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  • Swine Flu Is Way Worse Than Expected

    Swine Flu Is Way Worse Than Expected

    John Carney|Jun. 8, 2009, 9:03 AM|

    When we began writing about the impending swine flu pandemic, many readers thought we were buying into some kind of government created panic. Our view was exactly the opposite: the government was understating the risks of swine flu, worried that a "panic" would hurt the economy. Mainstream media sources started by being "responsible" and under-reporting the risks in the US, bought into the panic for a week or so, then quietly dropped the story.
    The story of swine flu has now effectively dropped out of public discussion. In fact, when it is discussed it usually as a critique of health authorities for needlessly creating a scare.

    Once again, however, this is exactly backwards. Swine flu has not turned out to be a non-event. It is not more confined than intially feared. Indeed, the official risk models of swine flu dramatically underestimated how widespread it has become.

    As the New York Times reports, two rival supercomputer teams made projections about the swine flu epidemic. One said that swine flu would hit 2,000 people by the end of May. Another said the number would be 25 percent higher: 2,500. (The innumerate editors of the New York Times call these estimate "surprisingly similar," but that's not important for now.)

    In fact, the Centers for Disease Control and Prevention estimate that by the end of May there were upwards of 100,000 cases of swine flu in the country. So much for the models that told us the risks weren't so big.
    Last edited by AlaskaDenise; August 15, 2009, 01:07 AM. Reason: remove photo

  • #2
    Re: Swine Flu Is Way Worse Than Expected

    16 Comments

    Henry Blodget said:
    Jun. 08, 9:08 AM

    So has anything happened from this? Or was the problem that widespread swine flu just wouldn't be a big deal relative to the normal flu, which kills thousands of people a year?

    I think the fear was that the swine flu would kill hundreds of thousands of people and lead everyone else to quarantine themselves for months, cutting off commerce. As far as I know, that hasn't happened.


    Anon. said:
    Jun. 08, 9:14 AM

    So does this article fall under the heading of 'scaremongering' or 'responsible reporting'? Maybe the number of people infected is (magnitudes) greater than the initial models but towhat effect? Are people dying in greater numbers or are our hospitals overloaded? If neither of these outcomes has occured then I fail to see the importance. We simply have another virus on our hands that is no worse, and possibly more benign, than the typical winter flu.

    I think this article reeks of sensationalism absent additional facts.


    John Carney (URL) said:
    Jun. 08, 9:19 AM

    The death rate outside of Mexico never reached the death rates reported in Mexico. That's most likely a result of under-reporting cases in Mexico. If you under-estimate how many people get swine flu, you wind up over-estimating the death rate.

    This is a major problem for people and the economy because it effectively added another season of flu outbreak to our calendar. What's more, we're most likely going to have another major outbreak or two of swine flu this year, one of which will coincide with the more traditional flu outbreaks in late fall and early winter. This has major productivity costs.

    But, yes, it's not wiping us out at the rate some feared, probably because it was never as deadly in Mexico as it appeared to be.


    jrh (URL) said:
    Jun. 08, 9:44 AM

    I think the big worry is that a relatively mild first wave in the spring/summer could be followed by a much more lethal wave in the fall/winter. This is what happened with the spanish flu in 1918.





    Jackson Stone said:
    Jun. 08, 9:52 AM

    It certainly could have an effect, but this will likely be at the margin. The effect (kill rate) is far lower than originally expected, so while the possibility exists for another flu season, or for the flu season to be worse at the margin (people out of work longer because of the H1N1 strain), it will be nothing like the fears when it first came out due to the appearance of a high death rate.


    kblog123 said:
    Jun. 08, 10:00 AM

    Kids, when the WHO considers a level 6 pandemic alert it is serious stuff. The flu is not as deadly as thought but the fatalities are in a different demographic group then most flu victims fall into. The economic concern is the effect of a major flu outbreak in a developing country or whatever anyone calls them today. Think of the impact on manufacturing in the flu hit China or Asia in a big way.

    Plus these things mutate. H1N1 was and is a big deal. Wash your hands, go to the doc if you get really sick and be thankful our helath care system can deal with this level of illness.

    It fell out of the headlines because of panic, the economy and it was not as deadly as it could of been.


    TJ said:
    Jun. 08, 10:04 AM

    The 1918 flu was preceded by several years of flu deaths that were dramatically elevated, probably due to the war in Europe. So that virus had a huge immune-compromised population to play in while adapting for virulence.

    That's not the case today, and the reason why the large number of cases are a non-item in the non-sensationalist news is that the flu isn't particularly deadly, although you can always cherry-pick a statistic and use that as the only axis of comparison to make things seem worse, 'cause fear sells.

    If there were 200 cases in the US but fifty fatalities, the headline on this article would still read, "Swine Flu Is Way Worse Than Estimated," even though there were far fewer cases, because the death rate was higher. Wake me up when the flu has a significant chance of being BOTH widespread and deadly. Until then it's a non-story.

    The CDC et al are doing a perfectly good job of keeping track of it, and will sound the alarm in the unlikely event that it's needed. Health authorities worldwide have done a good job on this, to the extent that even the scaremongers in the media have had a hard time getting anyone to be very afraid.



    chad said:
    Jun. 08, 10:07 AM

    Jackson Stone +1


    Matt Lehrer (URL) said:
    Jun. 08, 10:18 AM

    John, if you don't continue calling it The Oink, no one will.


    Concerned said:
    Jun. 08, 10:24 AM

    This article is not 'scare mongering', nor is it sensationalism. If we were to look at the facts, we would see several interesting things emerging.

    Firstly, apparently every agency and/or organization (this includes governments) are underreporting, and for good reason: money, as usual. It costs time, money, personnel, test kits, and laboratory resources to accurately test for swine flu. The net result of this expenditure? Higher numbers, of course. With higher numbers comes more potential for panic; a call for even more testing; and a reduction in revenue because tourism and commerce would suffer. When you measure potential economic impact against the safety and well-being of the public at large, you don't really need to ask about the respective priority levels.

    Secondly, how bad is swine flu, really? Well, the data can be skewed to make it look less bad: you hear comparisons between "seasonal" flu (also an AH1N1 virus) and swine flu. We've all heard the numbers: 36,000 people die each year from the "seasonal" variety, whereas only a couple of handful have died so far from this new strain. HOWEVER, let's compare apples to apples, shall we? The "seasonal" flu ENDS with the rising temperatures of spring, and we do not usually see cases in May and June. The current cases represent an anomaly of frightening significance: an upswing in cases when there should be virtually none. Check out the website recombinomics.com, and go the "what's new" section for additional info on this phenomenon. In a nutshell, the current strain contains a variant gene (mutation) that allows it to proliferate in much warmer temperatures than the seasonal variety. This is why we have had fatalities in Arizona, despite temperatures in the TRIPLE digits for more than a week ("seasonal" flu does not like temps above 70 degrees F).

    Thirdly, when we compare the current flu with the worst recorded pandemic, the 1918 flu, which killed anywhere from 40 to 100 million people, mostly within the span of 6 months, we see a pattern of relatively mild cases breaking out in the spring when there should not have been any (sound familiar?), followed by an apparent lull. In the fall, however, the second wave hit, and in October 1918 alone it is estimated that 695,000 people died as a result of the flu. Life expectancy in the U.S. dropped by more than a decade as a result of this single event. The current flu? It's actually AHEAD of the 1918 curve, since there does not seem to be a "lull" in the activity level. If this virus continues to mutate (as all flu viruses do) what will this fall bring? What will "wave 2" look like in 2009/2010? Are we better prepared than we were in 1918? In some ways, we are LESS prepared, since we no longer grow our own food or manufacture our own products...if we cannot get things we need for everyday survival, what happens then? If trucks, trains, ships, and planes won't (or can't) transport food, medical supplies, etc. because the drivers/pilots are sick, dead, or afraid, what then? Check out the history of the 1918 flu. It provides some serious insights into what could (and may) happen.

    Finally, the "seasonal" flu is resistant to Tamiflu, the one weapon we have to effectively reduce the severity of the new flu. Unfortunately, since both types are AH1N1 viruses, they tend to swap off genetic components very readily - it is almost a certainty that the swine flu will acquire resistance by the fall. And, regardless of the optimistic prognostications of the various agencies and companies (all of which are vying for research dollars), a vaccine will NOT be ready by the time the next wave begins.

    This is why the governmental agencies and the media are downplaying the threat. They are scared, and they don't want to see wholesale panic in the streets. The problem is, they don't seem to be DOING anything that could help the average person cope with what may transpire. The last time I checked the pandemic plan for the U.S., it was patterned after the fantastically successful ?Katrina? plan in terms of logistics, etc. And that was for an isolated geographical region ? imagine that sort of planning being applied to the entire U.S.

    So, is this scare-mongering? Not in my book. The really scary part of this is having people, agencies, the government, and the media attempting to downplay the potential severity of the current situation. It doesn?t work, and it doesn?t save lives. In fact, the last time this approach was taken was the last time there was a widespread outbreak of a swine flu variety?in 1918.



    V said:
    Jun. 08, 11:11 AM

    Yeah, sure. Quote the fear mongering NYT. Never mind the countless articles that state this strain is no more harmful than common flu that kills up to 30,000 a year in the US alone, huh? Also, this strain, according to the World Health Organization, and not some "supercomputer" model geek-nerds, to date, has only killed 139 people.

    Be afraid and panic all you like. "Concerned" (above) is ready to bury their head and come up with some interesting "theories" that are based on bunk. Such as this: "....the 1918 flu, which killed anywhere from 40 to 100 million people, mostly within the span of 6 months, we see a pattern of relatively mild cases breaking out in the spring when there should not have been any (sound familiar?)..."

    Ahem. NO! This flu is in it's 3rd - 4th month and once again, we've seen only 139 deaths. Mostly from underlying conditions. Nice post, "Concerned", but perhaps you should write rhetorical pieces for the lamestream media as your "facts" are seriously convoluted.

    I, for one, will not succumb to the fear and hype that is Pigmageddon or the Aporkalypse. And I live in Mexico (gasp!). Nor should anyone else, for that matter. I don't know why all the talk of 1918 when we went through this nonsense before in 1976. We're still here.


    MacQueeve said:
    Jun. 08, 11:45 AM

    Why no discussion of the adult-diaper-filling dread of epidemeologists: two strains of flu active in the population where less virulent H5N1 mutates with H1N1? If i've read correctly, this reduces H5N1's inherent kill ratio, but it gains ability to spread, and hence kills more.

    Didn't Kissinger say, "It is not a question of too few resources. Rather, it is a question of too many people."?


    Earl ValJohnson XVI said:
    Jun. 08, 12:15 PM

    i have a medical-field related friend (doctor)

    according to him the swine flu is just a different strain of the flu. There is no known differences that will lead to widespread death, chaos, scenes from the movie Outbreak, etc. Even went on to say, there probably were quite a few cases of the swine flu over the winter, but who really goes to the doctor for a normal flu, and even then...most doctors didnt send your results to get tested for swine flu, they just assumed it was a flu.

    no bigggie or diggity.




    Concerned said:
    Jun. 08, 12:53 PM

    Concerning the response from "V":

    I definitely do not use the NYT as a sole source of information. Epidemiology is a hobby of mine, and I know people in the field as well. I've been following both avian (bird) flu and swine flu for the better part of a decade now. Whether or not you believe me is of little importance to me - I try to prepare people for what may come.

    If you had bothered to research the 1918 pandemic AT ALL, you would have seen some things that were sure to raise red flags. For instance, both swine flu outbreaks started in the spring (March), when 'regular' flu viruses would normally peter out. As far as being in the 3rd - 4th month, you are correct in terms of the timing...but again, check where the 1918 flu was in its 3rd - 4th month as well. The current flu actually seems to have more of a foothold, although without genetic typing being available in 1918, it's hard to tell. My point is, this virus has less lethality, but appears to spread just as quickly. Should it mutate to a higher lethality while retaining the ability to spread (something known as "passage", whereby a new organism becomes increasingly lethal when it passes through multiple hosts - which is what happened in 1918), the second wave, which, if the timelines prove similar, should start to appear when our next flu season kicks in (early fall).

    Another red flag is the demographic: all age groups appear to be impacted, although in Mexico, the middle range (20's through the mid 50's) more so - this is not the typical flu demographic, and was a hallmark of the 1918 pandemic.

    Some other things are troubling as well. Have you seen any descriptions of the symptoms? The accepted term for all cases appears to be "flu-like symptoms". Don't you find that interesting? So, the cases that eventually died came in with "flu-like symptoms", and then quietly expired? Not likely. Again, the media and the governments do not want to tell of people choking on their own fluids while turning blue (cyanosis); nor do they want to describe how internal organs shut down from either lack of oxygen or from the body's own immune response (a chemical over-reaction of the body in its attempt to kill off the invading organism known as a cytokine storm). The symptoms are essentially similar to the 1918 flu as well as the avian, or bird flu.

    Which brings up another point: there are now cases in Egypt and China, both epicenters for the bird flu outbreaks. Should genetic material be swapped off there, we could see a recombinant variety that spreads as quickly as the swine flu, but with the 60%+ mortality rate of the avian flu, many strains of which are resistant to whatever antivirals we have now.

    Many people do not want to know about "worst case scenarios" because they feel as though they cannot do anything about it, anyway. I urge my close ones to take a few simple precautions, just in case: put away lots of bottled water; non-perishable food such as tuna, ramen noodles, etc.; medical supplies (including prescriptions, if you can get advance quantities); and things you would need for daily life (don't forget flashlights, batteries, etc.). These are steps that we should take anyway, in case of any other type of emergency - it just makes sense to have a reserve. Look at 9/11, the blackout of 2003, any number of hurricanes, etc. If nothing happens, big deal - no harm done, except an expense for items that you could use anyway. BUT - if something happens, and you didn't prepare...you could have problems.

    I do not advocate scare-mongering; nor do I advocate burying one's head in the sand or listening to watered-down versions of the "news" issued by a government or media that may be trying to placate the public. Authority figures do NOT always know what's best, nor are they always our best friend. Check out newspaper articles from 1918, when they were trying to downplay the severity of the flu, while people were literally dropping dead in the streets. Hopefully, this will not be the case this go-round, but I would rather be prepared than not. One other thing about the reassurances from "authorities": I was working downtown on 9/11, and ran into several people who opted against listening to the voice on the loudspeaker telling them that everything was okay, and for them to stay put. One construction worker who I met in the dust cloud barely made it out, and looked like a statue, covered in the white dust. Two members of his work crew lagged behind, after listening to the reassuring voice. He made it. They did not. Better safe than sorry, but the choice is always yours to make.


    g said:
    Jun. 08, 1:07 PM

    Don't fear the reaper, *****.


    g said:
    Jun. 08, 1:07 PM

    Don't fear the reaper, *****.

    Comment


    • #3
      Re: Swine Flu Is Way Worse Than Expected

      Some of the replys above are exactly the response i am getting off people. when i try to talk to them,that is why i will no longer talk about it to anyone,you can only tell people so many times and then you hit the wall.

      Comment


      • #4
        Who will be death #140?

        we've seen only 139 deaths
        My answer to them would be "Can you guarantee that I won't be #140? Are you absolutely certain that YOU won't be death #140?"

        Any flu can kill anyone. An epidemic just increases the odds.

        The families of each of those 139 victims wish their loved one had taken TamiFlu earlier, so they'd be alive today.
        Last edited by Siegfried X; June 8, 2009, 05:16 PM. Reason: spelling

        Comment


        • #5
          Re: Who will be death #140?

          Originally posted by Siegfried X View Post

          The families of each of those 139 victims wish their loved one had taken TamiFlu earlier, so they'd be alive today.
          From what I Understand these deaths goes way beyond taking tamiflu.

          Comment


          • #6
            Re: Swine Flu Is Way Worse Than Expected

            Regarding the comments from the article: another Darwinian moment or maybe it's an Ant and the Grasshopper moment. While everyone must hope that this new virus never achieves its worst case scenario, these commenting nitwits are a good example of why the US is in so much trouble -- financial, economic, ethical, moral, you name it.
            Absence of evidence is not evidence of absence

            Comment


            • #7
              Re: Swine Flu Is Way Worse Than Expected

              I am not sure this is the most appropriate place for this but there was some mention, in a thread, of swine flu starting much earlier than we realized. Perhaps this article points to an earlier version of it.




              CDC reports swine flu virus in Texas patient

              Lisa Schnirring Staff Writer
              Nov 24, 2008 (CIDRAP) ? The Centers for Disease Control and Prevention (CDC), in its latest update on the nation's seasonal influenza activity, reported on a person who was infected with a swine influenza virus following several exposures to pigs, including a sick one.

              The CDC said the patient was infected with a swine influenza A/H1N1 virus. Although human infections with swine flu viruses are uncommon, many years bring reports of isolated cases, the report said.

              The Texas Department of State Health Services, in a flu surveillance activity report for the week ending Nov 15, said the patient got sick in mid October. His or her specimen was collected and the virus identified during routine influenza surveillance. Texas officials, who gave no details about the patient's illness, said their investigation found no illnesses in his or her household or close contacts.

              According to the CDC's background information on swine flu, the agency receives about one human influenza isolate each year that tests positive for a swine influenza virus. H1N1 and H3N2 swine flu viruses are endemic in US pig populations.

              ......

              The report said that triple reassortant H1N1 subtypes are the predominant genotype in North American pigs and that human swine flu illnesses often mimic seasonal flu infections. The authors recommended that clinicians ask patients with unexplained influenza-like illnesses about exposure to animals, including pigs, and visits to petting zoos and county fairs.

              Human infections with novel influenza A subtypes now are nationally notifiable diseases in the United States, the group reported. Though human-to-human swine flu transmission is rare, the CDC said human infections with swine H1N1 viruses should be investigated to ensure that they are not spreading among humans?as spread could represent a pandemic threat?and to monitor changes in circulating viruses.

              In 1988, an H1N1 swine flu virus was found in a previously healthy 32-year-old pregnant woman who died 8 days after she was hospitalized for pneumonia, according to the CDC. Four days before she got sick she had visited a swine exhibit at a county fair where a flu-like illness was widespread among the pigs. Follow-up studies showed that 76% of swine exhibitors had antibodies to the swine flu virus, though no illnesses were reported. However, researchers found that one to three healthcare workers who had contact with the woman experienced mild flu symptoms with antibody evidence of swine flu exposure.

              Comment


              • #8
                Re: Swine Flu Is Way Worse Than Expected

                Dr. Niman has posted in a different thread other times in the last year or so when humans in the US had been infected by sick pigs with which they had had contact, but as in this case, the transmission stopped there.
                Wotan (pronounced Voton with the ton rhyming with on) - The German Odin, ruler of the Aesir.

                I am not a doctor, virologist, biologist, etc. I am a layman with a background in the physical sciences.

                Attempting to blog an nascent pandemic: Diary of a Flu Year

                Comment


                • #9
                  Re: Swine Flu Is Way Worse Than Expected

                  Originally posted by wotan View Post
                  Dr. Niman has posted in a different thread other times in the last year or so when humans in the US had been infected by sick pigs with which they had had contact, but as in this case, the transmission stopped there.
                  Correct. Swine H1N1 infections of humans are fairly common. The most famous example was in 1976 at Fort Dix, which led to the swine flu fiasco. However, ususually only 1-2 people are infected after contact with swine. The H1N1 from the human cases are isolated and sequenced, They do NOT match the swine H1N1 currrently in humans and circling the globe at this time.

                  Comment

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