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N.Y.C. Funeral Directors meeting

Re: N.Y.C. Funeral Directors meeting

If someone can find Mr. Kasdan's phone number and pm it to me, I will call him.
 
Re: N.Y.C. Funeral Directors meeting

http://www.cdc.gov/flu/weekly/


2008-2009 Influenza Season Week 31 ending August 8, 2009
All data are preliminary and may change as more reports are received.

On June 11, the World Health Organization raised the pandemic alert level from Phase 5 to Phase 6 indicating that an influenza pandemic is underway.
Synopsis:

During week 31 (August 2-8, 2009), influenza activity decreased slightly in the United States; however, there were still higher levels of influenza-like illness than is normal for this time of year.

  • A total of 7,511 hospitalizations and 477 deaths associated with novel influenza A (H1N1) viruses have been reported to CDC.
  • During week 31:
    • 809 (19.1%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.
    • 98% of all subtyped influenza A viruses being reported to CDC were novel influenza A (H1N1) viruses.
    • The proportion of deaths attributed to pneumonia and influenza (P&I) was below the epidemic threshold.
    • Three influenza-associated pediatric deaths were reported and all were associated with a novel influenza A (H1N1) virus infection.
    • The proportion of outpatient visits for influenza-like illness (ILI) was below national and region-specific baseline levels.
    • Four states and Puerto Rico reported geographically widespread influenza activity, 10 states reported regional influenza activity, 10 states and the District of Columbia reported local influenza activity, and 26 states reported sporadic influenza activity.
 
Re: N.Y.C. Funeral Directors meeting

Jmom said:
Please let us know where you got your information for the statement you made.
Click to expand...


This is based on the planning scenarios used by the federal government, including HHS and CDC. Typically the worse case events are patterned around the 1918 pandemic, which basically wiped out so many young adults in the US that the insurance companies dropped their life expectancy rates a full ten years. The article describes a New York event whose upper range far exceeds even 1918.

If those numbers came from the CDC, we really need to know the source, and then get an explanation, because once you get into worse case events like those described, most planners just throw up their hands. It is simply not one in which we can effectively deal.
 
Re: N.Y.C. Funeral Directors meeting

Mamabird said:
This is based on the planning scenarios used by the federal government, including HHS and CDC. Typically the worse case events are patterned around the 1918 pandemic, which basically wiped out so many young adults in the US that the insurance companies dropped their life expectancy rates a full ten years. The article describes a New York event whose upper range far exceeds even 1918.

If those numbers came from the CDC, we really need to know the source, and then get an explanation, because once you get into worse case events like those described, most planners just throw up their hands. It is simply not one in which we can effectively deal.
Click to expand...

I agree. I would like to speak to Mr. Kasdan to know from where/whom he obtained his information.
 
Re: N.Y.C. Funeral Directors meeting

The following URL is from Flu.Gov and is the original planning document distributed by Homeland Security for all critical infrastructure entities. In chapter 5 there are three scenarios from mild to severe. Please be aware that when this document was formulated, it was based on an H5N1 pandemic.

http://www.flu.gov/plan/pdf/cikrpandemicinfluenzaguide.pdf

From another Homeland Security Source:
http://www.hhs.gov/pandemicflu/plan/part1.html


Table 1. Number of Episodes of Illness, Healthcare Utilization, and Death Associated with Moderate and Severe Pandemic Influenza Scenarios*

Characteristic Moderate (1958/68-like) Severe (1918-like)
Illness 90 million (30%) 90 million (30%)
Outpatient medical care 45 million (50%) 45 million (50%)
Hospitalization 865,000 9,900,000
ICU care 128,750 1,485,000
Mechanical ventilation 64,875 742,500
Deaths 209,000 1,903,000

* Estimates based on extrapolation from past pandemics in the United States. Note that these estimates do not include the potential impact of interventions not available during the 20th century pandemics.
 
Re: N.Y.C. Funeral Directors meeting

Characteristic Moderate (1958/68-like) Severe (1918-like)
Illness 90 million (30%) 90 million (30%)
Outpatient medical care 45 million (50%) 45 million (50%)
Hospitalization 865,000 9,900,000
ICU care 128,750 1,485,000
Mechanical ventilation 64,875 742,500
Deaths 209,000 1,903,000

Here we go:

1,903,000 / 90 million x 100 = 2.114

There's 2.1%

He's been looking at 1918 scenario.
 
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.
 
Re: N.Y.C. Funeral Directors meeting

Andy2000 said:
Characteristic Moderate (1958/68-like) Severe (1918-like)
Illness 90 million (30%) 90 million (30%)
Outpatient medical care 45 million (50%) 45 million (50%)
Hospitalization 865,000 9,900,000
ICU care 128,750 1,485,000
Mechanical ventilation 64,875 742,500
Deaths 209,000 1,903,000

Here we go:

1,903,000 / 90 million x 100 = 2.114

There's 2.1%

He's been looking at 1918 scenario.

Sibelius's tone was plan for the worst, hope for the best.

This is just planning.
Click to expand...

Plus 50% on top of that. 3.3% CFR. I can't find anyone using numbers at that extraordinary level. Just has to be a mistake.
 
Re: N.Y.C. Funeral Directors meeting

Andy2000 said:
Characteristic Moderate (1958/68-like) Severe (1918-like)
Illness 90 million (30%) 90 million (30%)
Outpatient medical care 45 million (50%) 45 million (50%)
Hospitalization 865,000 9,900,000
ICU care 128,750 1,485,000
Mechanical ventilation 64,875 742,500
Deaths 209,000 1,903,000

Here we go:

1,903,000 / 90 million x 100 = 2.114

There's 2.1%

He's been looking at 1918 scenario.

Sibelius's tone was plan for the worst, hope for the best.

This is just planning.
Click to expand...

Actually, if that is where he got his information, then I think he was taking Nepatalino's statement about this being a "severe" pandemic and applied it to these numbers.

Remember, DHS has said to expect a severe pandemic, so either we are misreading their statements OR they are not being consistent with wording in committee meetings and what is on the HHS website.
 
Re: N.Y.C. Funeral Directors meeting

St Michael said:
Not necessarily.

Again, overall CFR for 1918 was 2.5%. This article references a CFR for those infected of 2.1 to 3.3%. But those infected represents only a subset of the total population. So the distinction being made is overall CFR versus CFR for those infected. The CFR for those infected related in this article assumes a certain infection rate. Once we get the assumed infection rate, we'll see where the CFR range for those infected came from.



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.
Click to expand...

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).
 
Re: N.Y.C. Funeral Directors meeting

Hattip crfullmoon:

Perhaps they are looking at this:

On p 29 - Most of the deaths are in the age range that has 1.50% CFR, (also our most productive workers, essential/critical infrastucture, & reproductive age/parents of minor children, and the experienced ages 50 to 64 have a 3.33% CFR.

http://cryptome.org/h1n1/cdc-071709.pdf
 
Re: N.Y.C. Funeral Directors meeting

I am on dial up and having trouble opening that pdf. How many total infections do they assume to calculate the case fatality rate?

There are probably more than a million undocumented cases.
 
Re: N.Y.C. Funeral Directors meeting

<TABLE dir=ltr border=1 cellSpacing=0 cellPadding=7 width=981><TBODY><TR><TD height=0 vAlign=top colSpan=4>
​
Modeling Different Case Fatality Rates for an 8-week Pandemic Influenza (PI) Event Using a
</TD></TR><TR><TD bgColor=#99ccff height=0 vAlign=top width="35%">[FONT=Arial,Arial][FONT=Arial,Arial]
Assumptions:​
​
[/FONT]​
[/FONT]​
</TD><TD bgColor=#99ccff height=0 vAlign=top width="32%" colSpan=2>
?​
[FONT=Arial,Arial][FONT=Arial,Arial]New York City (NYC) Population: 8,213,839 [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial](NYC Department of City Planning, Population Division, July 1, 2005)[/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]. [/FONT][/FONT]​
</TD><TD bgColor=#99ccff height=0 vAlign=top width="32%">
?​
[FONT=Arial,Arial][FONT=Arial,Arial]30% Attack Rate [/FONT][/FONT]​
</TD></TR><TR><TD bgColor=#c0c0c0 height=0 vAlign=top colSpan=4>
?​
[FONT=Arial,Arial][FONT=Arial,Arial]The percentage distribution of location of death in NYC [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial](NYC Department of Health and Mental Hygiene Bureau of Vital Statistics, 2005)[/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]: 67% in-hospital, 12% in assisted living centers, 19% at private residences, and 2% in other locations. [/FONT][/FONT]​
</TD></TR><TR><TD height=0 vAlign=top colSpan=4>? [FONT=Arial,Arial][FONT=Arial,Arial]The occurrence of deaths most likely will NOT be homogenously distributed among NYC hospitals or long-term care facilities. [/FONT][/FONT]
</TD></TR><TR><TD height=0 vAlign=top colSpan=4>[FONT=Arial,Arial][FONT=Arial,Arial]Minimum Fatality Scenario [/FONT][/FONT]
</TD></TR><TR><TD bgColor=#c0c0c0 height=0 vAlign=top colSpan=4>[FONT=Arial,Arial][FONT=Arial,Arial]
Most Likely Fatality Scenario​
​
[/FONT]​
[/FONT]​
</TD></TR><TR><TD height=0 vAlign=top width="51%" colSpan=2>[FONT=Arial,Arial][FONT=Arial,Arial]
Maximum Fatality Scenario Case Fatality Rate = 3.5%​
​
[/FONT]​
[/FONT]​
</TD><TD height=0 vAlign=top width="49%" colSpan=2>[FONT=Arial,Arial][FONT=Arial,Arial]
ESTIMATED TOTAL PI-RELATED DECEDENTS OVER AN 8-WEEK PI-EVENT:​
​
​
[/FONT]​
[/FONT]​
</TD></TR><TR><TD height=0 vAlign=top colSpan=4>[FONT=Arial,Arial][FONT=Arial,Arial]
27,106
51,747
86,245​
​
​
[/FONT]​
[/FONT]​
</TD></TR><TR><TD height=0 vAlign=top width="51%" colSpan=2>[FONT=Arial,Arial][FONT=Arial,Arial]
Total in-Hospital PI-related Deaths:
18,161
34,671​
​
[/FONT]​
[/FONT]​
</TD><TD height=0 vAlign=top width="49%" colSpan=2>[FONT=Arial,Arial][FONT=Arial,Arial]
57,784​
​
[/FONT]​
[/FONT]​
</TD></TR></TBODY></TABLE>
Looks like it is MITE BE older nformation he used?
From this at the NYC Department of Health and Mental Hygiene site:tiphat: http://www.nyc.gov/html/doh/html/bhpp/bhpp-hospital.shtml
This is the PDF handout for PI Rate:tiphat:http://www.nyc.gov/html/doh/downloads/pdf/bhpp/bhpp-fatality-rates.pdf
<TABLE dir=ltr border=1 cellSpacing=0 cellPadding=7 width=981><TBODY><TR><TD height=0 vAlign=top colSpan=6>
​
Modeling Different Case Fatality Rates for an 8-week Pandemic Influenza (PI) Event Using a
</TD></TR><TR><TD bgColor=#99ccff height=0 vAlign=top width="35%" colSpan=2>[FONT=Arial,Arial][FONT=Arial,Arial]
Assumptions:​
​
[/FONT]​
[/FONT]​
</TD><TD bgColor=#99ccff height=0 vAlign=top width="32%" colSpan=2>
?​
[FONT=Arial,Arial][FONT=Arial,Arial]New York City (NYC) Population: 8,213,839 [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial](NYC Department of City Planning, Population Division, July 1, 2005)[/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]. [/FONT][/FONT]​
</TD><TD bgColor=#99ccff height=0 vAlign=top width="32%" colSpan=2>
?​
[FONT=Arial,Arial][FONT=Arial,Arial]30% Attack Rate [/FONT][/FONT]​
</TD></TR><TR><TD bgColor=#c0c0c0 height=0 vAlign=top colSpan=6>
?​
[FONT=Arial,Arial][FONT=Arial,Arial]The percentage distribution of location of death in NYC [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial](NYC Department of Health and Mental Hygiene Bureau of Vital Statistics, 2005)[/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial]: 67% in-hospital, 12% in assisted living centers, 19% at private residences, and 2% in other locations. [/FONT][/FONT]​
</TD></TR><TR><TD height=0 vAlign=top colSpan=6>? [FONT=Arial,Arial][FONT=Arial,Arial]The occurrence of deaths most likely will NOT be homogenously distributed among NYC hospitals or long-term care facilities. [/FONT][/FONT]
</TD></TR><TR><TD height=0 vAlign=top colSpan=6>[FONT=Arial,Arial][FONT=Arial,Arial]Minimum Fatality Scenario [/FONT][/FONT]
</TD></TR><TR><TD bgColor=#c0c0c0 height=0 vAlign=top colSpan=6>[FONT=Arial,Arial][FONT=Arial,Arial]
Most Likely Fatality Scenario​
​
[/FONT]​
[/FONT]​
</TD></TR><TR><TD height=0 vAlign=top width="51%" colSpan=3>[FONT=Arial,Arial][FONT=Arial,Arial]
Maximum Fatality Scenario Case Fatality Rate = 3.5%​
​
[/FONT]​
[/FONT]​
</TD><TD height=0 vAlign=top width="49%" colSpan=3>[FONT=Arial,Arial][FONT=Arial,Arial]
ESTIMATED TOTAL PI-RELATED DECEDENTS OVER AN 8-WEEK PI-EVENT:​
​
​
[/FONT]​
[/FONT]​
</TD></TR><TR><TD height=0 vAlign=top colSpan=6>[FONT=Arial,Arial][FONT=Arial,Arial]
27,106
51,747
86,245​
​
​
[/FONT]​
[/FONT]​
</TD></TR><TR><TD height=0 vAlign=top width="35%" colSpan=2>[FONT=Arial,Arial][FONT=Arial,Arial]
Total in-Hospital PI-related Deaths:
18,161
34,671​
​
[/FONT]​
[/FONT]​
</TD><TD height=0 vAlign=top width="32%" colSpan=2>[FONT=Arial,Arial][FONT=Arial,Arial]
57,784​
​
[/FONT]​
[/FONT]​
</TD><TD height=0 vAlign=top width="32%" colSpan=2>[FONT=Arial,Arial][FONT=Arial,Arial]
Daily Average of Citywide​
​
[/FONT]​
[/FONT]​
</TD></TR><TR><TD height=0 vAlign=top colSpan=6>[FONT=Arial,Arial][FONT=Arial,Arial]
over an 8-week Pandemic:​
​
[/FONT]​
[/FONT]​
</TD></TR><TR><TD height=0 vAlign=top colSpan=6>[FONT=Arial,Arial][FONT=Arial,Arial]
619
1,032​
​
[/FONT]​
[/FONT]​
</TD></TR><TR><TD bgColor=#b3b3b3 height=0 vAlign=top colSpan=6>[FONT=Arial,Arial][FONT=Arial,Arial]
Daily Average of PI-related Deaths​
​
​
[/FONT]​
[/FONT]​
</TD></TR><TR><TD height=0 vAlign=top width="27%">[FONT=Arial,Arial][FONT=Arial,Arial]
(Assuming 63 Hospitals):​
​
​
[/FONT]​
[/FONT]​
</TD><TD height=0 vAlign=top width="24%" colSpan=2>[FONT=Arial,Arial][FONT=Arial,Arial]
5​
​
​
[/FONT]​
[/FONT]​
</TD><TD height=0 vAlign=top width="24%" colSpan=2>[FONT=Arial,Arial][FONT=Arial,Arial]
17​
​
​
[/FONT]​
[/FONT]​
</TD><TD height=0 vAlign=top width="24%">[FONT=Arial,Arial][FONT=Arial,Arial]
15​
​
​
[/FONT]​
[/FONT]​
</TD></TR><TR><TD height=0 vAlign=top colSpan=6>[FONT=Arial,Arial][FONT=Arial,Arial]
*Note: 9-26 decedents/day per facility (63) during weeks 6-7 of the outbreak.​
​
[/FONT]​
[/FONT]​
</TD></TR></TBODY></TABLE>
 
Re: N.Y.C. Funeral Directors meeting

thanks Treyfish -

from the date on the chart -

[FONT=Arial,Arial][FONT=Arial,Arial]New York City (NYC) Population: 8,213,839 [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial](NYC Department of City Planning, Population Division, July 1, 2005)[/FONT][/FONT]


It looks like a scenario made for bird flu, not the existing swine flu pandemic. I believe the case fatality rate world wide is still 60% ish for bird flu which necessitates a severe planning scenario.
 
Re: N.Y.C. Funeral Directors meeting

Florida1 said:
thanks Treyfish -

from the date on the chart -

[FONT=Arial,Arial][FONT=Arial,Arial]New York City (NYC) Population: 8,213,839 [/FONT][/FONT][FONT=Arial,Arial][FONT=Arial,Arial](NYC Department of City Planning, Population Division, July 1, 2005)[/FONT][/FONT]


It looks like a scenario made for bird flu, not the existing swine flu pandemic. I believe the case fatality rate world wide is still 60% ish for bird flu which necessitates a severe planning scenario.
Click to expand...

Apparently the most recent update to NY's planning information was October, 2008 as reflected in the following document:

http://www.nyc.gov/html/doh/downloads/pdf/cd/cd-pandemic-influenza.pdf
 
Re: N.Y.C. Funeral Directors meeting

I'm sure this will get resolved now that light has been shed on it. Hopefully we'll get an answer tomorrow.
 
Re: N.Y.C. Funeral Directors meeting

I called Mr. Kasdan at work and they told me he will not be in until after noon. I will call back then.
 
Re: N.Y.C. Funeral Directors meeting

I spoke to Mr. Kadsan and he told me that he got his information from the NYC Medical Examiner. He said that the projection of 2.1% -3.3 % case fatality rate is from bird flu scenarios. They do not know what they may face in the future as none of us do. H5N1 is still circulating.

However, I would add that New York has been hard hit by novel H1N1 and that this is a dangerous virus.

Please take all precautions as the school year starts and as the flu cycle begins again.

Please look to the left of our front page and review some of our suggestions for your protection.
 
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