Netherlands: "We expect 5 to 10 times more deaths than with seasonal flu"

[Gert van der Hoek]

Netherlands: "we expect a CFR 5 to 10 times higher than normal flu" , in case of a major outbreak of A/H1N1.

This was said by Roel Coetinho, director of RIVM, this morning on Dutch Radio.

CFR of seasonal flu in the Netherlands is 1 or 2 per thousand cases.

 

[gsgs]

Re: Netherlands: "We expect a CFR 5 to 10 times higher than normal flu"

Re: Netherlands: "We expect a CFR 5 to 10 times higher than normal flu"

what's RIVM ?

in NY it seems that the CFR was > 5 times lower than seasonal flu.

Maybe NL can import some viruses from NY ?

 

[Gert van der Hoek]

Re: Netherlands: "We expect a CFR 5 to 10 times higher than normal flu"

Re: Netherlands: "We expect a CFR 5 to 10 times higher than normal flu"

RIVM:

The Centre for Infectious Disease Control Netherlands (CIb) is part of the National Institute for Public Health and the Environment (RIVM). The Centre?s mission is to detect, control and prevent infectious diseases for the benefit of the public health in the Netherlands.


Tasks to be carried out by the Centre for Infectious Disease Control Netherlands are:

To gain insight in infectious diseases by carrying out diagnostic microbiology, surveillance and scientific research

To uniform prevention nationwide and to strengthen vigilance and swift response to possible outbreaks by coordinating infectious disease control activities and international cooperation

To stimulate effective prevention and control of infectious diseases by advising professionals and ministries, by granting subsidies and by providing public information

 

[Gert van der Hoek]

Re: Netherlands: "We expect a CFR 5 to 10 times higher than normal flu"

Re: Netherlands: "We expect a CFR 5 to 10 times higher than normal flu"

CFR's seem to be tricky to handle. Also compare CFR's is not without problems .

What CFR is indicated for seasonal flu in NY?

 

[Gert van der Hoek]

Re: Netherlands: "We expect 5 to 10 times higher number of deaths than with normal flu"

Re: Netherlands: "We expect 5 to 10 times higher number of deaths than with normal flu"



"Many deaths from the flu '

Tuesday, June 16, 2009 | 03:19 | Last updated: Tuesday, June 16, 2009 | 09:17

ENSCHEDE - The Swine flu could cause five to ten times more deaths
than during an ordinary flu wave. According to the National Institute for Health and Environment (RIVM) can
the death toll to rise to 4000 to 8000. One in three Dutch can get the flu.


According to the Ministry of Health outlines the RIVM 'the ultimate doomsday scenario. " This is only if the virus mutates. "


People who were born in 1957, seem immune to the H1N1 virus. According to Prof. Dr. Roel
Of the RIVM Coutinho, it seems that until 1957 a similar virus by our country and that attracted
Dutch by birth, that natural resistance.


The RIVM does not rule out that schools should close to prevent proliferation. Coutinho "
Children are there close together, there is coughing and sneezing. "The Margrietschool in Woerden
advised a group of parents yesterday to keep their children home after a father and a
students were infected. They made a trip to a petting zoo.

http://www.tctubantia.nl/regio/twente/5119364/Veel-doden-door-de-griep.ece

 

[Gert van der Hoek]

Re: Netherlands: "We expect 5 to 10 times more deaths than with seasonal flu"

"In a normal flu season 500 to 800 people die"

RIVM (= Dutch CDC)

http://www.volkskrant.nl/binnenland/article1243833.ece/Griepgolf_komt_na_de_zomer

 

[Giuseppe]

Re: Netherlands: "We expect 5 to 10 times more deaths than with seasonal flu"

If The Netherlands have 16,4 millions of inhabitants (http://www03.wolframalpha.com/input/?i=netherlands)

AND

if 33% of population will get the flu (16,4*.33=5,412,000)

THEN

a prediction of 8,000 excess deaths

RESULT in

a CFR of 8,000/5,412,000=0.001478*1,000=1.47 per 1,000 ...!

I think, however, that the RIVM may be raising an alert of a well higher CFR, similar to past pandemics, near 1% rather than 1 per 1,000.

But I could have misinterpreted the entire story.

Can Dutchy revise this calculation?

 

[Gert van der Hoek]

Re: Netherlands: "We expect 5 to 10 times more deaths than with seasonal flu"

Worst case scenario I suppose.


RIVM did not predict a CFR, but only a possible total of deaths.

Normally 500 to 800 wit seasonal flu, " could be 4,000 to 8,000" because of the novel H1N1.


Your calculation is OK, so RIVM says: CFR could be somewhere between 0.74 and 1.47 a thousand.


Min of Health commented: "this is a doomsday scenario, only real if the virus mutates".

Min of Health and RIVM (Dutch CDC) seems to disagree here, different angle?

When I heard a snip of the radio from Dr. Coetinho of RIVM on this subject, he referred to special risk groups,
like people with asthma, heart problems, pregnant women etc.


http://www.tctubantia.nl/regio/twente/5119364/Veel-doden-door-de-griep.ece

 

[gsgs]

Re: Netherlands: "We expect 5 to 10 times more deaths than with seasonal flu"

New York = 8 million, but only 20 deaths from this wave (so far, peak 26.May)

 

[Gert van der Hoek]

Re: Netherlands: "We expect 5 to 10 times more deaths than with seasonal flu"

New York = 8 million, but only 20 deaths from this wave (so far, peak 26.May)

20 deaths is one part of the calculation, the other is the number of cases.
That would be tricky.

I feel the message of RIVM is: don't be surprised if you have a death with every thousand cases. I cannot say if they are right or wrong.

 

[gsgs]

Re: Netherlands: "We expect 5 to 10 times more deaths than with seasonal flu"

6.9% reported ILI 1.May-20.May which was ~1/4 of the outbreak

 

[The Mountains Voice]

Re: Netherlands: "We expect a CFR 5 to 10 times higher than normal flu"

Re: Netherlands: "We expect a CFR 5 to 10 times higher than normal flu"

in NY it seems that the CFR was > 5 times lower than seasonal flu.

NO. Everyone needs to understand that all of these official statements use a baseline of 36,000 deaths on average from Seasonal Flu.

That's a number that has no basis in reality. That number is based on the already sick & already dying in many cases - AND it is inflated. I challenge anyone to provide data to support the publicly supported number of 36,000. And I am not taking about quoting official sources.

SHOW ME THE DATA!

 

[gsgs]

Re: Netherlands: "We expect 5 to 10 times more deaths than with seasonal flu"

> in 2006 in New York City alone over 2500 people died from influenza and pneumonia
http://www.nyc.gov/html/doh/html/cd/cdinflu.shtml


weekly deaths from pneumonia and influenza in New York City
weeks 17,2008 - 22,2009:

55,57,43,46,52,39,48,31,41,32,26,46,41,41,32,43,44,31,45,32,36,33,27,31,30,31,32,40,43,39,37,38,52,
42,25,??,51,63,52,60,52,54,53,47,55,43,46,49,45,61,45,33,34,32,44,23,51,30,42

average:42.5 per week

weeks 17-22,2009: 222 (37 per week)
weeks 17-22,2008: 292 (48.7 per week)

70 fewer deaths this year than in the same period last year.

~250 excess deaths from seasonality in NYC in 2008/9

15 weeks with most deaths : 53/2008-14/2009 = 776 (51.7 per week)
15 weeks with fewest deaths: 29/2008-43/2008 = 529 (35.3 per week)


no effect from typoflu visible

 

[pflu]

Re: Netherlands: "We expect 5 to 10 times more deaths than with seasonal flu"

> in 2006 in New York City alone over 2500 people died from influenza and pneumonia
http://www.nyc.gov/html/doh/html/cd/cdinflu.shtml


weekly deaths from pneumonia and influenza in New York City
weeks 17,2008 - 22,2009:

55,57,43,46,52,39,48,31,41,32,26,46,41,41,32,43,44,31,45,32,36,33,27,31,30,31,32,40,43,39,37,38,52,
42,25,??,51,63,52,60,52,54,53,47,55,43,46,49,45,61,45,33,34,32,44,23,51,30,42

average:42.5 per week

weeks 17-22,2009: 222 (37 per week)
weeks 17-22,2008: 292 (48.7 per week)

70 fewer deaths this year than in the same period last year.

~250 excess deaths from seasonality in NYC in 2008/9

15 weeks with most deaths : 53/2008-14/2009 = 776 (51.7 per week)
15 weeks with fewest deaths: 29/2008-43/2008 = 529 (35.3 per week)


no effect from typoflu visible

What percentage of those is influenza related, probably a small figure as pneumonia is caused by so many things.

Plus, there were 9 deaths in NYC from H1N1 alone between 6/5 - 6/12. That's roughly 25% of the total average weekly P&I, and I bet significantly higher than the Influenza portion of P&I. Plus these are all middle age and young adults, what happens when susceptible age groups start getting it in the fall.

I personally think the entire numbers game here is going to look dramatically worse come flu season and if Tamiflu resistance is achieved by H1N1 it will look similar to 1918.

 

[Giuseppe]

Re: Netherlands: "We expect 5 to 10 times more deaths than with seasonal flu"

Ah, 1918 ''spanish flu'' spectre...!

Even without major antigenic and genetic changes, this novel H1N1v virus could cause significant damage around the world, worsening an already critical situation in Africa and Asia.

I must remember to the readers that in the world there are at least half a billion of people malnourished, well below the poverty level...

If people want to do a random numbers game, all are welcomed.

But I think very strong facts are in front of us: thousands of millions without a single dollar per day, potable water, probably with other illness of the kind of tubercolosis, HIV/AIDS, malaria.

The impact of this novel pathogen is already poised to be immense between these populations.

Early people starts to understand this, it will be better for all.

For the CFR, nothing certain in front of us.

If one says that in a single community there are 100 cases and 10 deaths, the damage is proportionally great; if there are 10,000 cases and the same number of deaths, well...

 

[gsgs]

Re: Netherlands: "We expect 5 to 10 times more deaths than with seasonal flu"

is it more dangerous than H3N2 ?

which one should we wish to survive ? Or even both ?

 

[Gert van der Hoek]

Re: Netherlands: "We expect 5 to 10 times more deaths than with seasonal flu"

Not enough Tamiflu available for everyone

By MONICA BEEK

ROTTERDAM - The number of flu infections is growing as fast as the next step in addressing the Mexican virus' not far away. " Says Virologist Ab Osterhaus of the Erasmus MC.

Netherlands yesterday afternoon had 68 infections, of which 33 human-to-people . (Today 83, ed) infections in the Netherlands.

The RIVM assumes that the flu in the autumn will strike hard. Director Roel Coutinho predicts four to eight thousand deaths, especially among people born after 1957, because they have less resistance against the flu. These are five to ten times more deaths than the normal seasonal flu. Osterhaus is more nuanced. ,, I find that number quite high. I would not dare to predict that.''

In the forthcoming second phase will only have the patient virus inhibitors, not the people with the disease have been in contact. , Otherwise we are going through our stock of Tamiflu,''said Osterhaus. The government now has five million doses of virus inhibitors set, enough for 30 percent of the population. ,, If we give with each patient also ten other people preventive treatment, we don't have not enough.''

The Dutch policy aims to slow the flu outbreak with virus inhibitors, until hopefully early autumn vaccines will be available. In the second phase is still not advised to avoid large groups. ,, This is ad hoc, by location and view event,''says Osterhaus.

The GGD Groningen runs forward to the new policy and now only the patient and immediate relatives virus receive inhibitors, nobody outside that group. The RIVM has no opinion on the policy of Groningen. According to Osterhaus, the Groningen approach is a temporary solution. " ,, Finally, we draw one line.''

http://www.ad.nl/binnenland/3296262/Onvoldoende_Tamiflu_vrij_voor_iedereen.html