Discussion - N.Y.C. Funeral Director's Meeting

[Mamabird]

Re: N.Y.C. Funeral Directors meeting

Re: N.Y.C. Funeral Directors meeting

Funeral directors need hard estimates. The government needs funeral directors to be prepared. The government, at some level, is supplying the numbers these NYC funeral directors are discussing in this meeting for planning purposes.

Agreed. And if the government has changed their planning assumptions and scenarios from those well documented in the planning guides that the rest of us are using, then we need to know that, and for sure, we need to know why.

 

[wotan]

Re: N.Y.C. Funeral Directors meeting

Re: N.Y.C. Funeral Directors meeting

I have called Mr. Kasdan but he is gone for the day. I left a message that I am calling back again tomorrow.

If there is any arguing or further spec. on this thread I will move most of this to the discussion forum.

The news threads are for facts.

:surrender: I tried! :angel:

 

[St Michael]

Re: N.Y.C. Funeral Directors meeting

Re: N.Y.C. Funeral Directors meeting

I don't follow. CFR=case fatality ratio. The denominator is the number of cases, the numerator is the number of deaths among cases.

The CFR does not include consideration of those who are not cases (unless they are mistakenly misclassified).

I'm just going by this quote from the article:

The Centers for Disease Control has predicted a 2.1 percent to 3.3 percent death rate among those who come down with swine flu this fall

This seems like a different number than overall CFR.

There may be a basic misunderstanding going on here between CFR and mortality rate. Effect Measure has discussed this:

One observable measure of virulence, then, is the CFR, which brings us back to the question: what is CFR? Again, in simplest terms we can estimate it by using as the numerator the number of swine flu deaths in Mexico (or the US) and divide it by the total number of cases. That proportion is an estimate of dying of swine flu. Simple. Unfortunately a little too simple, because we have great difficult ascertaining both the numerator and the denominator.

...

So what's a mortality rate? A swine flu mortality rate is the number of deaths divided by the population at risk of dying. The numerator is the same (number of deaths from swine flu; a time period should be specified) but the denominator is now all the people in Mexico City. CFR is a proportion, a number between zero and one. The mortality rate is a number of deaths in some convenient unit of population, say number of swine flu deaths per 100,000 people. It is a whole number between zero and 100,0000 (hopefully not, because that would mean it wiped out the whole city). These two numbers are telling us different things about the virus. A mortality rate is easier to calculate because the denominator is easier to estimate, using census information, but doesn't reveal virulence, so CFR is what is interested in this case.

There seems to be a basic confusion in this article between CFR and mortality rate, and I'm afraid I made have made that confusion worse in this thread by failing to make this more clear. By overall CFR, I'm referring to mortality rate.

I'll go back to lurking mode now.

 

[mixin]

Re: N.Y.C. Funeral Directors meeting

Re: N.Y.C. Funeral Directors meeting

This was presented at the June pandemic workshop by Neil Ferguson, based on the data from past pandemics. He then goes on to talk about ways to mitigate the current pandemic.
--------------------------------------------------

* Mr. Ferguson estimated that a national, unmitigated pandemic would infect about one third of the population in the first one or two waves.
* He anticipated a seroconversion rate of about 50–60%.
* Models suggest that by the fall of 2009, about 100 million Americans will be sick, but most will have mild illness, even if the pandemic is severe.
* The pandemic is likely to be concentrated and not expected to be synchronized with seasonal influenza.
* The peak attack rate would be about 1,500 cases per 100,000 people per day. However, perceptions of peak attack rates at the county level may be higher.
* Some localities may see absentee rates as much as 30% higher than the national average, and those events may be significant enough to cause disruption.

 

[Pathfinder]

Re: N.Y.C. Funeral Directors meeting

Re: N.Y.C. Funeral Directors meeting

Agreed. And if the government has changed their planning assumptions and scenarios from those well documented in the planning guides that the rest of us are using, then we need to know that, and for sure, we need to know why.

If I refer to my experience with Katrina, 3 days before the hit, my friend from Canada called me panicking, asking me why I was still there. She had just heard that Canada was sending 10,000 body bags to New Orleans. The news we had here was that the hurricane was supposed to turn towards Florida. I started packing after her phone call. Mandatory evacuation was called on Saturday night. Sunday, people were leaving with the first outer bands of the hurricane.

So Mamabird, when you are saying that "we need to know" I totally agree with you and we need to hear what is going on from officials, not from funeral directors.

 

[Mamabird]

Re: N.Y.C. Funeral Directors meeting

Re: N.Y.C. Funeral Directors meeting

If I refer to my experience with Katrina, 3 days before the hit, my friend from Canada called me panicking, asking me why I was still there. She had just heard that Canada was sending 10,000 body bags to New Orleans. The news we had here was that the hurricane was supposed to turn towards Florida. I started packing after her phone call. Mandatory evacuation was called on Saturday night. Sunday, people were leaving with the first outer bands of the hurricane.

So Mamabird, when you are saying that "we need to know" I totally agree with you and we need to hear what is going on from officials, not from funeral directors.

OK, Treyfish found the source. It's on the other thread - a link to NY assumptions. Their "most likely" case is federal government's worst case. NY's worst case is a 3.5% CFR. So the director mis-spoke. These higher numbers are certainly not from the CDC.

http://www.flutrackers.com/forum/showthread.php?p=282688#post282688

 

[Jeremy]

Re: N.Y.C. Funeral Directors meeting

Re: N.Y.C. Funeral Directors meeting

OK, Treyfish found the source. It's on the other thread - a link to NY assumptions. Their "most likely" case is federal government's worst case. NY's worst case is a 3.5% CFR. So the director mis-spoke. These higher numbers are certainly not from the CDC.

http://www.flutrackers.com/forum/showthread.php?p=282688#post282688

Well, to be fair, I would say that this is the most logical conclusion based on evidence to date.

However, I am sure we will get more information tomorrow if we are able to contact Mr. Kasden to find out which sources he used.

 

[tropical]

Re: Discussion - N.Y.C. Funeral Director's Meeting

From the original N.Y.C.... FT news thread given pdf link (2008 document):

http://www.nyc.gov/html/doh/downloads/pdf/cd/cd-pandemic-influenza.pdf


"This Plan was developed with the support of the
City of New York
Department of Health and Mental Hygiene,
Bureau of Communicable Disease,
Healthcare Emergency Preparedness Program (HEPP)
Office of the Assistant Secretary for Preparedness and Response (ASPR)"
Preface:
...
"Disclaimer Statement- This document was supported by the Office of the Assistant Secretary for Preparedness and
Response (ASPR) via Grant Number 1 U3RHS07565-0100. Its contents are solely the responsibility of the authors and
do not necessarily represent the official views of ASPR."

PAGE 6:
...
"Characterization of Deaths Due to a Pandemic Influenza Event

As numerous deaths occur during a PI event, the Office of Chief Medical Examiner (OCME) will characterize the event as a ?mass fatality event,? consistent with OCME?s Mass Fatality Incident (MFI) criteria.

Magnitude

National planning experts have not been able to characterize fully how a PI event might unfold. PI deaths will likely increase and decrease in waves, over a 12 -18 month period nationally, affecting NYC for several weeks.

Many agencies use a 5 -7% mortality rate of the infected population (as indicated by the Department of Defense Joint Task Force Civil Support), but vary the time period when these fatalities may occur. Some experts believe a PI event may encompass two or three 8-week periods, spanned over 8-10 months.

In any event, the OCME must be prepared simultaneously to recover bodies, conduct operations to identify remains, determine cause and manner of death and, in many cases, facilitate final disposition, in addition to managing its usual caseload.

To understand the magnitude of a PI event in NYC, the OCME worked with the Department of Health and Mental Hygiene (DOHMH) to estimate the number of decedents.

Based on NYC?s estimated population of 8.2 million (which increases to about 8.7 million during business hours3), an estimated infection rate of 25-35% of the population and an associated mortality rate of 2.1% of the population infected,4 the OCME must be prepared to manage 51,747 additional decedents.

This is more than twice the number of decedents that the OCME processes annually and it must be prepared to manage this influx during an 8-week period. (See figure on pg. 7 for other fatality rate calculations.)"