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A Severe Pandemic is Likely, Part 5
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
enza – at 17:37 from the previous thread.
Please send my analysis to whomever you wish. I hope it helps.
opens the door and pokes his head inside… “no pandemic today?” “whew” closes the door and goes to work ( hopefully)
Monotreme:
I’ve been watching the Indonesian thread and one thing sticks out. Most go to the hospital days after symptoms present or out of Tamiflu treatment range. And, they give them the Tamiflu which is totally against recommeded procedure. I’m wondering if some of these people have been taking preventive doses of Tamiflu and still got infected? So, in hospital the dose is increased. This would explain the testing problems IMHO. We’re reading or deducting the Tamiflu blanket has been effective—but I’m not so sure. What’s your opinion on this? Could Tamiflu be like the birth control pill? Skip a few days and junior is on the way?
Leo7 – at 10:58
I know your comment and question is for Monotreme, but I just want to make the comment that I believe the tamiflu blanket in West Java has been thrown and is now tattered into shreds. While I do not have any real proof to back up this belief, I’m afraid that what we are seeing now on the island of Java is what got out from under the blanket.
Okieman:
I know you’re following the story—closely. And, I agree you’re right. Just wanted to see if I’m in the mainstream thought after being distracted by other things for weeks.
I don’t have enough data to come to that conclusion, Okieman. What do you know I don’t?
Okieman - at 11:56 - Yes, I too am worried that the recent comments about Tamiflu resistance may stem from family and neighborhood contacts of victims being given prophylactic Tamiflu and yet days later becoming symptomatic anyway.
Not only Tamiflu resistance, but consistency, also. I can’t remember the exact article, but I remember reading about villagers being superstitious about taking the meds. They often refused them. I am afraid the Tamiflu blanket has alot of holes in it.
OnandAnon:
I know you addressed Okieman, he addressed me. What caught my attention and I wouldn’t call it data, but data will lag on this topic. Newsthreads a month ago talked about Tamiflu blankets. Doctors are giving Tamiflu to patients outside of the recommendation time in current news articles. Tamiflu’s own research said it wouldn’t be effective used in this manner. So—it makes sense that if someone given a preventive dose of Tamiflu shows symptoms to increase the dose. That’s not wasteful, that’s practice.
Remember the man that started Tamiflu in one of the early clusters, then left the hospital and returned home after all the rest of his family died from H5N1. The point is that things like that are “perfect” for development of resistant strains.
Yes, DennisC you’re right. I read between the lines as a HCW. I don’t know practice of Indo docs but a lot of them get their training in other countries like Europe or USA. Why give Tamiflu to someone sick for six days? It’s wasted on them and just a few weeks ago Indo claimed they were low on cash for BF treatments. I assummed-presummed-that these people could have been on preventive dose because they’re relatives and neigbors of other victims. Therefore when they had symptoms the Tam dose was increased which lead to the testing issue problems. I also am guessing-that Tamiflu needs to be in the system awhile before throwing off a viral test. Just my thoughts..not really worth 2 cents.
OnandAnon – at 12:03
Please note in my post above that “I do not have any real proof to back up this belief”.
That said, I would refer you to the post I made at 17:40 yesterday in the Indonesia thread (the same article was posted by others in several places). In that article is the following quote:
“Apart from San, he also worried one of the neighbours TJ, Gugun Useful (19), that already five days showed the cough and the fever. However, when being checked by the community health centre side, his body heat has begun to descend to 36.2 Celsius levels. Gugun that yesterday was met in his house, more chose quiet. He only hoped bird flu medicine could be immediately found. “Gugun quite frightened was infected, his matter he often to the side of (the TJ house). Even, several days ago he could sleep in the room TJ,” said roses (21), the nephew TJ.”
http://www.pikiran-rakyat.com/cetak/2006/092006/29/0101.htm
Notice the sentence I have highlighted. Has all the tamiflu been used up in that area? Remember this is in a hospital in Bandung and the cases mentioned are from the Garut area. This is not far from the Cikelet area where the tamiflu blanket was thrown over at least 2000 people. If the tamiflu is gone, to where has it gone? If tamiflu is no longer available in this area now, is this the reason we are now seeing cases?
Again, I do not have any proof, only suspicions and questions.
I intend to do an updated map this evening of the suspect cases in Indonesia for the past ten days. I expect it to be somewhat disturbing to those that have followed this the past few months.
Okieman-
Thanks for the response.
No disrespect or criticism intended; Since I know you are better connected in that part of the world, I was simply curious what you knew that I didn’t. I agree that the news reports are suggestive, and I agree that the increase in cases is of concern. Prophylactic Tamiflu is only 10 days per packet of pills, and it is entirely possible that they have gone through their stocks. I do wonder whether the medicine being referred to is Tamiflu or some other medicine? And does anyone know how many doses Indonesia still has available for use out of the 3 million they got?
Question: Am I correct that the US does not have the capabilities/plants to make vaccines?
Okieman – at 12:51 “Is this the reason we are now seeing cases? “
Notice I predicted about this when the Blanket was started back Aug 20′s. It would take a week or so to spread the blanket, the blanket would knock out symptoms for 10 days to two weeks, then it takes about 5 to 7 days after the exposure for symptoms and 10 days to two weeks till deaths. That brings us to about now. The good thing is that, if that view is correct, people don’t seem to be very contagious when on Tamiflu.
The other thing that is happening (from my point of view) is in Thailand. They had that one death in mid Aug and now they have 5,037 patients under surveillance and 19 awaiting tests. Notice they got 9 negative tests when the patient was alive and then a positive test only after an autopsy on the lung tissue)
I have absolutely know idea about China.
DennisC – at 14:17
Yes, I remember your prediction. I also remember hoping you would be wrong.
Thailand is mostly just a big question mark for me. I have been concentrating on Indonesia, but there is nothing to prevent the monster from revealing itself in Thailand. I think the patient you mention with 9 negatives while being postitive is an ominous development. Not just because of the negatives, but also because he lasted a month before dying. He did not get tamiflu until the second week. This is very different from how bird flu has been effecting humans up till now. Both of these things, the negatives and the different disease presentation, seems to me to indicate a substantial mutation has taken place. Put that with the recent announcements by Thai scientists and I think there is substantial proof (albeit circumstantial) that something bad is afoot in Thailand.
Scorsbee – at 14:16
If I am not mistaken, they are in the works, but not up and running yet. But even if we had several vaccine plants up and running we would not be able to create a vaccine until the mutated/changed virus causing the pandemic had revealed itself. I think the numbers batted around right now is four to six months before any vaccine is available, after the pan flu virus has been identified.
Bottom line: Don’t count on there being a vaccine available during the first wave, and maybe not the second.
there is prepandemic vaccine. USA has 2 million dodes. Switzerland will have some in Feb.07 for its 8million inhabitants. We could make some with the most important actual H5N1-strains. I assume, it’s just a matter of money how much vaccine to make now and many strains to include. So, how much does it cost ? What’s the expected number of saved lifes for a pandemic ? What’s the calculated worth of one expected saved life then ? Where is the threshold ?
Thanks Monotreme. Due in part to the excellent analyses of yourself, anon-22 and others here who are doing a historic job at the FW; I have been able to rouse many people out of their self induced comas of denial. As for that individual who ‘doesn’t do bird flu’, thank God he is not too high up his food chain. We have been able to essentially circumvent him (he he) to partner with that group.
anonymous – at 14:50
I think what vaccine has been produced up to this point has been done for basically two reasons:
1. To at least have something, versus having nothing.
2. To work out the process for H5N1 vaccine production ahead of time. (This is the primary reason I believe.)
It is prettys well recognized and admitted that the panflu vaccine cannot be developed until the panflu virus has shown up on the world stage. I am glad that they have something versus nothing, and I am glad they are working out the kinks in the H5N1 hipath vaccine development process, but I am not planning on staking my life or my family’s life on a vaccine being available during the first wave.
Okieman – at 14:35
That is what I thought as well. And even once vaccine begins to roll off production lines I don’t expect any countries to be volunteering there limited supply to send to the US….
Anonymous at 14.50,
Did you not see the following news report from yesterday?
WHO: Deadly bird flu virus mutating Associated Press
GENEVA - The deadly H5N1 strain of bird flu which has killed at least 148 people is showing signs of being able to mutate and develop resistance to the most effective anti-viral drugs and any possible vaccines yet to be produced, a WHO scientist said Thursday.
The H5N1 virus is splitting into genetically different groups, said Mike Perdue, a team leader with WHO’s influenza program who took part in a two-day bird flu conference earlier this week sponsored by the U.N. health body.
No vaccine for the H5N1 virus has been produced yet, but scientists are confident they will develop one in future.
However, the virus has now been shown to mutate like seasonal flu viruses that require new vaccines every year. “We are going to have to come to the realization that these viruses are genetically variable,” Perdue said. “The vaccines that we have predicted to be protective today may not be protective a year from now.”
full article
Leo7 – at 10:58
I’m wondering if some of these people have been taking preventive doses of Tamiflu and still got infected?
Tamiflu doesn’t prevent infection. It slows down replication of the virus, hopefully by enough to give your immune system time to ramp up. Inconsistent and insufficient use of Tamiflu might give the virus time to evolve a resistant strain. This definitely happens with antibiotics. This is why people are told to finish their course of antibiotics even if they feel fine. Note, I am not a MD!
I want to re-iterate some comments on the news thread. It is hard to understand how Tamiflu-resistant strains of H5N1 could evolve unless large numbers of individuals of H5N1 infected individuals are being treated with Tamiflu. These individuals could be birds, pigs or people. The only other way this could happen would be if H5N1 had reassorted with tamiflu-resistant H3N2 or H1N1 virus. No evidence of this that I am aware of.
We’re reading or deducting the Tamiflu blanket has been effective—but I’m not so sure. What’s your opinion on this?
I frankly don’t know what’s going on in Indonesia. I have been following that thread, but it’s hard to tell how many people will turn out to be truly infected. As I said some time ago, if R0 is just above 1, say 1.1, you would see a very slow rate of increase in cases. There was a similar discussion of this today on Flutrackers. (can’t find the thread now). That may be happening. If so, the pandemic has begun. However, there is not nearly enough information to be sure of this, which is why I hesitate to discuss it. It’s quite possible that many of the cases will turn out not to be H5N1 or that separate clusters were started by a widespread reservoir (chickens, pigs, dogs, cats, etc.)
As always, by the time we are sure, it will be too late. Which is why now is an excellent time to finish personal preps and get cracking on community preps.
If I remember correctly, during the Karo outbreak, the whole communtiy thought it was the pills that were giving them the avian influenza and refused to take them.
There is no blanket there never was a blanket…they are assisting the viruses evolution rather than hindering it…in exactly the same way that vaccines have only accelerated the development of H5N1 albeit under the radar of clinical infection.
I had hoped the keystone cops routine would stop but it hasn’t they are still hiding and spinning with their friendly regulators assistance.
We have all been discussing H5N1 for six months or more…trust your intuition…There’s no point having it if you do otherwise!!
I would bet that more tamiflu has been fed to chickens, pigs, dogs and cats…then was taken by humans…heck, if they gave it to me…and I have two degrees…I would spit it out too.
Monotreme – at 22:45 If so, the pandemic has begun. However, there is not nearly enough information to be sure of this
Monotreme I have nothing but the greatest respect for you but I hope to god you are wrong on this one.
Anon_451 – at 23:22
I don’t mean to cause any alarm. I’m not at all sure that the pandemic has started (but I’m also not sure it hasn’t). All I’m saying is that it would difficult to distinguish between a virus with a very low, but sustainable R0 and many independent clusters. I’m not anywhere near ready to SIP.
Monotreme – at 23:40 No alarm here. I have said that I felt it was so close you could smell it. I just hate being right on this. Maybe the current clusters will burn them selves out and we will have another year or two. Besides TPTB are not moving on it and I am not picking up on any warning signs from them. Maybe we are just having another Melt Down (Gone through 2 already).
OK People nothing to see here move along.
TomDVM - What exactly should we be doing if the blanket is nonsense?
Monoteme - Pretty infectious words!
Monotreme at 22:45
Thanks for the reply. I know it doesn’t prevent infection—but that’s exactly what I typed. Tam did seem to help some survive, but I not sure anymore. The clusters in 4 seperate areas at the same time seem to bear out what you mentioned regarding RO. I am doing some prepping mostly in supplies for hospital—its mind boggling the people who will not step up to the plate and even cover the most minimal spect of their job. It’s almost like mediocrity became the norm overnight. I actually splurged for the Lotto-how sick is that on the rare strike of luck that might allow me to SIP. A HCW (me)buying my own supplies in order to work is bizzarre. Am I the only one who thinks this? I feel like I’m in a bad dream. I was told the last time I worked the seasonal flu shot would protect me, course I begged to differ, and now the article released today. How conveinent is that? I’m not gonna kick a gift horse, cause we need one, but the word staging floated into my head. I think I should get used to the bizarre as the norm if I’m going to get throught this mentally intact.
The past few days the TPTB seem more verbal than they have since the Dec/Jan scare, IMHO and that has me worried that they all know that it is too late to stop this virus and they are buying time. I fear that Monotreme is right when he says by the time we know for sure it will be too late and we will already be in a pandemic.
I am at the point that I am resolved to the fact that we are headed for a similar fate as the people in 1918–1919. We Americans are a changed people since 911 and Katrina, but I believe we still think that bad things will happen to the other guy and not to us personally. We can watch horror unfold on television in the safety of our homes but not actually experience the pain first-hand. Katrina did change my life, but I could still shut the TV off and go about my life and forget for a few hours.
I am not afraid to admit that I am scared. I am trying to think of all possibilities to ensure my family’s survival, but then I think of all the kids in my school whose parents will not provide due to lack of knowledge, not lack of planning; others will not have the resources to prep even if they wanted to stock up on extra food. Also there will always be those think they can “ride it out.”
All of us who are prepared somewhat will be thinking of others we know who aren’t and many of us will feel a sense of guilt similar to what someone feels who has survived a terrible accident and their friends die. It is not their fault, but they have a deep sense of guilt. Jon Kraku (SP) wrote about this in his book ‘Into Thin Air’ which was his account of his surrvial during a summit on Mt. Everest during a huge blizzard where I think 9 climbers died. I remember a TV interview where he told how how guilty he felt and he was clearly tormented, so much so, that I can still visulize his face telling his story to this day. Some survivors of the Holocaust have talked about the same feelings and found some peace when they finally decided that it was God’s Will for them to live. This may surprise some of us who feel that the others did not heed the warnings so it is their own faults…which is true to a point, but when it comes down to people actually dying from H5N1… or worse from starvation, it is going to be hard on those of us who are surviving. I want my loved ones to be among the suvivors, and I will adopt a high level of logic and analytical thinking during the waves, but Good God, my heart is breaking for us….
Well that took my breath awawy…
Seacoast: I echo your sentiments. It is only 3:30 in the Chicago area and I have been reading the recent posts for the past 90 minutes. I only had a few hours of sleep last night before I was awakened by one of my unpleasant pandemic dreams. I’m sure you know the kind. This happens much too often these days. Anyway, I am thoroughly convinced that most of my relatives are going to experience pure hell and a lot of them will die. It no longer matters what I say to them, because they have simply chosen not to prepare. In spite of my encouragement and cautionary statements, they have made up their minds not to do anything about the impending pandemic, so I can not be responsible for what happens to them. They were warned. It has been their decision.
I am living my life on the assumption that we are all just one day away from a full-blown pandemic. That is the state of readiness we all require, but most people will not even be prepared for more than a couple of weeks before their lack of preparation drives them from their homes and puts them into contact with sick people from the outside world. This will happen to my relatives, too, and some of them will surely die as a result. The survivors in each household will have to live with the guilt of knowing that it was largely their own fault that their family members died, because they failed to take the slightest steps to prepare, and by failing to prepare they had to leave their homes, and by leaving their homes, et cetera… You know how that works.
I do not mean to imply that those of us who have prepped for several months of SIP will not becme ill, but the longer we can isolate ourselves from society, the greater our chances of survival. And the news from Asia is not good.
Dr Dave most people will not even be prepared for more than a couple of weeks before their lack of preparation drives them from their homes and puts them into contact with sick people from the outside world.
We need to work for the huge number of others.
We need to work on simple masks and educational material in many languages (1 and 2) and how to deploy all of that, not just in our country (wherever you happen to live right now), but also into different continents and into countries different than our own. Yes, we want to get into continents and countries other than the one we live in, because what happens to them does matter to us; just think onion-skin borders (and other issues). We need to think past the internet and into human networks that might carry the message because we and they care about people; in short: reach out.
Fast.
So could we work at Forum.CooperativeThinkingRespiratoryPreventionPackage2?
Leo7 – at 01:04
You are commended to having the intelligence and courage to prepare while others around you do nothing. Peer pressure is very strong, in adults as well as adolescents. And we all know what happens to people who succumb to it.
seacoast and Dr. Dave,
We have all had the same thoughts as you have, as I’m sure you know. I’m reading a book called “Deep Survival” right now. If you haven’t read it already, I highly recommend it. It’s not a “Survivialist” book. There aren’t any instructions on preps. It’s about people who find themselves in extremely dangerous circumstances, who dies, who lives and why. One of the things I learned is that many people die in spite of having everything they need to survive all around them. They just give up. Other people die because they listen to people in authority who don’t know what they are talking about. This happend on 9/11 at the WTC. Remember “the man with the bullhorn” telling people to go back to their offices, everything is OK, after the first plane hit? Many, many people listened to the man with the bullhorn. Only a few ignored instructions and went down the stairs. They lived, the obediant people died.
This brings me to lugon’s post. Based on what I’ve been reading, I think we can get about 25% to prep solely on the basis of getting the information to them. Another 50% will prep, but only if they get a strong message from the proper authority figures, in this case, the President and their Governor. Another 25% will not prep no matter what. I think Fluwkikians should focus on the 25% that will be convinced by information alone. I hope the Man with the Bullhorn gives correct instructions in time.
I wonder what the percentage of prepped homes is needed for us to survive as a civilization relatively intact?
Goju – at 09:34
I don’t know how to answer this without offending alot of people, but it’s it an imporant question, so I’ll answer it anyway: Not more than 10%, if it’s the right 10%. The truth of the matter is that most of us could disappear tomorrow and there would be no effect on civilization. The people who must survive are the essential workers (powerplant workers, water plant workers, farmers, doctors, nurses, etc.). After them comes engineers and teachers.
wait just a cotton picking minute.. paint my ego red, but I think if I survive I’ll be quite handy at resurrecting civilization. Count on it! (smiles.. good morning)
Scorsbee – at 14:16, I found some quotes for you:
Mar 15, 2006…”HHS plans to allocate $1.781 billion to vaccine development and $731 million to antivirals, Leavitt’s report says. Other allocations include $350 million for state and local preparedness; $162 million for medical supplies; $133 million for domestic surveillance, quarantine, lab capacity, and rapid tests; $125 million for international activities;
and $38 million for risk communication.”.. [!What?! Is that only during-pandemic? The public hasn’t heard even a PSA on TV about the US fed. pandemic site and checklists… Heck with risk -what about Preparation Communication?]
…”HHS awarded a $97 million contract in April 2005 for development of a cell-based flu vaccine, and the agency expects “to award additional contracts for developing cell-based vaccines this spring,” Leavitt wrote. The 2005 contract went to Sanofi Pasteur. When the pandemic plan was released last fall, HHS officials predicted it would take
4 to 5 years to bring cell-based flu vaccines to the point of usability.
In other comments, Leavitt said it will probably be necessary to develop “a series of vaccines” against the H5N1 avian flu virus as it evolves. He noted that HHS has contracted with two companies (Sanofi Pasteur and Chiron Corp.) to make about 8 million doses of vaccine based on a strain of the H5N1 virus that infected humans in Vietnam in 2004. Last week HHS announced plans to begin working on a second “pre-pandemic” vaccine, based on a 2005 strain of H5N1 from Indonesia.
However, in releasing his report this week, Leavitt noted that no vaccine precisely matching the virus will be available for the first 6 months of a pandemic. “We will be dependent upon traditional public health measures to contain and limit it,”
(and I’ve read elsewhere that limited batches will be distributed as they are made, and they will have to ration it out to people we can’t do without first) (Or, who “they” think we can’t do without…)
Don’t count on vaccines being available; think about what our communities need to keep functioning that can be pre-positioned now.
moeb – at 09:59 Having done a lot of different things throughout my life, I agree with you I would bring some real skills to the table. We will need you just to keep everyone laughing <Grin>
Leo7 – at 01:04, but the word staging floated into my head.
That is exactly what has been running through my mind this past week. The variety of news stories just feels like they are laying the groundwork - especially the one about seasonal flu shots offering some protection from H5N1. Will concede though that perhaps I am just oversensitized this week.
Patch – at 00:02 TomDVM - What exactly should we be doing if the blanket is nonsense?
Patch. Thanks for the question. It would take a few days of contemplation and concentration to give you a complete answer and today I have a ‘Honey-do” project if you know what I mean.
Anyway, if I could I will give you my incomplete answer and maybe you could start a thread on this really vital and interesting question.
The war was over in 2003. The last correct piece of regulatory medicine and science was by Dr. Webster and the Veterinarians.(not the new DG. for the WHO - who ‘waffled’)in Hong Kong.
If I ever get a chance to ask Dr. Webster a question, I would want to know if he knew the index case was in Guandong when he eradicated the chickens in Hong Kong…because if that was the case, then he would know the chances of the eradication working would be zero and the virus would percolate in China like most other influenza viruses of the past.
Since 2003, every move made in relation to H5N1 and China by Governments and the World Health Organization has assisted the virus. H5N1 has exploited every human weakness there is in the past nine years…and just because a human regulatory strategy is doomed to failure does not mean that we try another path when the first doesn’t work (ex. antivirals- vaccines).
The tamiflu blanket is just one more useless procedure that is assisting the viruses adaption to humans. It is being used in a population that not only does not believe in it but fears it as the cause of disease…it is being used in concert with corrupt officials but that is not unique to Asian countries and would happen in my country Canada under the same conditions…
…this is analogous to taking a whole infected region and saturate it with too low a concentration of a preventative-treatment…the laboratory method proven to be the fastest way to produce new and resistant strains.
Patch…you know your stuff…you must know how unique this virus is among zoonoses.
Okay what would I be doing?
I would have the all of the world leaders get together for a conference of 1 week duration with world scientists. The World Health Organization would be specifically excluded from these talks.
I would then have a press conference with the somber leaders telling the world of the results of the conference and the decisions made.
1) Dr. David Nabarro had been empressed (against his will if necessary) to take off all pandemic planning including becoming the Director General of the WHO.
3) The world will be put on a war footing. Dr. Nabarro’s role will be analogous to Dwight D Eisenhower during the second world war.
The message would be clear…we are in deep trouble…the pandemic is imminent…we have no time to lose…this is not political posturing.
The first issues dealt with…will be food, water, electricity and pharmaceuticals.
The infrastructure problems will be dealt with by a combination of civilian and military authorities.
The pharmaceutical issues will be dealt with by an immediate increase in production…forced if necessary…of antibiotics etc. to produce a stockpile distributed as soon as possible so that families may have them…families with young children will be first in line…followed by teenagers and young adults.
Sytems to immediately improve hospital services plus telephone and internet facilities will be set up so that no one will go through the pandemic without sound medical advice.
Fast food restaurants have been notified…each community will choose which ones will be used as a distribution arm during a pandemic…
…communities will immediately recieve an influx of cash to start significant planning and stockpiling of supplies…this is where the local effort will be made…
…the approach will be…that if we don’t work together we will die together and the goal will be that every citizen will have the same level of protection to prevent social breakdown.
The underlying message would be…we are serious…this is not a joke…we have little time to prepare.
And each leader would individually say that he or she is making the decision in consideration to the scientific information recieved…
…and if the pandemic by some miracle misses us…then they would be happy to resign if that is what their countries citizens decide…
…the issue is too important this time to play politics with.
If we possibly won’t have people to man the major utilities because of illness and shipping/delivery shutdown, who believes there will be enough healthy folks and supplies to manufacture and distribute a vaccine? Better count what can be made within each’s own country - imagine trying to get supplies from overseas…
(any journalism students in the house? or any Canadians want to video a shadowy TomDVM reading that, and put it on the internet?)
Tom DVM – at 10:37 You have in a nutshell given the best PanFlu plan I have heard. However; the small minded world leaders are not concerned about the people they only want power and they are stupid enough to believe that they will keep there power during and after H5N1 burns through the world.
We need you as the President of the UN.
crfullmoon – at 10:04
“Don’t count on vaccines being available; think about what our communities need to keep functioning that can be pre-positioned now.”
Having been through a couple of hurricanes as a child, I yelled a lot at the TV in the 2–3 days before Katrina about pre-positioning supplies and getting people out sooner. Much more could have been done than was.
The sad truth is that the world doesn’t have a three-month food supply, etc., to pre-position. I’m thinking it’s going to take a six-months-plus supply anyway, because I don’t see H5N1 “moving out” after three months in a given place. We’ll have to be prepared to weather the six months until we have a vaccine and then hope it can be distributed. As a high school English teacher, I don’t think I’m going to be first in line ;→.
We need to pre-position essential people and do everything we can to make sure infrastructure, food production, and medical research/vaccine production and distribution don’t fall apart. We need to replicate essential knowledge because we can depend on this person or that person surviving. This is true within families and organizations.
I think TPTB aren’t talking about the real worst-case scenario and adequate prep for it partly because they know that our resources are not adequate to enable such preparation for masses of people and because they know that they are presenting many people with limited means and possibly little time an insurmountable challenge likely to lead, even sooner, to social chaos. A panic would threaten consumer behaviors which prop up corporations that prop up TPTB and our economy as a whole.
The best we. as people alert to the threat, are going to be able to do is Monotreme’s 25% (however close to 25% the actual figure may turn out to be). At least if we can get information to people, they can decide what to make of it, and some people will choose to prepare. It will be those people upon whom civilization depends, if H5N1 turns out to be the nastiest pandemic the world has known.
Monotreme - I’m glad you are reading Deep Survival. That’s an incredibly relevant book because it won’t be our supplies alone that save us - it will be tenacity, resourcefulness, and hope.
Tom DVM - great plan…
Dr. Nabarro - Great choice…
Never gonna happen…
opposing points: Pandmic will happen soon - Put all plans into place now Pandemic will happen in the future - we have time to wait
It will be mild - no need for all this end of world preparation it will be catastrophic - nothing we can do will help
Tell the public a sugar coated version to avert panic tell the public the hard truth and risk a paniced but prepared population.
Tell them now and risk it not happening for a year or two - they will never take u seriously again. dont tell them now - wait till it happens and hope for the best.
from one of our Mod’s site- kind of Effect Measure
“We didn’t know then (nor we know now) how far the train was, whether it would get all the way to us or how fast it would be going if it did get to us. But we could feel the vibrations on the tracks and we knew enough about train wrecks of the past to worry. … …Now it’s almost two years later and the bird flu train has not arrived. But the tracks are vibrating more strongly, we can hear the engine noise more loudly and we know the train is in the vicinity, crashing through half the world’s poultry flocks, flicking off various other mammalian host species and the occasional human (251 at last count). We know much more about the virus than we did two years ago, but some of what we have learned is that what we thought we knew was wrong. That’s progress, but of a peculiar sort. Still no effective vaccine in production and no likelihood of significant quantities for several years, if then. Uncertain quantities of antivirals on hand and with uncertain efficacy. And public health systems still tottering on the edge, with social service systems weakened as well. These are gross failures of government, and those government failures are traceable to gross failures in leadership.”
This is impossible for “human nature” to cope with. We are our own worst enemy. We are Humans, and to collectively rise up and ADEQUATELY meet the threat of H5N1 we would have to be “Vulcans”.
Has mankind ever marshalled itself ahead of time (other than for war) for what it considered to be a nebulous threat that could not pinpointed in time or actuality?
Hasn’t mankind always reacted after the fact, after the “sucker punch”?
It is too bad H5N1 is not an alien from another galaxy. That would get our atavistic juices flowing, and maybe some meaningful action would follow.
Government in the U.S. no longer serves the people as much as it serves corporate interests and uses the people to do so, manipulating the sensibilities and the behavior of the essential majority at the ballot box as ably as any puppeteer. Leadership on behalf of the welfare of the people is not tops on the agenda. We will hope for it in vain; we’d best figure out what do to without it for now.
Anybody out there-name one government, society, tribe (other than fluwiki) in the world that is ADEQUATELY preparing for a “1918″ event or worse or even contemplating such a major marshalling of resources?
Medical Maven - at 11:34
We are going to have to rise above our predilections as a species if we are to survive. We will learn about proactive collective action on a large scale the hard way and after great loss. Hopefully, we’ll enact proactive collective action here and there on a local scale such that we have an opportunity to start again, more wisely.
The problem is that fluwiki functions in cyberspace, which is likely to go “poof.” It is not enough to rely on an ephemeral Internet community. We must create 3-D, flesh and blood enclaves of people collectively prepared. Where I am, not much is happening. I’m not in the best position to leverage change in my community, though that will not stop me from trying.
Monotreme – at 09:30 Based on what I’ve been reading, I think we can get about 25% to prep solely on the basis of getting the information to them. Another 50% will prep, but only if they get a strong message from the proper authority figures, in this case, the President and their Governor. Another 25% will not prep no matter what.
25% solely on information? My feeling is you’re revealing yourself as a real optimist here.
I’m possibly in a darker mood today, or maybe different places react differently, but I think we can get 25%, the first 25%, with a mixture of information and hard facilitation. Which includes what anon_22 has suggested about Leaders Speaking Out, and also businesses making lots of money through making it easy to prep, and yes, lots of information.
If part of that first 25% includes part of the prioritary 10% (whatever it is, and I do think it includes people without proper credentials or jobs - just plain personal resourcefulness), then that’s much better than nothing.
I feel we’re getting there, but we need time. And ideas.
And we also need simple masks for 100% of the population. And fast-learning strategies that can be deployed at the speed of light.
Monotreme, my feeling is you’re revealing yourself as a real optimist here … I meant to say this:
My feeling is you’re revealing yourself as a real optimist here … AGAIN. :-)
I mean, you really think it’s worth doing all we’re doing and more!
(So do I.)
lugon, I’m a pessimist with respect to the virus and an optimist with regard to what s small group of determined individualists working as a community can do. Fluwkians as cooperating cats.
Monotreme – at 9:30 & Inky – at 11:08: I find it really interesting that you are both reading/have read “Deep Survival” as it is one of those rare books that had a deep effect on my thinking. I wonder how many others here have also read it? That at least three of us on this thread have read it is probably not sheer coincidence.
I liked this book so much that I threw it into a box of treats that I was sending to a Navy SEAL team I support, usually with more traditional fare like cookies. But I thought that even for those guys and their level of training, if someone can pick up just one idea from this book, it can make all the difference.
The book is actually called: “Deep Survival: Who Lives, Who Dies, and Why” by Laurence Gonzales. It is filled with disparate stories of mountain climbers, airline crash survivors, Navy pilots, and office workers that happened to have found themselves in the wrong place, at the wrong time, during the WTC attacks. While the scenarios differ, what these survivors had in common was the ability to quickly and succinctly assess and sum up, for themselves, their situation (and to do so with great accuracy), and use that information to take appropriate and swift action. While we may not all be mountain climbers faced with an emergency or Navy pilots landing a jet on a carrier, it is not the particularity of the situation but the mindset and mental acuity of these individuals that led to their survival. For any who might think it would be their cup of tea, “Deep Survival” might give some valuable insights as to how to survive a pandemic. Highly recommended.
Anybody else out there a fan of the book?
Pixie, reading Deep Survival is one of the best preps people can do, IMO. No matter how much we plan, we will never be ready for a severe pandemic. We need to be humble in the face of nature. And resourceful.
No, but I am going to buy the book this week. Thanks all.
FloridaGirl and Dude have prepared a very informative series of graphs concerning the frequency and sizes of clusters over time. DemFromCT has uploaded them to the Wiki here.
I won’t prejudice anyone as to what they mean, but it will be interesting to get people’s comments.
moeb – at 09:59 — wait just a cotton picking minute.. paint my ego red, but I think if I survive I’ll be quite handy at resurrecting civilization. Count on it! (smiles.. good morning) Some would call this “deep survival”, sorry if I make you blush. I’d say the majority of FW’s have the mindset and mental acuity, and… the physical capacity of resurrecting civilization. ROFLMAO.
Please state the definition of “cluster” near the graphs. There’s no possible interpretation if “cluster” means “cases inside the same country” - though if I remember well that’s not the definition. I can look it up myself but you want other people’s comments.
JACAF
Just Another Cat At Fluwikie … and yes, I’ll try and grab da book, too.
lugon – at 16:08
Done. The text was provide by Dude in an email to me and I forgotten to add it to the page. It’s now at the bottom of the graphs.
JACAF
Good graphs..I like graphs!
It shows that Indonesia should do what China’s done…and cull mass quantities of birds before it’s too late!
I think.
You can find a statement of the methodology used by florida girl on muse in the orginal data and excel spreadsheet. The file name is clustersyear2003–2006[1][1].9.28.2006 she took great pains to see that the information was as accurate as a resonable person could view it…all WHO nonsense aside.
The graphs are great. The clusters definately seem to be happening more often, but not necessarily getting larger. I wonder what that means.
I take that back, clusters are happening more often and increasing in size.
I think the graphs show what I was looking for in that I wanted the data to speak to us. It is my position that if this virus is adapting to humans then the data should show that the cluster size is increasing over time. It should also show that the clusters are happening more frequently. She plotted the information to see if it supported that idea. Floridagirl deserves lots of credit for all of her hard work in getting the data together. Without her I would just be another bag of wind with an idea…grin.
Nice job. I think we should send these graphs to the WHO, CDC, etc.
All, please check the WHO’s graphs of data at
http://www.wpro.who.int/sites/csr/data/data_Graphs.htm
On the first graph, please notice the singular peak in January 2004, the dual peak in January+March 2005, and the dual peak in January+March 2006. Notice that the peaks in 2006 were higher than the peaks in 2005 and 2004 (though 2005 was not higher than 2004).
Shall we look for the next peak in January+March of 2007?
By the way, the other three graphs on that page are also very interesting … and rather disconcerting in the information they convey.
You would have to say that if mass culling wasn’t carried out in China…then it may already be here.
Mass culling should be carried out in Indonesia.
It would seem.
Ok, so let’s look at other possible explanations (not that I share them!):
Any other alternative explanations? Ways to prove or disprove either? Data needed and wanted and kindly requested from those who may (or may not) have it?
Skeptics will say interesting hypothesis so let’s move past that.
Thanks - the charts look - frightening.
Great work of those graphs. I’m going to send them around. Thanks.
The WHO graphs are scary.
The case fatality rate look’s to be stable at around 60%, and then the Cumulative Graph looks like it will never end.
What is the answer?
Perhaps we should stop people coming in and out of Indonesia?
Blue – at 17:25 There really is no answer but the big question is how much time is there for this to erupt out into the world? That is the question I wish I really had an answer for
I’m going shopping again tomorrow. When you look at the graphs, you can see a very clear picture of what is happening. Not that I didn’t think it, but the visual makes me even more nervous. Why are we the only one’s who get this?
Gary-
The culling of massive amounts of birds certainly seems to of had good effect in China.
I hear it is now back, but it seems-as evidenced by the graphs- to have had an effect.
That would seem to be at least a partial answer.
The pressure, peer pressure, should continue to be applied to make these necessary changes to the way Indonesia looks at this problem.
Blue, and then there is Africa, the ultimate redoubt for H5N1, (even if by some miracle Indonesia would clean up its act). Frankly I don’t think it is possible short of a revolution and a Pol Pot type regime to enforce the culling. And Africa can’t even be controlled by its despots.
Thanks for the graphs, Dude and FloridaGirl, and thanks for the WHO graphs, Dennis in Colorado.
Blue – at 18:04
I doubt that we can place too much faith in the validity of the data for China on these charts. Let us just say that it may be a gross understatement to say that the transparency of the reporting by China to the WHO leaves much to be desired. In addition to this, TPTB in China have threatened dire consequences to anyone (else) reporting news about the H5N1 situation in that country.
In fact, it’s my opinion that the data in these graphs probably represents a small percentage of the true scope of the problem throughout the world.
Gary near Death Valley, you are wondering the same thing all the rest of us are wondering: how much time do we have left? People have jobs, kids have school, we don’t want to head for the hills and then find out that we have a year or two more before it gets here. So that’s the big question. At what point will we know for sure? All we can do is to be very watchful and be ready to take action without delay.
One of the things I will be watching for is any indication that people who are in a position to be more “in the know” than most of us here may be have started to sequester their families. I would ask that if anyone here somehow comes by this knowledge that they post it for the rest of us. Names might not be appropriate, but general information would, I’m sure, be of interest. One more piece of the puzzle, so to speak.
Ruth – at 17:53
Women!!! ANY excuse to go shopping! If I sent my wife out to buy preps she would come back with 3 new pairs of shoes!
8-D
The graphs are great! No. Awesome!!!
The WHO graphs are the exact ones I have been showing to Town officials and Media. They work!
NO one can walk away saying
1 - its going away 2 - Its not getting worse. 3 - i dont care that it is killing the kids 4 - if this comes here my kids will be safe. 5 - i shouldnt do anything about it like preparing to SIP
The reason that we chose the layout of the cluster graphs that we did is that the human mind can see trends and interpret data better than we can articulate it. The WHO data actually shows the increase in cases, but does not show the distribution of these cases in any clear way. Only when you seperate the data by year and put them in visual alignment can you really see the trends. The next graph is more ambitious and will show the yearly distribution of all cases by case onset date. If you have any data on the case onset dates please contact me at dudeatsingtomeohmusedotcom. This is for the period of 2003–2006. We are looking for the areas in green on the word document on muse entitled individual cases by month [1][1].plus cluster info. So put your snoop hats on and let us know if you find this information anywhere. If we don’t have data we will make some assumptions that we hope will be as valid as they can be. Thanks.
…”send these graphs to the WHO, CDC, etc”? Nah; send them to media, community organization leaders, power/fuel workers, grocery managers, morticians, teachers, other essential, or influential people…
Medical Maven: “Hasn’t mankind always reacted after the fact, after the “sucker punch”?
No reason not to do the right thing for once! Listen to scientific warnings.
No excuse for not informing the public; telling them it is important to prep. No good reason for so many families with children to not be told to get ready by school systems nor their physicians, who know. I also don’t believe the, “If it doesn’t happen right away, the public will never listen to us again” is true. People don’t all listen about not drinking and driving, or not smoking, or not polluting the environment, or about evacution warnings, but that is no reason not to educate and warn them. (Certainly hasn’t been another large terrorist attack on US soil lately, yet the country seems to listen and obey no matter how much money or rights it costs. How about the public hears “Prepare for pandemic” only just half as many times politicians have said anything about terrorism? That would be an improvement. Give it equal billing as a clear and present danger, though it has been the top one on my list for years.)
OK, it seems like we all are a bit freaked out here right now. Is is possible we are all just building on each other… the echo chamber affect? I mean, we have all been waiting/watching for this pandemic for quite a while. You see what you look for if you know what I mean.
Can anyone out there offer some yin for all this yang? I mean, I’m getting a bit alarmed here. I guess tomorrow is another box store day, at the rate you all are predicting the time until pandemic!
I’m sure hoping all this is unecessary panic and it turns out we all laugh at ourselves later. Please?
Closed and continued here.