Pig flu and an economic crisis...

[Sunfish]

Bradley gets it.

An Influenza A pandemic normally occurs over an extended period and occurs in waves, each succeeding wave having a greater impact (CFR) than the last. It isn't the death toll that is the real problem for us. It is the load it places on our society in terms of already overstretched health care, supply lines, utilities etc. We are better off in care and science depth than 1918 but have nowhere near the resources to deal with the number that may fall ill in a pandemic. Today we live in a 'just in time' society. Disrupt the supply chains even a little and see what happens.

This is why the experts are worried. H1N1 has met the three criteria in spades. It will be some time before we really know if it will go pandemic or not and it will be too late to get ready once teh first wave really gets going. That is why you are being warned now. It is your choice to take it or leave it.

The CFR isn't the thing. The 1918 pandemic had a CFR of "only" 2.5%. It's the massive number of cases in a short time (think 20% of the population - say in Australia 4 million), that totally overwhelms the healthcare system. Now even if just One percent of those 4 million cases die of flu or complications, that's 40,000 deaths in three months or less. This is hardly "business as usual".

Please read Flu Wiki - please note that this is not wikipedia at all but among other things a collection of reference works and commentary on Influenza in general.

Flu Wiki - Main - Flu Wiki


Furthermore, as you do your research, you will discover that the W.H.O. is a highly political organisation, as is our Government, and what they tell you is what is in their best interest to tell you, not necessarily what is in your best interests.

[assasin8]

If people stayed home when sick, maybe spare a thought for their healthy fellow workers who would prefer not to be coughed upon, then the world really would be a better place!

[Angle of Attack]

It's all very good for people to have confirmed cases but quite frankly there is NO cases in Australia. And even if you have it seems it is a no brainer. Oh shucks 11 people have died in almost 3 weeks! Lol! Quite frankly this is a distraction not a real issue. Lets move to the next issue those saying this is one have surely succomed to the media hype ^^. If you dont believe me send me a message in a month Why are you so gullible btw?? hehe!

[Sunfish]

AA, you do not know if any Australians are infected. What we know is that no suspected cases have been confirmed. What we also know is that we cannot keep the flu out, the best we can do is DELAY the onset of a pandemic if we are lucky and work hard. Thats the phase of the National Pandemic Plan we are in right now - DELAY. Thats why we have introduced thermal scanning and health cards etc., it may help us catch a case or two, but sooner or later an asymptomatic individual is going to fly in and then come down with Flu Four days later.


The other thing you need to understand is that Influenza pandemics follow an exponential law. It's a bit like a bushfire. It starts with a tiny little spark, for the first few minutes it's easy to put out, but then it gathers strength. All the stuff about washing your hands, using a handkerchief and isolating your self if you get sick, closing schools and public events is aimed at removing both fuel and sources of ignition from the Influenza bushfire.

The other thing you need to understand is that even if a Pandemic is mild, at the height of it, there could be upwards of 2 million Australians sick with it at once, even if its mild. That is going to swamp the health care system even if people don't die.

[Bradley Marsh]

Updated page

Back from work yet again so here is a bit of an update on the webpage I wrote a few years back:
Flu A Page

I can only suggest that rather than playing the man you chaps play the ball. Go learn a bit first and then argue. There is plenty of room for differeing opinions but if you are ignorant of the facts then you having nothing to stand on. Oh and at PPRuNe .. ALWAYS keep your Bull**** filter firmly in place!

Cheers,

Brad

[Bradley Marsh]

Just as a brief primer for those of you actually interested in Professional Aviation and what a pandemic - any pandemic - means

Please start here: None of what is written below is conjecture. I am simply relaying the information provided by the worlds foremost experts on Influenza A, virology, epidemiology and what a pandemic may mean for us all. Lets start with a set of interviews conducted late in 2005 with many of the world leaders in the relevant fields, so if you are in any doubt about the chances of a Pandemic occurring you might consider reading this 11JAN06 set of interviews by the worlds experts

So what is a pandemic? It is a world wide epidemic. That's all. It is a widespread pathogen. It does not imply any particular level of morbidity or mortality. But to to become a pandemic strain a pathogen we should be concerned about (in this case Influenza A) must meet three criteria:
1. It must be an emergent virus - that is it has not been seen before. Each virus has a host species in which it is endemic but which usually remains asymptomatic. Typically birds (H5N1), Pigs (H1N1) etc. The host species just acts as a reservoir. Occasional a virus will change such that it can jump the species barrier. A virus can change (some same say mutate) in one of two ways. Antigenic drift - this is a result of the sloppy way copies of the virus are reproduced in the host cell, primarily because a virus is so simple it is like building a house with only roughed out plans.. the end result is often different to the original. Reassortment is when two different virus infect the same cell there may be some swapping of genetic info between the virus' so that a new one emerges containing properties of both precursors. The guts of it is that Viruses change and fast!


2. The new virus must be able to infect humans and cause disease therein {otherwise who cares?} This is generally a property of being a novel virus to us, that is we have no pre-existing immunity through exposure to previous strains of the particular virus. The current H1N1/2009 strain seems to be affecting mostly people born after the mid1960s. This is possibly due to the exposure of older people to the 1967 pandemic strain of Influenza A. This is theory only at this stage. Pandemic strains kill an additional demographic to seasonal influenza (normally the young and the old) in addition to it's usual victims - those with depressed or inadequate immune function. Another cause of mortality is called a 'cytokine storm'. In effect it is a healthy bodies extreme reaction to a pathogen that is so over the top it attacks healthy cells as well. This is why many victims in 1918 were healthy people between age 18-45.


3. It must be easily transmissible and able to reproduce successfully within humans. Virus is transmitted in two ways. Aerosolisation - someone coughs or sneezes and you inhale their nasal secretions, mucus etc .. pretty yucky eh? Contact transmission - they contaminate a surface, you then touch it and then touch your face (nose/mouth/eyes) and self infect. BTW a virus can remain inert on a surface for days! The best way to avoid infection is get no closer than about 6 feet to someone and the main one is to practice good hygiene (wash your hamds well and often) and stop touching your face!

Pandemics are different every time. The received wisdom is that they come in waves of some weeks. Each wave more deadly than the first. 1918 started as a relatively mild Flu and got steadily worse. Towards the end there is anecdotal evidence of people being asymptomatic as they get on the bus to go home and dead just hours later. Another danger of flu is you are contagious for up to 48 hrs BEFORE becoming ill and for some days after you have apparently recovered. This means you can be spreading the disease around the world before you even get a temperature. Do you wonder why the WHO is taking this seriously? There is no question an Influenza A pandemic will occur. What version of Flu A it will be, when, what it will look look like and how it will affect us is a different story. So these posts are about being prepared, both with knowledge about how it happens and what each of us can do about it.

Cheers,

Brad

[heads_down]

US swine flu cases jump to 642

From correspondents in Washington

Agence France-Presse

May 07, 2009 07:25am

THE number of confirmed US swine flu cases surged by 60 per cent today to 642 from 403, with infections reported in three more states and the death toll now at two.

Forty-one US states are now reporting confirmed cases of (A)H1N1 flu, and the US death toll has gone up, with the first US citizen reported to have died from swine flu.

The victim was a woman in her thirties "with chronic underlying health conditions" who died in a Texas hospital on Tuesday.

"This reminds us that influenza can be a very serious infection and it's one that we need to continue to take very seriously," Richard Besser, acting head of the Centers for Disease Control and Prevention (CDC), which compiles the daily flu tally, said.

The death of the American woman was the second in the United States after a Mexican toddler died last month while visiting Texas.

It was also only the second death outside Mexico, the epicenter of the outbreak, where the authorities on Wednesday upped the death toll from swine flu to 42 from 29, but insisted the worst of the epidemic was over.

Mr Besser, however, said he expected the virus to continue spreading in the United States and around the world, and fully expected the outbreak to become a pandemic.

"With the number of cases in other countries, I would be suprised if we don't get to level six" on the World Health Organization's six-phase pandemic alert scale, Mr Besser said as Poland and Sweden reported their first confirmed cases and other countries in Europe extended their tally of (A)H1N1 cases.

Mr Besser said there were around 850 probable cases - where a first test comes back positive for type A influenza - in 44 states.

Earlier this week, he said that the overwhelming majority of probable cases eventually become confirmed cases, meaning results of subsequent tests for the (A)H1N1 virus have come back positive.

[Bradley Marsh]

Testing lag

There has recently been released a new test for Flu A. It is called PCR (Polymerase Chain reaction). It is much faster than traditional identification techniques (culturing). There will be a jump in the number of confirmed cases of H1N1 over the next couple of weeks as the PCR test is used to clear the backlog of swabs awaiting ID. Best thing to do is listen to the experts. If they say it is a pandemic then be assured it is. WHO will not move to Phase 6 unless it is sure.

Cheers,

Brad

[philr]

The Swine exhibits exponential Growth??

Hey Sunny

Me thinks that a Logistical growth model may be more appropriate....try a wiki!

FP

[Mr. Hat]

Pig Flu

Its been pretty quiet on the media front, I wonder if this one might just dissapear quietly.

[Bradley Marsh]

It is possible that it just may disappear quietly. A/H1N1/2009 is following a similar pattern to the original A/H1N1/1918 inasmuch as it entered human circulation towards the end of the Northern Hemisphere winter and was relatively mild.

It was only the successive waves than exhibited increased morbidity and mortality and of course had the benefit of a veritable diaspora with all those young men leaving Europe and heading home.

The guts of it is we still just don't know if this will become a pandemic and if so what CFR we will see. Certainly there is a lot of attention focussed on the Southern Hemisphere as we head into our Flu Season. It may, or may not, be an indicator of things to come.

So just before we all go back to our usual daily grind please be aware that the 'people that know' are still very wary. Click here for an interesting viewpoint http://www.nature.com/nature/journal/v459/n7243/full/459009a.html

CDC expects more infections, hospitalizations and deaths over the coming weeks. CDC H1N1 Flu

There are now over 2500 cases world wide, the majority of which are still in the Americas. This is a function of a number of factors inclduing the ability to detect and identify H1N1 (the new PCR test is helping a lot) and the serial interval (how long it takes from one contagious person becoming symptomatic till the next person they infected doing the same).

In reality there is nothing you or I can do to prevent a pandemic. What we can do however is be aware of what it means - and if it does happen be as prepared as we can be. This is not a panic call. It is the same as we as professional aviators spend our professional lives doing, imagining the worst and making sure we have done our homework.


Cheers,

Brad

[Borneo Wild Man]

PERSPECTIVE -

36,000 people die from seasonal influenza every year in the US.


I note the media doesn't print actual active or recovered cases - good news obviously doesn't sell .

[Bradley Marsh]

Orangutan, your point is what exactly in relation to seasonal flu?

Might I ask if you have read the thread? Perhaps done some research into what a pandemic strain of a pathogen actually means?

Not having a shot at you at all mate, just asking if you are informed by anything other than MSM.

Cheers,

Brad

[ZEEBEE]

Bradley

If they say it is a pandemic then be assured it is. WHO will not move to Phase 6 unless it is sure.

While I don't argue with yourself or Sunfish regarding the "potential" severity of this, I do have some problems with that statement above.

Being a born again skeptic, I am mindful that the WHO is a political body that is continually looking for relevance.
And relevance comes to them in these imagined or real pandemics in buckets, so it would be un-natural for them not to whoop it up.

If it goes away, they can bask in the glow of "having fixed it" and get funding...or if it gets worse, then "we have to fix it" and they get funding.

It's a no brainer for them really.

[Bradley Marsh]

Reprint from Nature magazine for those interested

Between a virus and a hard place : Article : Nature
Between a virus and a hard place
Top of page
Abstract

Complacency, not overreaction, is the greatest danger posed by the flu pandemic. That's a message scientists would do well to help get across.

Damned if you do, damned if you don't. The emergence of a new, swine-flu-related H1N1 strain of influenza in people in North America, with sporadic cases elsewhere in the world, has left the US Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, and the World Health Organization (WHO) in Geneva in an unenviable position.

For more than a week now, these two agencies have been holding daily media briefings to keep the world informed about the rapidly unfolding story. There is ample reason for concern: a new flu virus has emerged to which humans have no immunity, and it is spreading from person to person. That has happened only three times in the past century. The pandemics of 1957 and 1968 were mild in most people but still killed many, and that of 1918 — which also seemed mild in its early phases — killed at least 70 million people worldwide. As Nature went to press, the WHO had already upped its pandemic threat level from 3 to 5, and a final step to its highest level of 6 — a global pandemic — seemed only a matter of time.

Yet at this early stage, the consequences of the pandemic are so uncertain that communicating the risks is a delicate matter. Influenza viruses evolve rapidly, making it extremely difficult to predict what this strain might look like a few months from now. If the agencies alert people and the pandemic fizzles out, they will be accused of hyping the threat and causing unnecessary disruption and angst. Indeed, just such a media backlash is already beginning, because most cases so far have been mild. But if the agencies downplay the threat and an unprepared world is hit by a catastrophe on the scale of 1918, the recriminations will come as fast as you can say 'Hurricane Katrina'.

The risk is not hyping the pandemic threat, but underplaying it

To their credit, the WHO and the CDC have avoided the kind of falsely reassuring officialese that has too often accompanied past crises. As Peter Sandman, a risk-communication consultant based in Princeton, New Jersey, aptly puts it: "Anyone who's paying attention gets it that we just don't know if this thing is going to fizzle, hang in abeyance for months, disappear and then reappear, spread but stay mild, replicate or exceed the 1918 catastrophe, or what. The reiteration of uncertainty and the insistence on what that means — e.g., advice may change; local strategies may differ; inconsistencies may be common — has been almost unprecedentedly good."

Also encouraging is that many governments now have at least some kind of pandemic plan in place, thanks to the scare over the H5N1 avian flu virus earlier this decade. Five years ago very few of them did. But many of those plans contain an important element that has been conspicuously absent in the current communication by governments and public-health authorities: during a severe pandemic, there is only so much they can do. Much of the response will depend on local communities taking action for themselves.

Scientists can help, by serving as credible voices to inform their communities of the risks and uncertainties, and by pointing people to the pandemic-planning resources on the CDC and WHO websites, the PandemicFlu.gov site, and many others. For the moment, the risk is not hyping the pandemic threat, but underplaying it. We know a tsunami is coming. No one can say whether it will be just a large wave, or a monstrous one, but it is time to start thinking about at least being ready to move to higher ground.Between a virus and a hard place : Article : Nature

[Bradley Marsh]

CDC position

CDC H1N1 Flu

The ongoing outbreak of novel influenza A (H1N1) continues to expand in the United States. CDC expects that more cases, more hospitalizations and more deaths from this outbreak will occur over the coming days and weeks.

CDC continues to take aggressive action to respond to the expanding outbreak. CDC’s response goals are to reduce spread and illness severity, and provide information to help health care providers, public health officials and the public address the challenges posed by this emergency.

CDC is issuing updated interim guidance daily in response to the rapidly evolving situation.
Antiviral Guidance

CDC has issued guidance for health care providers on the use of antiviral medications during the current outbreak. The priority use for influenza antiviral drugs is to treat severe influenza illness and people who are at high risk of serious influenza-related conditions.
School Guidance

At this time, CDC recommends the primary means to reduce spread of influenza in schools focus on early identification of ill students and staff, staying home when sick, and good cough etiquette and frequent hand washing. Decisions about school closure should be at the discretion of local authorities based on local considerations. (See the School Guidance.)
Increased Testing

CDC has developed a PCR diagnostic test kit to detect this novel H1N1 virus and has now distributed test kits to all 50 U.S. states, the District of Columbia, and Puerto Rico. The test kits are being shipped internationally as well. This will allow states and other countries to test for this new virus. This increase in testing capacity is likely to result in an increase in the number of reported confirmed cases in this country, which should provide a more accurate picture of the burden of disease in the United States.

[skylarker]

QF16 pax tests positive to Swine Flu

NSW woman tests positive to swine flu | smh.com.au

[heads_down]

you do realise in instances like this, your team manager suddenly double up as a medical practitioner telling you not to worry, you did not get it.

It is very predictable what they will say.

Any procedures in place after this? Like gloves and mask? Absolutely not, they figured you are the one who would be very ill, not them, they don't care.

QCC will spin you around once again that no you did not have to worry, nothing will happen to anyone.

You wait and see.

[Crew rest.]

Yes September, a Swine 'flu "information"m page that is brought to you by the people who also sell the 'ION-70' air purifier (kills the swine flu virus and other viruses-fast!), the "P2 standard face mask" and "Purel (what evr the f#$% that is) that kills germs and bacteria instantly.
Presumably cures baldness, lumbago and dandruff---"HURRY!!--WHILE STOCKS LAST....!!"

[Bradley Marsh]

I hope this willprvide some persepective for those who still think this is a media beat-up or over-reaction. I think the current number of identified cases is over 4000 atm. Not many but that isn't the point.

Swine flu: features of past pandemics : Effect Measure

Cheers,

Brad