is that it won’t stay bird flu much longer, it’s already well on the way to being people flu. And we are nowhere near ready for it. The population has no immunity, the government has no vaccine or anitviral drugs, and the Feds have told us we’re on our own. So how do you plan to deliver food and water to all the residents of our fair (city, town, county) if this does happen?”

anon_22 – at 17:56

Anonymous seems to think that ‘experts’ opinion of probability can be fully accepted at face value as accurate predictions for the future without investigating the grounds upon which such ‘experts’ base their opinion.

Expert utterances are only as good as when they can support them with sound methodology. That’s why scientific publications require detailed description of both laboratory and analytical methods and not just findings.

anon_22 – at 18:01

To add to my 17:51 post, the only thing that might reduce the CFR is some trade-off at the molecular level between transmissibility and virulence, which no scientist has been able to find so far. The one exception being that a pandemic virus arising out of H5N1 reassorting with a circulating strain of human seasonal flu, might result in a pandemic virus that humans have partial immunity to, in which case the CFR could drop. But the current trend of increasing cluster sizes and frequency brings the more serious concern of a pandemic strain arising simply from progressive mutations, without reassortment, in which case all bets are off with regards to virulence.

ducksoup – at 18:01

Before hosts show symptoms, how do they shed virus? My sense was that the virus needs body fluids to pass from one subject to another, so while asymptomatic carriers could infect some people, somebody going around wheezing and sneezing could presumably do so more efficiently. Although the peak of virus shedding and the peak of symptoms likely don’t coincide, I still think that a low pathogenic, low transmissible form would have a better chance of spreading widely, when compared to a high path, low trans form.

LMWatBUllRunat 18:06

true only as long as it stays low trans. Anon_22′s point is that H5N1 appears to be acquiring the high trans ability on it’s own.

ducksoup – at 18:11

I don’t think the data support that inference. Highly transmissible influenza spreads like wildfire. If and when a virulent form of H5N1 becomes highly transmissible, the bodies will pile up so fast that even the degraded information channels we have available will show the change. We’ll see thousands per day, not hundreds per month.

anon_22 – at 18:12

Ducksoup,

I don’t understand why it is necessary to compare 2 strains ie low path and low trans, high path and low trans, or whatever. All we need is one strain, of whatever virulence, to achieve sufficient transmissibility (R0 >1, which is not very highly transmissible) for the virus to take hold. After which, the more it is passed between human hosts, the more adaptations it makes, increasing the transmissibility. Here is the point where the argument as to whether transmissibility and virulence has to have trade-off’s become important. Suffice it to say that the answer at the molecular level is that there isn’t a formula that guarantees that virulence has to diminish as transmissibility increases.

anon_22 – at 18:14

ducksoup – at 18:11 “I don’t think the data support that inference. Highly transmissible influenza spreads like wildfire. If and when a virulent form of H5N1 becomes highly transmissible, the bodies will pile up so fast that even the degraded information channels we have available will show the change. We’ll see thousands per day, not hundreds per month.”

Yes, if and when that happens, that’s what we will see. Something that spreads like wildfire and killing many at the same time. There is no data to think that that is unlikely to happen.

So it is possible to have a pandemic with lower virulence, but it is not a guarantee.

James in MT – at 18:16

I just posted this in the Pandemic Scenario Analysis thread and i feel it is appropriate for this thread as well.

Here is an article from the Ravalli Republic county newspaper, published Friday, November 18, 2005. Although this has been posted before, it is pertinent to this discussion.

Hamilton officials briefed on possibility of bird flu By PERRY PEARSON - Ravalli Republic

The chances of a pandemic bird flu hitting the Bitterroot Valley anytime soon are extremely slim, Ravalli County health and emergency officials told Hamilton city leaders at their meeting Tuesday.

But if one were to hit, similar to the worldwide Spanish flu pandemic of 1918, as many as 8,000 Bitterroot residents could die.

“These pandemics, usually you have about three a century, and we are about due for another one,” said Dr. Marshall Bloom, associate director at Rocky Mountain Laboratories. … Mayor Joe Petrusaitis requested Bloom and others speak to city officials about the bird flu, which is making headlines in the news lately. …

Bloom was joined Tuesday by Charmell Owens, Ravalli County’s emergency preparedness coordinator, Ron Nicholas, the county’s disaster and emergency services coordinator, and Dr. Richard Eggleston, the county’s health officer. ….

Owens said the ‘8,000 deaths’ number comes from a worst-case prediction that of the about 40,000 people living in Ravalli County, 40 to 50 percent of those people would get the pandemic flu. Of those with the flu, 50 to 60 percent would die.

This is the link. http://tinyurl.com/qkhqh

This is the joint projection of the BioSecurity Lab staff and the County’s emergency preparedness coordinator. It is a one in five kill rate using the low numbers and it is almost one in three kill rate from the general population just from the pandemic using the high numbers.

This certainly may not happen, yet it is of note to see it in the local MSM last November. For me it resonates with Robert Websters statements, and is a realistic probability. As always we will each follow our own conscience.

Pixie – at 18:23

LMWatBullRun – at 17:22 - “H5N1 acquires structure needed to become highly infectious while resident in (pick your bridge species, pigs, dogs, cats, whatever,) and hits the ground running with a 30% CAR and a 80% CFR. (for the first wave)”

Or, the bridge species could come in the form of a 15yo sister that has been exposed to her two brothers, both H5N1 fatalities, and who appears to be ill with H1N1.

If the virus reassorted in this case and picked up higher transmissiblity from the “regular flu,” can one assume that most of the resistance we have to H1N1 in the new reassorted virus would be trumped by the virulence of H5N1? Or is it all just pretty much chance?

Jane – at 18:35

Months ago, Osterholm said that if he had been exposed to the flu the other day, he wouldn’t feel sick yet, but he would have infected the first five rows of Oprah’s audience during his interview.

Tom DVM – at 18:43

Nature never does the same thing twice…so one way I look at things is how could it shock us by being different this time…

…I think LMW’s scenario is entirely possible…there is no use comparing H5N1 to 1957 or 1968 because it and H1N1 (1918) are ‘kissin cousins’, it has had plenty of time to show us something different and hasn’t.

If they caught a break in 1918 it was that the first wave was mild…therefore, there was a sigificant porportion of the population immune to the second and third waves which were both more viurlent.

This time I am afraid it “hits the ground running” like LMW says…first wave virulent…no immunity…big losses…short pandemic.

That is exactly what I have observed nature doing in the past to shake things up…the only thing I can absolutely assure everyone of is that it will not be a carbon copy of 1918.

Secondly, if it does reassort, I would be afraid that it would revert a few months into a pandemic back into its more virulent form…it seems this time the norm is 75% mortality…

…that’s getting up to smallpox territory.

Tom DVM – at 19:08

By the way, my estimate is in the other pandemic thread…5–10% CFR with high attack rates.

Monotreme – at 21:26

JWB – at 13:30

LOL. That is the second funniest post on this thread. The funniest, however, belongs to

anonymous – at 15:51

We get Samuel L. Jackson and start with “We’ve gotta get this Mutha F*@#ing Bird Flu off this Mutha F*@#ing planet!”

I am a huge Samuel L. Jackson fan and think his no-nonsense, low tech approach just might work. :-)

Scaredy Cat – at 22:10

anonymous wherever you are,

You and I have both been posting here for a long time (assuming you are who I think you are). I know you’re not a troll (although I did at first), and I feel really bad about the abuse being heaped on you now. Thank you for your persistence in posting. You have far thicker skin than I do, and I admire you for that.

Scaredy Cat – at 22:16

I don’t normally correct my boo boos here on the forum, but this time I will. My last post should read:

anonymous (etc.),

You and I have been blah blah blah (assuming you are blah blah blah). I know you’re not a troll (although at first I thought you were), and I feel really bad about the abuse being heaped on you now. Thank you, etc. I admire you.

Monotreme – at 23:29

closed and continued here

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