
A few comments on pandemic influenza - ivankirigin
http://www.fluidinfo.com/terry/2009/04/26/a-few-comments-on-pandemic-influenza/
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jraines
I always thought the W-shaped spike in deaths-by-age from the 1918 pandemic
was due to it spreading rapidly in infirmaries and barracks full of already
sick and/or stressed out soldiers.

~~~
Zaak
Another possibility is cytokine
storms:<http://en.wikipedia.org/wiki/Cytokine_storm>

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pfaux
"In conclusion, I’d say that the thing is largely out of our hands"

But remember your mother's best advice : wash your hands and don't touch your
face.

<http://www.cdc.gov/flu/protect/stopgerms.htm>

~~~
tjpick
My mother's best advice was drink more water and get an early night. But yeah,
both are good.

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ivankirigin
Quite literally a hacker talking about news. This was a good read.

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gojomo
Oh, great. A disease panic, now accelerated by online social media and
Twitter. This could be worse than the bird flu (panic) of 2004-2005!

Despite the opening claim to being "fairly sober -- neither alarmist, nor
dismissive", I thought the choice of emphasis here is somewhat in the alarmist
direction, mostly making sure to mention how bad it could be. Examples:

 _I expect it will go global in the next couple of days, maximum._

 _The social breakdown in a pandemic is extraordinary._

 _No-one knows how bad another pandemic might be in terms of mortality...
single digit millions... 100M might be possible._

 _...you should probably not believe anything any politician says about
pandemic influenza._

So let me offer as a small counterweight the at-least-as-likely alternative
scenario: flu deaths worldwide in 2009 will be about the same as previous
years, around 40K in the US and up to 500K worldwide.

At this point: eat well, sleep well, and discourage sick people from coming to
offices or socializing. Same as always.

~~~
henryw
the 1918 flu pandemic was worse than the black plague and it's not even
airborne like this one.

[http://www.puertorico-
herald.org/issues/2003/vol7n30/KillerV...](http://www.puertorico-
herald.org/issues/2003/vol7n30/KillerVirus-en.html)

~~~
tomjen
There are properly more people living in Washington DC than in Europe during
the time of the plague.

~~~
gojomo
Not at all. According to Wikipedia, the population of Europe before the plague
peaked at 70-100 million, while the plague killed 25-50 million, still leaving
the population over 20 million, possibly over 50 million. The population of
Washington DC is 592,000; if you include the metro area, 5.3 million.

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tlrobinson
"Don't eat pork from Mexico!!"

 _Sigh_

Surely this sort totally false information and rumors has spread verbally
before Twitter was around, now we just have a permanent record of stupid
things people say.

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Herring
_The virus is an influenza A virus, carrying the designation H1N1. It contains
DNA from avian, swine and human viruses, including elements from European and
Asian swine viruses, said the CDC, which is already working on a vaccine._

\-
[http://www.reuters.com/article/domesticNews/idUSTRE53N228200...](http://www.reuters.com/article/domesticNews/idUSTRE53N22820090424)

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ashot
if the virus spreads as well in the real world as it does in the virtual one
we're screwed

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silentOpen
Population variability and imperfect interfaces make that unlikely.

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sachinag
As I said in the other thread, the only certainty in a pandemic is that the
public will react in bizarre and strange ways.

The general feeling is that the reaction will almost certainly be an order of
magnitude over the threat, given our knowledge and expertise with pandemics,
and that most deaths will be from human response as opposed to the pandemic
itself (as would be the case with a dirty nuclear bomb).

~~~
smanek
How?

I'm not disagreeing, I just don't see any obvious ways that the human response
would cause a lot of deaths - so I'm curious.

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gojomo
A crash nationwide vaccination program in response to a swine flu scare in
1976 appears to have triggered hundreds of cases of Guillain-Barré syndrome,
and "at least 25 deaths":

<http://www.semp.us/publications/biot_reader.php?BiotID=177>

~~~
forkqueue
Given that the geographically concentrated swine-flu related death toll is
already over 81, this doesn't provide compelling evidence that 'most deaths
will be from human response as opposed to the pandemic itself'.

TV news stations will of course hype this thing beyond all proportion, as they
always do, but that doesn't mean the threat isn't real and that, as the
article suggests, the death toll from Swine 'flu itself won't run into tens if
not hundreds of millions.

~~~
gojomo
I wouldn't suggest that overreaction necessarily kills more than the disease
itself. (Your quote is from another poster.) But I did want to share one
example where it clearly did, to show it's not impossible.

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xel02
This is actually a pretty interesting case as the virus is such an odd mix.
For those who aren't aware Influenza has a multipartite genome (separated
segments), I think we're pretty lucky this didn't show up during flu season in
which case there would have been a very high chance of it mixing with another
strain that easily transferred among humans but still resistant to antivirals.

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DanielBMarkham
This is going to sound strange, but I love watching how people act on
incomplete information.

Some will fall back to observe-hypothesize-test. Some will ignore/dismiss all
observations unless someone in authority tells them to pay attention. Some
will make the most outlandish claims. Some will make false statements, like
the "don't eat swine" claim, just to add momentum to the story.

Of course there's no right answer in a situation that could be fast-moving yet
requires immediate decisions based on incomplete information. It's just cool
to watch all the different modes of thinking critically.

I hope this story turns out to be bogus -- I have a job where I deal with
hundreds or thousands of people in small meeting rooms. But I've read up many
years before today, and I understand that the pandemic IS coming. It's just a
matter of time.

Just not this year, I hope.

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rms
Anyone know an online pharmacy stocking Tamiflu? The one I know only has
Symmetrel.

~~~
m_eiman
According to what I've read Tamiflu won't do you any good. There's no vaccine
for this strain yet.

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arrrg
Tamiflu is no vaccine but a antiviral drug. It doesn’t help with the current
seasonal flu but it seems to help with the swine flu.

Vaccines won’t be ready for months.

