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A Flu Pandemic?
Pedrito writes "Scientific American is running a story in this month's issue about preparing for a flu pandemic. What this article tries to convey is that a pandemic is definitely coming. Whether it's from the H5N1 strain (which would likely cause hundreds of millions of deaths) or another strain a few years down the road. There have been 3 other flu pandemics in the past 100 years. The 1918 strain being the worst, with 40 million killed. The reason H5N1 is being followed so closely is because it's already spread to people and because it's incredibly lethal (a roughly 50% fatality rate at th moment). Even if the fatality rate dropped to 5% when and if it mutates into an easily communicable form, it would be twice as deadly as the 1918 virus."
Scientific American used to be a fine magazine with level-headed articles, which presented difficult scientific topics in language that a well-read lay person could understand and appreciate. In the last few years, however, it has increasingly moved toward the sensationalistic article which predicts that doom "could happen any day now." It's bad journalism and it's bad science but it does sell subscriptions. For some reason, I still have mine.
One thing that bothers me about all this sudden talk of pandemics, how much cause for concern is there for the average American citizen? This flu strain is apparently more dangerous than SARS, yet it has recieved nowhere near the amount of press that SARS did, and SARS primarily affected the elderly and people with poor immune systems (there were exceptions, though, back off).
In my case, I haven't been sick enough to need antibiotics in more than a year and a half. I'm a full time college student living in a thirty year old dorm in western Pennsylvania. I regularly have contact with over 1000 people on any given weekday. At any given moment, there is at least 5 people in my hall who are sick.
Is this pandemic something that American college students at small schools should worry about? Obviously, there is a much higher chance at a university or much larger school (like Penn State with ~45,000 students from all over the world).
Colin Dean Go a year without DRM
50% of what? Of people who got sick enough to go to a doctor. Where do the people who never showed up at a hospital fit into this statistic?
Being somwhat affiliated with a few online pharmacies, I know, that Tamiflu (possibly a cure, or at least a good suport medicine to avoid getting any flu) has been withdrawn form public pharmacies and are stocked by the government.
.....
Why is that happening ?
Is this flu propaganda for the drug companies, and fear mongerin ?
These questions came up almost every day looking at searches for that medication, and many claim that this flue, when getting ins a country with decent medical practices/health services has a very small fatality rate. Most people get it in developing countries, and get it in agricultural professions (e.g. farmers being exposed to chickens)....
Before you start trolling on online pharmacies, I never send spam, or sell dangerous meds such as hydrocodone, so don't bother.
Anyway I am exposed to medication news because it became part of my revenue, and dunno what to think anymore about that flu panic....
Most people I know say, that it is just a panic by the drug mob to boost sales, but the stocking of flu meds by governments send me a different message....
We all know that the news cycle runs on hype, and that there are always charlatans, snake-oil salesmen, and fear mongers waiting to pounce when danger threatens.
However, immediately dismissing pandemic warnings is foolish. It makes sense to develop a vaccine and work on contingency plans.
That said:
There are a lot of differences between 1918 and 2005, and 1963 and 2005.
Diabetes and obesity epidemic aside, people are a lot healthier:
* Vitamin deficiences and plain malnutrition are rareities.
* Lice, bedbugs, intestinal worms and such, while not unknown and on the rise in certain populations, are very, very rare on the whole.
* The vast majority of people sleep in their own beds, in warm bedrooms.
* Simple palliative medicines like aspirin, decongestants, anti-diarrheals, and re-hydration drinks can turn what in 1918 were deadly menaces into something merely serious.
* Most people take hot soapy showers every day; soap and hot running water are available in restaurants and workplaces.
A pandemic would certainly be bad news for people on the margins, especially the very poor, very old, and recent illegal immigrants crammed into shared housing. But on the whole, the factors listed above will work together to turn a life-threatening menace into something serious -- possibly temporarily debilitating -- but survivable for most people.
Stefan
P.S. Hey! You! Wash your goddamn hands after you use the bathroom and cover you mouth when you sneeze. Yeah, you!
Before people jump on my back saying I'm an evil heartless person... I'm just putting things in to perspective. I don't want a pandemic to break out, but I'm just looking at this with an objective eye.
I'm assuming that 'twice as deadly', as meaning killing twice the number of people.
Yes, the new flu virus may will kill twice as many people as the 1918 pandemic did, however our population has more than tripled since the beginning of last century.
Lets say that the numbers are true. 40 million people died in the 1918, with a world population of, say, 2 billion people. This would mean that there was a 2% death rate.
Now, say in 2005, 80 million people die, with a world population of say 6.45 billion. The death rate would be 1.2% of the total world population.
That's 0.8% lower, than it was in the past. Actual numbers will most likely be less, with better technology, better sanitation in many parts of the world, and an understanding of genetics.
The numbers are here to scare people, and sell headlines.
Money cannot buy happiness, but can buy something soo darn close, that you can't really tell the difference
Two posters comment on a thread about a SUPERFLU with direct references to a bestselling book about a SUPERFLU, and moderators rate both posts as offtopic?? Where are we getting moderators these days, the Republic of Illiteracia? FWIW, I thought both posts were quite topical AND funny. "M-O-O-N" indeed :))
"He who throws mud, loses ground." - proverb
So do you want to feel safe, or know something about a valid threat to the well-being of you and yours? Do you want to have any reasonable idea of which direction to try to chase your government to act responsibly? The US government does not have the ability to act in a timely fashion, as discussed in the article. The Katrina debacle gets a (IMHO valid) specific mention, as they give the numbers on CDC timelines.
Somewhere between the madness of Fox News, and knowing nothing about it whatever, a balance needs to be struck. I've followed the popular press in this a bit, though mostly the BBC, rather than US news agencies (though born, raised, and live in the US), as they seems more informative and essentially sane, regarding many international issues.
Certainly there will be panic buying of various products--many of them snake-oil. Some will die because of this. Human nature is what it is. But on balance I thought the article fair, and useful in reducing some of that thoughtless panic buying.
Here in the US, the next influenza pandemic will once again reveal the vast differences between our rich and poor, in the most basic terms of all: who lives and who dies. Part of the problem is the huge size of an underclass that will not be reading that SciAm article, or anything like it. Many will never even know that SciAm exists. 'No Child Left Behind' is *not* getting the job done.
URLs, or maybe hardcopies for the half of the US population with no Internet access, might be a good thing to disseminate. The truly poor may not have the resources to do what they think best, but they should have an opportunity to know the facts. I don't trust the government to inform them without a 'This here FEMA director is doin' good. He's workin' 24x7.' [ slant | ignorance | lies ]. It could save some lives.
What you do with a computer does not constitute the whole of computing.
I can't call myself an expert in the field, but I am definitely on my way there. And I can tell you that H5N1 is coming... and all we can do is prepare to manage the disaster whenever it comes.
However, there are a few hope-instilling facts:
1. Most bird-derived influenza strains that infect humans were more lethal when they were xenobiotic infections than when they were once they gained the capability to transmit human-to-human.
2. We do have drugs (oseltamivir, amantadine and rimantidine) that can fight influenza at the molecular level.
But aside from that, if it's even 1/10th as lethal in its pandemic form, it will lead to a crisis unlike any the world has seen since the plague. Actually, worse, since the plague epidemic was largely limited to europe.
Uh... no. Ones with access to modern medical treatment are the only ones accounted for in the WHO statistics. If they never made it to a hospital they won't be accounted for at all.
Now before I get modded down, I be to remind whoever might read this that what I am saying is FACT. - bogaboga
If you're not one of the typical flu victims (elderly, very young or compromised immune system from other causes), you'll have an excellent chance to shrug it off, even if it does spread. Same thing said by all the other ignorant people who are blissfully unaware that the immune system reacts so hard and fast it causes extreme rates of inflammation in the lungs, and you die. The better your immune system, the harder that response and inflammation. The elderly, young and those with compromised immune systems are going to be better off than you.
You only have to avoid eating the chicken RAW.
Unlike the mad cow disease (which is caused by [very rare] self-replicating proteins, not virii),
the flu virus (like other chicken disease, lysteria, and so one) doesn't survive cooking.
So if cook your chicken soup well, or roast correctly your roasted chicken, you're safe, at least from virii and bacteria.
"Sufficiently advanced satire is indistinguishable from reality." - [Tips: 1DrYakQDKCQ6y52z6QbnkxHXAocMZJE61o ]
Mad cow/scrappies/Chronic Wasting Disease-CWD/curu-CJD (all prions) is/are such that it takes years for it to show up, with no test for it. What many have missed here, is that it has been showing up in Colorado,Idaho and Montana in humans.
Keep in mind that CDC knew about AIDS in 1980/1981, and was trying to get money to slow it down. Reagan turned them down when they requested funding in 81,82,and 83. Keep in mind, that in 1981 when reagan turned down CDC request for 50 million to be spent on it, there was fewer than 1000 in the USA with it. It was possible that they could have caught more than 50% of the infected when it would have been easy and made a difference.
Now, the CDC is focused on this pandamic, and GWB is only now starting to consider it. Considering that influenza is an unstable virus, it is very mutangenic. When H5N1 comes into contact with a flu that supports human-human transmision, it will most likely pick up the ability. Once that happens, the morbidity rate is about 50% amongst HEALTHY people (the vast majority of infected has been healthy). According to CDC and WHO, last week they announced that it was not stoppable. It is now a matter of when.
I prefer the "u" in honour as it seems to be missing these days.
Everyone I know that actually deals with disease for a living, ... is scared, and takes bird flu VERY seriously
I was in the hospital last week for routine blood tests, chatting with my favorite nurse, and she was telling me about all the new plans they have in place for dealing with the coming pandemic. The top health authorities in each country have reviewed the actual hard data on what is coming, and getting ready for various worse case scenarios. They just aren't certain which winter it will hit, probably not this year, but almost certainly one of the next three winters.
The hospital had just reviewed and practiced for a "plan blanc" (white plan) of being overwhelmed with large numbers of highly contagious patients. The plan blanc was mostly aimed at preventing infection of the hospital staff, and how to isolate the sick and keep visitors from circulating and possibly spreading the disease. Next week they are reviewing their "plan noir", to deal with huge numbers of dead, and the disposal of highly contagious bodies and medical waste. The hospital never really had a plan noir tested before, what once was a short couple pages of suggestions is now a whole large book. In my town of 40k population, the hospital was looking for a place to store up to 1000 bodies, with 200-400 deaths per week over a 10 week period, and only being able to dispose of 100 per week. Scary shit, indeed.
The town authorities are preparing for a 50% worst case mortality rate, with all the subsequent recovery problems; no more younger school age children for years, half of the tax revenue generating population dead, food shortages if the borders are closed, longterm drop in tourism, local exports blockaded, and no financial aid from any direction because the devastation may be all around Europe.
All the hospitals in the Benelux, France and Germany are preparing for the worst, and its not in response to some poorly written articles in the mainstream press. They have the experts looking at the data and are getting very, very nervous.
I just got my flu shots, something I've never felt the need before.
the AC
Hemos is like...sci-fi fans;he thinks technology is cool, but he hasn't bothered to understand the science it's based on
Offtopic I know but this guy seems to have beaten HIV, the precursor to AIDS.
> That's one of the reason we didn't see a Ebola pandemia
...
Actually, the reason we don't see an Ebola epidemic is because ebola is spread by contact with blood and/or secretions of an infected person. I'm sure you're aware that flus spread easier than that. The one thing ebola had going for it was the fact it caused people to bleed. Other than that, it's not much more virulent than AIDS.
I'd also point-out something else: the Black Death killed very quickly - most people died four to seven days after infection, which is about the same amount of time that H5N1 takes to kill a person. Your "whole family drops dead the same evening" scenario is not realistic given what we already know about H5N1.
The Black Death is believed to be carried by fleas on rats. The rats (along with lots of other mammals) were dying from the Black Death as well. So, your "if a flu virus like H5N1 can both cross infect birds, but is almost harmless to them, and humans, and is highly lethal," scenario doesn't need to be true in order for H5N1 to be a big problem.
So, the Black Death was killing its hosts and doing it quickly, but that didn't stop it from wiping out a third of europe's population within a few years. In many cities, it wiped out 50-60% of the population. So, the Black Death had the attributes (according to you) would've caused it to burn itself out too quickly to be a real problem. Yet, it killed 1/3rd of europe's population.
The danger will be if a flu virus like H5N1 can both cross infect birds, but is almost harmless to them, and humans, and is highly lethal, then there's some chance of such a "everyone drops suddenly dead" scenario.
I don't think this is the danger. We're talking about the possibility of millions of deaths, which is less severe that your "everyone drops suddenly dead scenario", but also more likely to happen.
Apparently, most of the pandemic level 'virulent' flus kill through something called cytomic(sp?) shock?
This means an immune system over-response which destroys various membranes in your body, like your lungs, or spinal cord.
Healthier people get hit harder.
WhiteWolf666 an exBush supporter. All you new-school,compassionate,save the children Republicans can rot in hell
I remember back in the 90's taking some Amantadine to help fight the flu. And I wondered why the news keeps going on and on about Tamiflu. So I did a quick check and yes Amantadine is an antiviral drug, but thanks to the fucking Chinese they have made it useless to fight H5N1 because they'd been abusing it the way our ranchers abuse antibiotics. Amantadine costs a lot less but it doesn't matter. Now we have to use the much more expensive Tamiflu.
It gets better. One of the primary ingredients for making Tamiflu is something called Shikimic acid which is difficult to produce and is extracted from star anise that is only grown in four provinces in China. And their is a global shortage of star anise so that's why their's a global shortage of Tamiflu. Anyway it probably won't matter since H5N1 will probably develop a resistance to Tamiflu because of overuse. Anyway, we'll just have to wait and how the next pandemic evolves.
"You'll get nothing, and you'll like it!"
Actually,
I've been reading some serious epidemiology journals for a class I am TA'ing, and they are pretty serious about this. I usually have my hype squelch turned up pretty high about this sort of thing, but those scientists don't seem to be joking around.
They Are Night Zombies!! They Are Neighbors!! They Have Come Back from the Dead!! Ahhhh!
If you're not one of the typical flu victims (elderly, very young or compromised immune system from other causes), you'll have an excellent chance to shrug it off, even if it does spread.
Actually the 1918 virus was much more deadly in people with strong immune systems. I can't remember the exact figures, but the percentage of death in the 20-40 age range was higher than any other. This was because the victims died from the over-response of the host's immune system. Unfortunately, it looks like this virus would be the same way if it mutates to humans.
I see only two problems with moving research of this type into non-profit organizations (e.g. the government, since they're the ones funding the majority of research into obscure and rare diseases anyway, as no company would do it, since they can't make money on the treatments). The first is the usual inefficiency and waste associated with a lack of profit. But that is countered by the life-saving purpose of the research, which is more of a drive for the majority of the researchers than any monetary return. The importance of the research more than makes up for the lack of a year-end bonus. The second is that though there's knowledge, there won't be anyone or any resources to materialize the knowledge. That's where companies come in--to turn the knowledge into a product that the average layman can use. And that's what they should only be allowed to make money doing.
But what happens when there's simply no interest in the knowledge and hence no funding. Well, even for the most obscure disorders and illnesses (like the genetic disorder where children physically mature many times faster than natural whose name I forget), there's someone working on it. It may be slow, but research is still happening. As for a lack of interest by companies in producing actual pills or machines that deliver the treatment, well, that would be true whether companies have patented the science to the treatment or not. Companies should still be able to donate their resources in such situations.
To use the example you cite, there's still plenty of AIDS research going on. Just today, there's news about someone who appears to have fought off the virus, and there's a great amount of public interest in that person. The interest and subsequent research is just not in the private sector. So no one manufactures the deliverable product if they can't control the formula (who would want to compete when they can have a monopoly?). But forcing pharmaceuticals to only be able to make money from manufacturing treatments solves this particular problem, since companies then have no choice but to use public domain knowledge to make their products (or they don't make products, go bankrupt, and someone else jumps in). In addition, AIDS research has also slowed down because though AIDS isn't cureable, it is treatable, and even better, preventable. If AIDS turned airborne (which is very unlikely right now), you'd better believe that people will jump to find a vaccine or cure, money or no money.
As for this avian flu, I'm certain if the Tamiflu was never created (because no one saw that it could make money), there'd still be researchers looking for a cure, likely in the academic world. And once one's found, at least one company will try to produce a product from it. By now, there'd be a dozen companies jumping onto it with their own version of the medicine, and there wouldn't be any problems. On top of that, the death rate by now would likely be much lower, since those who actually sought treatment would be able to afford it too.
Generally speaking, I'm of the opinion that all scientific research should be in the public domain. What should be patentable is the engineering end, which covers methods and applications--like a new method of delivering the treatment. Patenting science will only result in the halting of progress in any civilization (imagine if Newton patented calculus). If knowledge is horded like some kind of treasure, then only the dragons will be wealthy and everyone else impoverished, not to mention at the mercy of said dragons (major companies, in case you don't get the metaphor).
"If a nation expects to be ignorant and free in a state of civilization, it expects what never was and never will be."
The pharmaceutical industry is one of the best examples of corporate breach-of-ethics in recent history. Money money money money money. People are disposable, once they run out of money for their meds. R&D expenses? Nonsense. You gotta pay off the advertising bills! It's great you can give men boners for hours on end and make people believe they've licked their allergies. Very fufilling, I'm sure.
what makes you think my bosses are insane enough to invest that research money when the product is going to be confiscated?
When large numbers of people start dying, and your bosses face the possibility of contracting the disease and facing death themselves, I think you'll find that they'll suddenly develop a motivation to invest research money into cures.
Okay, fine. How about pharmaceutical companies that benefit from government funded research (at Universities, etc.) start paying for the value they get from that?
>> Everyone knows that organisms don't change from one form to another
Except when The Flying Spaghetti Monster commands them to.
Arrr, matey!
-dZ.
Carol vs. Ghost
OTOH, we have better medical care and nutrition now. Rapid communication enables us to isolate outbreaks more effectively. They may or may not cancel out the factors you mentioned, but you can't just assume things will be worse.
It's true I tell you, feller at work's next door neighbour read it in the paper.
Considering my town has effectively been wiped off the map by at least 4 wars and a couple of plagues in the last 600 years, and the two pandemics last century left the town struggling for years afterwards, the town councilors have a lot of data to go on. They've even employed a couple of historiens to dig up summaries of the recoveries for the last 2 centuries of disasters. A couple of people with actual degrees in history that I always knew as either barmen or system administrators. I never thought a degree in history was worth much, but history has ways of proving me wrong. I haven't seen anything in the local press, I get my information first hand from town council meetings, a necessary evil in my line of work.
/. in complete denial that there might be a pandemic coming. The 100 epidemioligists are sounding the alarm, starting last year, and now with human transmissible h5n1 cases and new strains being found in birds in Europe, the alarm has gone out. They have scheduled to drop by your house next week with all of their raw and cooked data to help convince you, personally, that the risk has jumped way higher than some random asteroid.
The hospitals started reworking their disaster plans at least two years ago, probably in response to SARS or some other event which freaked the powers that be.
What bothers me is the large percentage of people posting on
the AC
Hemos is like...sci-fi fans;he thinks technology is cool, but he hasn't bothered to understand the science it's based on
> As one of those researchers, I've got to ask -- given that Taiwan is already breaking
> the Tamiflu patent, what makes you think my bosses are insane enough to invest that
> research money when the product is going to be confiscated?
Because even if they are, it's not causing Roche and everyone down the royalty chain to lose any actual money. Roche is already producing at 100% capacity, selling 100% of its output at its chosen price point, and refuses to license manufacturing rights to anyone else. As long as Roche is still selling 100% of its chosen capacity at its chosen price point, it has no right to bitch.
Personally, I take immense comfort from the high likelihood that right now, multiple factories in mainland China are almost certainly working around the clock, secretly cranking out pirated Tamiflu as fast as they possibly can, quietly filling warehouses with it, under the direction of one or more government officials motivated mainly by the thought of making billions of dollars and euros selling it to Americans and Europeans on eBay (or direct) for, say, a thousand dollars/euros for a 3-month twice-daily supply, when/if a real, honest to god pandemic strikes and the rights of Tamiflu's IP owners fall off the bottom of their list of concerns.
Think about it... the Chinese have little regard for IP anyway, they're faced with a potential future domestic crisis whose sole possible cure -- Tamiflu -- is already being rationed and suffering from limited availability. Does ANYONE *seriously* think they're going to sit back with their hands neatly folded, obediently refraining from violating Roche's IP and settling for the crumbs Roche might allocate to them at some outrageous, inflated price? And of course, if they DO make lots and lots of it, and demand far outstrips supply worldwide, the fact that they'll have to build a few new skyscrapers just to warehouse the money they'll make selling it abroad just seals the deal.
The genuine danger is that if no pandemic emerges within 5 years or so, some "bright" government official in China will decide to keep it from going to waste (since they won't be able to sell it, or even admit it exists, under any conditions besides an outright pandemic) and order it ground up and added to chicken feed. THAT would be a Very, Very Bad Thing(TM).