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Archive: WHO, 2009 H1N1 Pandemic Influenza - Updates (until the end of July 2010)

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

gsgs said:
just your opinion, others (Fukuda,Chan,Palese,...) disagree
Click to expand...

I was positing thoughts and posing questions.

That being said, no one has still answered the question:

However what impact will it have if WHO moves to Phase 6. What changes and what is the net positive?

Henry, while I am not disagreeing with you on the fact that there are asymptomatic spreaders, mild spreaders and people who get sick but don't go the doctor. I am still a little unclear as to what difference it makes whether or not you go to Phase 6. Disregarding the reality on the ground, what it logistically different? What steps are going to be taken that have not already been taken?
 
Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

the question is : does the amount(percentage) of nonreported cases
increase ?

Why should they nonreport more cases now than 10 days ago ?


I mean, outside North America, where the reporting/confirming capacity
is becoming exhausted
 
Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

gsgs said:
the question is : does the amount(percentage) of nonreported cases
increase ?

Why should they nonreport more cases now than 10 days ago ?


I mean, outside North America, where the reporting/confirming capacity
is becoming exhausted
Click to expand...

10 days ago they still had relatively little information about the virus. When they thought it was a higher virulence strain it was critical to work on containment to slow the spread. Hence, the travel shutdown to and from Mexico.

Furthermore, at some point you move away from lab confirmed cases to a clinical case definition.

If the issue is with WHO not announcing phase 6, it is because they do not have scientific data to support the move. Which could be a result of countries not reporting.

WHO makes decisions based on hard science, not hunches, best estimates, etc... While it may be slower, they rarely have to backpeddal on a WHO update. It may be frustrating but like I said before what changes if they officially move to phase 6 that isn't already being done right now?
 
Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

But it did not happen in North America.
The number of new cases had been steadily increasing there.
 
Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

gsgs said:
But it did not happen in North America.
The number of new cases had been steadily increasing there.
Click to expand...

Containment was going to be a futile effort in the U.S. because it was too late. The horse was already out of the barn so to speak.

For example, the U.S. plan for containment, and closing of the borders, was always predicated on the belief that the pandemic virus would appear somewhere far away, like Indonesia.

That didn't happen, the virus appears right next door so there was no chance for containment.

That being said, a country like Indonesia did have an opportunity for containment, because they were farther away from the epicenter of the virus outbreak.

Proximity to the epicenter of the outbreak had a lot to do with it.
 
Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

yes,...

so the horse is not yet out of the barn in Europe,Asia (?!?!)
 
Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Jeremy said:
I was positing thoughts and posing questions.

That being said, no one has still answered the question:

However what impact will it have if WHO moves to Phase 6. What changes and what is the net positive?

Henry, while I am not disagreeing with you on the fact that there are asymptomatic spreaders, mild spreaders and people who get sick but don't go the doctor. I am still a little unclear as to what difference it makes whether or not you go to Phase 6. Disregarding the reality on the ground, what it logistically different? What steps are going to be taken that have not already been taken?
Click to expand...
WHO typically issues announcements that are for public consumption, such as the denial of local H5N1 H2H transmission in the vast majority of clusters. Typically, the actions are consistant with the true pucture, but the announcements are not.

Right now most of the public assumes the H1N1 pandemic is disppearing and the media over-hyped H1N1 expansion, when in reality most of the media still has little understanding the close relationship between the 2009 pandemic and 1918.
 
Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

gsgs said:
yes,...

so the horse is not yet out of the barn in Europe,Asia (?!?!)
Click to expand...

There are attempts at containment being implemented in Europe and Asia.

Whether there is any meat behind them is debatable due to the issue of asymptomatic spreaders, symptomatic but mild, and symptomatic but not tested versus symptomatic and tested.

Is the horse out of the barn in Europe? Most likely.

Is the horse out of the barn in Asia? Possibly, but still to early to tell.

Regardless, it will hit everywhere....it is really only a matter of time.

That being said, no one has taken the challenge to answer the question:

However what impact will it have if WHO moves to Phase 6. What changes and what is the net positive?

;)
 
Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

gsgs said:
the question is : does the amount(percentage) of nonreported cases
increase ?

Why should they nonreport more cases now than 10 days ago ?


I mean, outside North America, where the reporting/confirming capacity
is becoming exhausted
Click to expand...
Testing is focused on new arrivals from North America, instead of spread within countries outside of North America.
 
Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

niman said:
WHO typically issues announcements that are for public consumption, such as the denial of local H5N1 H2H transmission in the vast majority of clusters. Typically, teh actions are consistant with the true pucture, but the announceemnts are not.

Right now most of the public assumes the H1N1 pandemic is disppearing and the media over-hyped H1N1 expansion, when in reality most of the media still has little understanding the close relationship between the 2009 pandemic and 1918.
Click to expand...

Henry,

So do you feel that lack of movement from Phase 5 to Phase 6 has taken H1N1 off the public radar, thus reducing the potential prepardness that could be taken place if we have a 1918 redux?
 
Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Jeremy said:
Henry,

So do you feel that lack of movement from Phase 5 to Phase 6 has taken H1N1 off the public radar, thus reducing the potential prepardness that could be taken place if we have a 1918 redux?
Click to expand...
It is MUCH more complex than simply removing H1N1 from the public's radar. H1N1 is a ticking time bomb, which could explode at any moment, yet WHO is spending time putting out utter nonsense about a swine H1N1 not being a swine H1N1 and denying that phase 6 is phase 6.
The virus really doesn't care if samples are tested or covered up. The CDC data for last week demonstrated what is happening in North America, but the same thing is happening at a lower level in Europe, South America, Asia, and Australia.

Testing is focused on North American travelers, but levels peaked in Mexico a month ago, and H1N1 has been seeded worldwide. Checks at airports largely limit spread on airplanes. Those infected within 1-2 days of their flight will not have symptoms until after the leave the airport at their destination. Moreover, the vast majority of spread will not be detected because symptoms are mild and many will not seek medical attention, and those that do will be treated for seasonal flu.

WHO shuld be marshalling forces to test samples much more broadly. Instead efforts are focused on travelers. In the US the CDC was overwhelmed and handed the confimatory testing off to state labs, who have already said that they will focus on severe cases.

The vast majority of cases remain off the radar, so many sequences changes will be missed.

Similarly, vaccine companies are not fully scaled up, so production of a second or third generation vaccine will signifiantly trail the virus.

H5N1 surveillance has been abysmal, and that will exted to H1N1. Many countries will cover-up cases, as they were allowed to do for H5N1.

H1N1 spread is a train wreck in motion, and most are just watching, rather passively.
 
Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Centers for Disease Control and Prevention ​
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Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

I got it figuresd out. Thx. It was the aggregate of all the Americas....

On the right hand side of this website, in the Comparison table, it says the Americas have 61 deaths. Have I missed something, is this past events, or am I not understanding how to read this? Can you help?

http://ais.paho.org/flu/sm/en/atlas.html

Thank you.
Click to expand...
 
Last edited:
Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

gjs47 said:
On the right hand side of this website, in the Comparison table, it says the Americas have 61 deaths. Have I missed something, is this past events, or am I not understanding how to read this? Can you help?

http://ais.paho.org/flu/sm/en/atlas.html

Thank you.
Click to expand...

Not sure of your question. 61 is the total for Mexico (56), USA (3), Canada (1) & Costa Rica (1).

hth
 
Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Jeremy said:
There are attempts at containment being implemented in Europe and Asia.

Whether there is any meat behind them is debatable due to the issue of asymptomatic spreaders, symptomatic but mild, and symptomatic but not tested versus symptomatic and tested.

Is the horse out of the barn in Europe? Most likely.

Is the horse out of the barn in Asia? Possibly, but still to early to tell.

Regardless, it will hit everywhere....it is really only a matter of time.

That being said, no one has taken the challenge to answer the question:

However what impact will it have if WHO moves to Phase 6. What changes and what is the net positive?


;)
Click to expand...

As far as I can tell (and I am new to FT), having read everything I can find on the WHO website, the only difference between levels 5 and 6 is that one number has been added to the alert level. Maybe that's why noone has tried to answer your question?
 
Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

looking at the graph and assuming the same rate of positives
for normal flu and that the light blue cases are novel flu,
I calculate a rate of ~24% positives for novel flu and
~8% for normal flu
 
Last edited by a moderator:
Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

Re: WHO Update #26 - 5251 cases - 61 dead - 30 countries

the ratio
dark blue(H1) / red (H3)
is already decreasing due to pressure from novel flu ?!


but not (H1+H3)/B
 
Last edited by a moderator:
WHO Update #27 - 5728 cases - 61 dead - 33 countries

WHO Update #27 - 5728 cases - 61 dead - 33 countries

Influenza A(H1N1) - update 27
13 May 2009 -- As of 06:00 GMT, 13 May 2009, 33 countries have officially reported 5728 cases of influenza A(H1N1) infection.

Mexico has reported 2059 laboratory confirmed human cases of infection, including 56 deaths. The United States has reported 3009 laboratory confirmed human cases, including three deaths. Canada has reported 358 laboratory confirmed human cases, including one death. Costa Rica has reported eight laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Argentina (1), Australia (1), Austria (1), Brazil (8), China (3, comprising 1 in China, Hong Kong Special Administrative Region, and 2 in mainland China), Colombia (6), Cuba (1), Denmark (1), El Salvador (4), Finland (2), France (13), Germany (12), Guatemala (3), Ireland (1), Israel (7), Italy (9), Japan (4), Netherlands (3), New Zealand (7), Norway (2), Panama (29), Poland (1), Portugal (1), Republic of Korea (3), Spain (98), Sweden (2), Switzerland (1), Thailand (2), and the United Kingdom (68).

WHO is not recommending travel restrictions related to the outbreak of the influenza A(H1N1) virus.

Individuals who are ill should delay travel plans and returning travelers who fall ill should seek appropriate medical care. These recommendations are prudent measures which can limit the spread of many communicable diseases, including influenza.

Further information on the situation will be available on the WHO web site on a regular basis.
 
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