This "MILD Swine Flu" vs. A "BAD Seasonal Flu" - the CDC Numbers

[The Mountains Voice]

The following data was acquired from the CDC website -
(I did the % math myself)

Total U.S. Population = 300,000,000 +/-

Average Number for High Severity Seasonal Flu
60,000,000 People Infected (20%)

# of Hospitalizations = 200,000 People Hospitalized
Hospitalization Rate Percentage of the total infected population = 1/3 of 1 percent

# of Deaths = 36,000 People Dead
Death Rate Percentage of the total infected population = 6/100's of 1 percent

JUST TO PUT IN PERSPECTIVE THE CURRENT PECENTAGES OF SWINE FLU, LET'S COMPARE -

Current Numbers for This "MILD Swine Flu"
Current Total Infections = 1,639 People Infected

# of Hospitalizations = 57 People Hospitalized
Hospitalization Rate Percentage of the total infected population = 3.48 percent

# of Deaths = 2 People Dead
Death Rate Percentage of the total infected population = 12/100's of 1 percent

According to these numbers, the Hospitalization Rate is 58 Times Greater for this "MILD Swine Flu", even when compared to a High Severity Seasonal Flu.

According to these numbers, the CFR / Death Rate is Twice as Great for this "MILD Swine Flu", even when compared to a High Severity Seasonal Flu.

 

[sharon sanders]

Re: This "MILD Swine Flu" vs. A "BAD Seasonal Flu" - the CDC Numbers

Thanks Mountain Voice but I do not think you have the total case count. This would greatly change your percentages of hospitalized and dead.

I think the numbers of ill in the U.S. numbers in the thousands. Only a fraction are accounted for - the same for Mexico.

Ask yourself - how many of your friends, neighbors, and co-workers are ill. What is going on at your local hospital? Are there any lines outside? How easy is it to make an appointment to see your doctor? Any delays?

There is your answer.

By now in a medium or high case fatality rate influenza we should see some obvious signs in our communities.

 

[The Mountains Voice]

Re: This "MILD Swine Flu" vs. A "BAD Seasonal Flu" - the CDC Numbers

Thanks Mountain Voice but I do not think you have the total case count. This would greatly change your percentages of hospitalized and dead. I think the numbers of ill in the U.S. numbers in the thousands. Only a fraction are accounted for - the same for Mexico. Ask yourself - how many of your friends, neighbors, and co-workers are ill. What is going on at your local hospital? Are there any lines outside? How easy is it to make an appointment to see your doctor? Any delays? There is your answer. By now in a medium or high case fatality rate influenza we should see some obvious signs in our communities.

I was anticipating this observation, and am prepared to reply -
F1 - I agree with your reasoning. I respect it - but I also disagree with it. It is perfectly clear that the numbers are fudged. However, it is also important to note that fudging the numbers works both ways. If you assume there are infections not counted (which is without question), then I think you have to assume that there are hospitalizations and deaths not counted as well.

How many stories have Flutracker members dug up of H5N1 Deaths / Hospitalizations that were swept under the rug?

Just reviewing stories of members, myself included, that involved trips to the hospital, OR stories of doctors that say they were told to to call the death "Pneumonia" and not mention the flu. Or the death in California (sorry, don't have the link) where it was classified non-flu - but the medical examiner refused to certify it until tested.

The CDC / WHO have their reporting standards. I have mine - and my numbers are based on their own figures. But I do agree that the numbers are fudged - but again, I think they are fudged in both directions. So you go with what you have. You gotta start somewhere.

And one last argument that supports my thesis is the symptomatic reports of people (members, news report, even my own families experience) - they/we aren't reporting "Mild" symptoms..... it's a gut wrenching, puking, high fever, mind paralyzing knockout. While not hospitalized - my son did have to GO to the hospital. He's had the flu darn near every year. This trip to the hospital was a 1st. If the symptoms are this severe - it stands to reason that the actual hospitalization/death report numbers might probably be fudged as well.

And you only have to fudge a small handfull of hospitalizations/deaths - to still get the same percentages - even if you assume fudged infection numbers off by thousands.

 

[AlaskaDenise]

Re: This "MILD Swine Flu" vs. A "BAD Seasonal Flu" - the CDC Numbers

I'm just uncomfortable trying to use any numbers to characterize this flu, at this point. It's too new to have defined characteristics. Until we finish a "flu cycle", I don't think we can have meaningful numbers. i don't know whether the first completed cycle will be when it exits the northern hemisphere (where it may not be fulfilling a normal full cycle), or when it finishes a 6 month duty tour in the southern hemisphere, or when it has completed 2 full seasons (one south + one north). I just think we need more history.

.

 

[The Mountains Voice]

Re: This "MILD Swine Flu" vs. A "BAD Seasonal Flu" - the CDC Numbers

I'm just uncomfortable trying to use any numbers to characterize this flu, at this point. It's too new to have defined characteristics. Until we finish a "flu cycle", I don't think we can have meaningful numbers. i don't know whether the first completed cycle will be when it exits the northern hemisphere (where it may not be fulfilling a normal full cycle), or when it finishes a 6 month duty tour in the southern hemisphere, or when it has completed 2 full seasons (one south + one north). I just think we need more history..

Alaska, I agree again. I was mainly practicing an exercise in futility to primarily show that "official" numbers can work both ways. We've got plenty of Media and ordinary folk that follow these pages. My main point is that numbers can be spun. It IS too early to run numbers to make any substantive qualification & pronouncements - so the media should stop. The governments should stop. What is important is the science - and the science indicates that this virus has characteristics that are NEW, EVOLVING, and NOT NECESSARILY MILD.

But in the face of spin - I'll offer my own, and I still hold that my reasoning for this "picture frame in time" are valid arguments / numbers. People need to see 2 sides of the spin coin. My only goal in this is to cast doubt upon the wisdom of believing everything you hear. People need to look deeper into the facts and science of this virus, instead of just taking a kneejerk "Oh the Officials Say....." approach to preparedness.

 

[prepdeb]

Re: This "MILD Swine Flu" vs. A "BAD Seasonal Flu" - the CDC Numbers

I don't have a lot of faith in most of the numbers flying around right now. There are so many reasons for people not being counted and most of the infection has been relatively mild.

It's clear from reader comments posted on any and every H1N1 related news article on our local paper's website, that most people are totally bored with any news about this new strain of flu that isn't killing enough people to hold their attention.

Sad to see that most have completely dismissed the new strain already as posing any threat. Despite the number of articles and comments pointing out that the virus is not static, they've dismissed it.

Judging from what I read and hear locally, very few people view this as any potential threat. If it's not an immediate threat, it doesn't exist.

 

[Siegfried X]

new H1N1: the same, yet different from seasonal flu

new H1N1: the same, yet different from seasonal flu

Two medical articles compares the new H1N1 with regular seasonal flu. Basic conclusion is that the severity and age-distribution is basically the same, but the new H1N1 causes more GI symptoms.

They also mentions the possibility that "elderly persons may have some level of cross-protection from preexisting antibodies".

In the United States to date, most confirmed cases of S-OIV infection have been characterized by self-limited, uncomplicated febrile respiratory illness and symptoms similar to those of seasonal influenza (cough, sore throat, rhinorrhea, headache, and myalgia), but approximately 38% of cases have also involved vomiting or diarrhea, neither of which is typical of seasonal influenza.

The clinical spectrum of novel S-OIV infection is still being defined, but both self-limited illness and severe outcomes, including respiratory failure and death, have been observed among identified patients ? a wide clinical spectrum similar to that seen among persons infected with earlier strains of swine-origin influenza viruses and seasonal influenza viruses.

The age range of the 642 patients with confirmed cases of S-OIV infection was 3 months to 81 years, but 60% were 18 years of age or younger. This age distribution is typical for seasonal influenza;

The clinical manifestations of S-OIV also were typical of seasonal influenza, with fever in 94% of patients, cough in 92%, and sore throat in 66%; in addition, however, vomiting (found in 25%) or diarrhea (found in 25%) was common... The spectrum of illnesses seems very much like those of seasonal influenza.

Emergence of a Novel Swine-Origin Influenza A

Implications...

 

[Shannon Bennett]

Re: This "MILD Swine Flu" vs. A "BAD Seasonal Flu" - the CDC Numbers

I wonder how the WHO squares that information with the number of healthy mid-life deaths in Mexico.

 

[Siegfried X]

Re: This "MILD Swine Flu" vs. A "BAD Seasonal Flu" - the CDC Numbers

The Mexican deaths at the start of this outbreak are a tragedy which we will probably never know all the answers about. However, the limited evidence we have seems to indicate that a lot of those deaths were caused because the patients received terrible medical care, and probably because some unrelated deaths were lumped together with flu.

It's the same virus and yet the deaths that are happening now follow the pattern of seasonal flu. But speaking of the early days in Mexico, several patients said they didn't receive anti-virals, or any treatment at all.

 

[sharon sanders]

Re: This "MILD Swine Flu" vs. A "BAD Seasonal Flu" - the CDC Numbers

Welcome Siegfried X!

 

[Siegfried X]

They've mostly stopped testing in the USA

They've mostly stopped testing in the USA

Numbers don't matter that much any more in the USA since they've mostly stopped testing. The CDC changed their recommendations so that many patients aren't tested:

Clinicians should test persons for the novel influenza (H1N1) virus if they have an acute febrile respiratory illness or sepsis-like syndrome. Certain groups may have atypical presentations including infants, elderly and persons with compromised immune systems. Priority for testing includes persons who 1) require hospitalization or 2) are at high-risk for severe disease...

Some US states have focused on that last sentence and only test hospitalized patients and those with special risk factors.

The CDC even discourages patients from seeing their doctor, except in special cases, which would make it impossible for most patients to be tested:

Not all patients with suspected novel influenza (H1N1) infection need to be seen by a health care provider. Patients with severe illness and those at high risk for complications from influenza should contact their medical provider or seek medical care.

 

[The Mountains Voice]

Re: This "MILD Swine Flu" vs. A "BAD Seasonal Flu" - the CDC Numbers

And you only have to fudge a small handfull of hospitalizations/deaths - to still get the same percentages - even if you assume fudged infection numbers off by thousands.

Just off the wire....

http://www.google.com/hostednews/afp...zt9JrQS95UTVpA
US confirms 2,254 swine flu cases, 104 hospitalizations
6 hours ago

WASHINGTON (AFP) ? US health officials said Saturday that swine flu was continuing to spread in the country, with the number of confirmed cases rising to 2,254, with 104 people hospitalized.

In this particular "limited frame of time view", the new math looks like this.....

Current Total Infections = 2,254 People Infected

# of Hospitalizations = 104 People Hospitalized
Hospitalization Rate Percentage of the total infected population = 4.61 percent (up from yesterday's 3.48%)

While it isn't scientific - it does go to show what the CURRENT REPORTED STATS are. (and yes, all my prior qualifications, and those pointed out by others still stand...)

But it is going up. If I am correct, it will be up at the next report also - based on official count numbers.

 

[mixin]

Re: This "MILD Swine Flu" vs. A "BAD Seasonal Flu" - the CDC Numbers

The CDC is also changing its testing recommendations in yet another way. I wonder if in the beginning the doctors weren't looking at gastrointestinal cases as possible flu cases.

From a Bloomberg article: "Patient reports also suggest the swine flu, which CDC researchers are now calling swine-origin influenza H1N1/A, causes more vomiting and diarrhea than standard seasonal flus, the CDC said. The agency is advising doctors to look for flu patients with gastrointestinal symptoms and have them tested for swine flu, Dawood said."

http://www.bloomberg.com/apps/news?pid=20601124&sid=aLnivLSRTSyw&refer=home

 

[Shannon Bennett]

Re: This "MILD Swine Flu" vs. A "BAD Seasonal Flu" - the CDC Numbers

Magnify the numbers to a real pandemic. Now just imagine all vents are currently occupied.

 

[the doctor]

Re: This "MILD Swine Flu" vs. A "BAD Seasonal Flu" - the CDC Numbers

We in North America are experiencing an atypical influenza epidemic. Supporting this view is that it is occuring outside the normal flu season and the number of confirmed cases reported are rising exponitially.

The reason our PH officials have decided to focus on testing ILI's in hospitalized patients only is because they have already conceded the fact that we are currently experiencing an influenza epidemic that has spread to almost all if not all of North America.

So what we need to do is not second guess them for why they are now only focusing on testing of hospitalized patients with an ILI but understanding why they have taken this course.

Simply put, there are too many "mild" cases present within NA already. The testing facilities and resources are limited. By focusing their efforts on the hospitialized patients with an ILI, our PH officials will be able to get a much better grasp of the severity of this pandemic.

So, what should the Flutrackers amoung us do given these new circumstances? Follow the PH lead. The key metric from this point on is not the number of confirmed cases but the number of confirmed hospitalized patients and deaths due to Mexican Flu.

As stated above, we are already witnessing an atypical influenza epidemic within North America. What the PH authorities are trying to determine now is whether this epidemic is "mild, moderate or severe" by focusing only on the most severely ill.

This is a very smart approach to the problem IMO since it makes the best use of our limited resources.

What we need to do as influenza observers is to watch the rate of change in the number hospitalized and dead from flu or its complications. These will be the most informative metric for planning how to respond to the current situation, not simply the CAR.

Grattan Woodson, MD

 

[Siegfried X]

The government's flu approach is wrong

The government's flu approach is wrong

So what we need to do is not second guess them for why they are now only focusing on testing of hospitalized patients with an ILI but understanding why they have taken this course

I do second guess them, because they are wrong. At each step of the way, the government recommends a "go slow" approach which, if I followed it, would risk my health.

As an individual there is no doubt that if confronted with the flu my best chances of good health would come from immediately beginning treatment with anti-virals, and by seeing a doctor. That is the standard medical recommendation when focusing on one individual that the sooner they begin anti-virals and see a doctor, the better off they will be.

Yet the CDC focuses on the big picture, the overall population. It is like that Star Trek movie where they keep saying "For the sake of the many, the few must die". The CDC doesn't want to run out of anti-viral medicine or flood doctors offices with patients or for the new H1N1 to become resistant to Tamiflu because of over prescribing.

For those reasons the CDC is risking my health, and the health of each of us as individuals, by encouraging us to ignore the swine flu until it makes us very, very ill. According to the CDC we aren't supposed to even visit a doctor until we "have severe illness" and not use anti-virals until we have "severe influenza illness". So anyone who listens to the CDC throws away their window of opportunity, the first 48 hours when the anti-virals work best. We wait until the new flu has trashed our body, then hope that doctors can save us.

And the CDC is fighting phantom threats which aren't real or could be fixed without risking our health. The medical system could use triage nurses to screen out the "worried well" patients by taking their temperature; those who don't have a fever or severe cough could be informed that they don't have swine flu. There are already more anti-viral medicines in the manufacturing pipeline -- with the proper government incentives we would soon have more medicines to choose from. The obstacles to Tamiflu production has mostly been eliminated. There is a streamlined manufacturing process, and several manufacturers in multiple countries are ready to produce millions more doses as soon as they are asked.