Qinghai: H5N1 epidemic causes mass bird dieoff (PICTURES; 8000+ dead)

[wschalle]

Abundant News:
(http://www.boxun.com)
ORIGINAL ARTICLE (in chinese, 2 pictures)

BABELFISH TRANSLATED ARTICLE (2 pictures)


{ The article describes an unprecedented dieoff of waterfowl on Niao Island, in the Qinghai province of China, caused by the H5N1 flu virus. More than 8000 birds of many species are very sick or dead, as can be seen in the two images. Notice that no birds are flying, most of them are simply laying down. A few birds can be seen standing. The Chinese government has launched a massive vaccination campaign in the area to try to contain the outbreak. }

[wschalle]

1. Photo series of outbreak (CAUTION: GRAPHIC)

photo series

[RPM]

11. those red X's have me terribly scared...

Hope they get their pic back up soon.... :-)

[pandemic_1918]

17. Graphic Close-ups of Dead and Dying Bar Headed Geese

Graphic close ups of dead and dying H5N1 bar headed geese at

http://news.google.com/news?q=photos%20qinghai%20flu&hl=en&lr=&sa=N&tab=wn

(pictures may load slowly because of excess traffic)

[ElsewheresDaughter]

70. 8 reporters were arrestedtotal news blackout....

http://www.recombinomics.com/News/06050501/H5N1_Qinghai_Arrests.html

8 Arrests Linked to Photos of 1000's of Bird Flu Deaths

Recombinomics Commentary
June 5, 2005

>> because the news disclosed the person already was arrested, officially terminated about Qinghai birds and beasts flu information disclosure in June 5, 2005.

Chengdu retransmits

(Abundant news editor's note: This news has not verified after the abundant news. Before this, the abundant news once retransmitted on May 27 which transmits the birds large-scale death picture.) <<

The above machine translation of a story describing the arrest of 8 people in and around Gangcha County Qinghai China appear to be related to the bird flu reports on over 8000 H5N1 bird flu deaths and 121 human deaths.

The comment specifically mentions the two photos showing dead and dying birds on Bird Island on May 27.

There were earlier reports of a news blackout and third parties have had problems accessing information to verify or refute the nine who have reported on the H5N1 outbreak. It is unclear if the 8 arrested are 8 of the 9 reportong. However, if China would present data on the 121 alleged bird flu deaths, the influence of the reports would be minor. However, instead of providing more data, China appears to be more focused on limiting any information other than official reports which have had little detail

The sequences from the H5N1 isolates has not been released nor has any specific information on the 121 deaths.

A third party investigation of the situation in Qingahi is long overdue.

[pandemic_1918]

100. H5N1 Outbreak Near Russian Border

Today China is report an H5N1 outbreak in domestic gees in Xinjiang near border with Russia, Kazakhstan, and Mongolia

http://news.google.com/news?hl=en&lr=&tab=wn&ie=UTF-8&q=bird+flu+xinjiang

[pandemic_1918]

104. WHO Requests Qinghai Site Visit

WHO asks to visit Qinghai to see just what is going on there

http://news.google.com/news?hl=en&ned=in&ie=UTF-8&q=bird+flu+visit+Qinghai

[pandemic_1918]

101. Pathology of Dead Crows in India Sounds Like H5N1

Check out the pathology report on the dead crows in India. sounds just like H5N1

http://news.google.com/news?q=h5n1%20india%20crows&hl=en&lr=&sa=N&tab=wn

[pandemic_1918]

39. Reporters Arrested

The reporters linked to the photos of 1000's of bird dead on dying on Bird Island have been arrested

http://news.google.com/news?q=qinghai%20arrests%20bird%20flu&hl=en&lr=&sa=N&tab=wn

[Media_Lies_Daily]

66. If there was any question that there is a news blackout on this subject...

...in China, this story should answer it.

[pandemic_1918]

89. 3rd Bird Flu Photo Has Been Doctored

Third photo has been doctored

http://news.google.com/news?q=qinghai%20photos&hl=en&lr=&sa=N&tab=wn

[elehhhhna]

2. s-delete

[XemaSab]

3. The horror...... the horror!!!!!!!!

On June 3, 2005 the Xining news, according to internal public figure's news supply, the partial pictures material which presently just collects sends out, following picture material photography time blocks after for Niao Island on May 27, 2005, the picture provides by the internal public figure, is unable stemming from the security reason to provide this public figure material, through the picture may understand the birds and beasts flu the serious harm, the entire Niao Island nearly becomes the bird birds and beasts the hell, we can collect with every effort may prove the person infects the picture evidence, refutes the government the absurd opinion.

[pie]

6. The picture evidence refutes the government the absurd opinion!

Strong language, indeed!

[pandemic_1918]

4. 8000 Bird Flu Deaths?

Yes, the photos support the 8000 deaths detailed

http://news.google.com/news?hl=en&lr=&tab=wn&ie=UTF-8&q=photos+qinghai+flu

[snooper2]

9. I can't tell if they are dead or just hanging out..???

[slackmaster]

23. Maybe they're pining for the fjords

:crazy:

[NNN0LHI]

25. I think you may be onto something

:woohoo:

[pie]

5. Wait until that starts happening here

Birds falling from the sky

[ozymandius]

7. pictures

[Dogmudgeon]

8. 8000 out of how many?

If this is half of the avian population of Bird Island, it is truly frightening. But if it's 8000 out of fifty million, it's merely scary.

Have any morbidity/mortality figures been established?

BTW, most of the links here are already dead, so you may want to re-check your sources.

--p!

[wschalle]

10. Which links?

The links on my posts all work for me, which are broken for you?

[Dogmudgeon]

13. The photos here are showing up as red X icons

Your links are OK, as are Recombinomics'. The "Photo Series" link leads to a discussion board with the same icons (they indicate that the link isn't available).

--p!

[pandemic_1918]

18. 8000 and Counting

The numbers are going up daily. The two wide angle shots have 1000's dead or dying on the one day (May 27). The nature reserve is large and the geese are like sitting ducks before they die. See graphic close-up

http://news.google.com/news?q=photos%20qinghai%20flu&hl=en&lr=&sa=N&tab=wn

This is a major die-off.

[wschalle]

12. Pics Mirrored

[newscott]

19. They don't look dead to me.

They look like they are sitting as birds are wont to do from time to time.

Besides, the pics are taken from too far away and are very poor resolution to even tell what's going on.

[mr_hat]

14. Maybe they're just resting after a long squawk.

[Babette]

15. They're not dead....

They're just pining for the fiords!


Seriously though, I find this very disturbing. How long until the virus jumps to humans?

[wschalle]

16. well...

The virus has already jumped to humans. There are some 80 deaths associated with H5N1. The question is when the virus becomes able to spread easily via a cough, or a handshake, as the more common human influenza strains do.

Also, the US has a plan for dealing with this virus. The plan, unfortunately, is in a draft state, and hasn't been revised for 9 months. Call your congresspeople and ask them to get the US caught up with flu preparations.

[Karmakaze]

21. Oh my, 80 dead??? That is terrible!

By the way, can you tell me how many people have died from NORMAL HUMAN INFLUENZA so far this year? Is it 20,000? 50,000? 100,000? More?

In fact, does anyone even know or care? The answer is NO.

Although difficult to assess, these annual epidemics are thought to result in between three and five million cases of severe illness and between 250 000 and 500 000 deaths every year around the world.
Source: WHO | Influenza

Remember, that is referring to common Human Influenza strains NOT Bird Flu.

So with up to HALF A MILLION deaths EACH YEAR from normal flu, you'd think the WHO would be very seriously monitoring normal flu outbreaks, well at least as closely as Bird Flu, right?

Well you would be wrong. A disease that has killed 80 odd people in the last year, Avian Influenza, is far more closely monitored than Human Influenza which infects millions and kills hundreds of thousands.

Here is an example of this disparity:

Communicable Disease Surveillance & Response (CSR) - Influenza

That page is a list of updates on Influenza outbreaks. What you will find is that the disease that has killed 80 people is the topic of EVERY update since 27TH MARCH 2004!

Yes, that's right! In the period of time where Bird Flu killed 80 and Human Flu killed HUNDREDS OF THOUSANDS, not one single update considered monitoring Human Flu the more important task!

Now tell me, why am I supposed to be scared of Bird Flu? And tell me also, why shouldn't I believe that Bird Flu is just a concoction of WHO to scare the public on a relatively minor and controllable disease so that (like SARS) they can gain huge funding increases then "save" us from doom?

[NickB79]

24. The 1918 flu pandemic strain was most closely related to avian flu

Read up on what happened then, and realize that it would be much worse today, despite our medical advancements.

[Karmakaze]

29. No, you read up on what happened then...

because you can't even begin to compare the health system of 1918 with the health system of today.

For god's sake, a popular preventative measure was the setting up of oxygen booths where people would go to breathe "clean air" only to share their infections in an even more efficient manner!

[NNN0LHI]

36. Doggone barbers were still removing bullets and doing dentistry in 1918

[pandemic_1918]

40. Health Care 1918 and 2005

With regard to pandemic flu, there is not much different between 1918 and 2005. In fact the increased mobility of the general population and the higher case fatality rate could create a 2005 pandemic that is markedly worse than 1918.

There is no vaccine, antivirals are very limited, and there is no surge protection (and in the US there is no plan).

[Karmakaze]

49. Oh BULL!!!

Come on, simple things like respirators didn't even exist in 1918, and you are trying to tell me there is no difference between the health care of then and now?

As for the case fatality rate - I have explained over and over again that the fatality rate is not even known. The sample size is just far to small to know whether the current rate is the actual rate.

What IS known is that Bird Flu is BARELY communicable from human to human, IF AT ALL. If no one catches it, it doesn't matter if the mortality rate is 100% - no one dies.

[pandemic_1918]

52. Respirators - How Many Not in Use?

How many respirators are not in use in 2005? There is virtually NO surge capacity for a real pandemic.

You are dreaming. Modern medicine will be AWOL in a true pandemic.

[Karmakaze]

58. That was merely an example

Another example is that we now know how diseases such as Flu are spread - unlike in 1918, where breathing oxygen in communal oxygen booths (not sterlised between use) was considered state of the art flu prevention.

The fact is, SARS is a good example of why Bird Flu is not as major a threat as people like you are making out. Sure it may be a nasty disease, but modern infection control measures can stop such a disease in its tracks - just like SARS.

In any case, should what you fear come to pass then there is nothing anyone can do about it, so why try and scare everyone over it?

[pandemic_1918]

62. In Any Case - No Nonsense Posts Needed

In any case, there is no reason to post nonsense on this board. SARS was kept under control because the initial reservoir was small and eventually infection control limited spread in hospitals. The incubation period was long, so quarantine had a chance to work.

In the case of H5N1, the reservoir is large and the incubation time is short. Moreover, transmission can happen before symptoms arise.

There are many reasons why 2005 could be significantly worse than 1918 and some steps to take to be better prepared.

Posting nonsense on a message board is not one of them.

[Karmakaze]

73. Umm total and utter bull

You are ascribing characteristics to Bird Flu that it doesn't have.

For example, you claim "transmission can occur before symptoms arise". Is that right? Well, not as far as WHO is concerned:

Is there evidence of efficient human-to-human transmission now?

No. However, in Thailand, on 27 September 2004 the Ministry of Health announced possible human-to-human transmission in a family cluster. Thai officials have concluded that the mother could have acquired the infection either from some environmental source or while caring for her daughter, and that this represents a probable case of human-to-human transmission. While the investigation of this family cluster provides evidence that human-to-human transmission may have occurred, evidence to date indicates that transmission of the virus among humans has been limited to family members and that no wider transmission in the community has occurred. Continued vigilance is needed to determine whether the epidemiological situation in humans remains stable. (published 5.10.04)

So there is no evidence of efficient human to human transmission, and what limited evidence of ANY kind of human-to-human transmission there is involves a mother being infected by the sick daughter she was caring for.

By the way, the latest WHO figures state that world wide there have been 97 confirmed cases of infection and 53 deaths from H5N1 Bird Flu. Each one of those cases involved people who had close contact with infected birds, and possibly with a person sick from having contact with infected birds.

Even SARS was worse than Bird Flu, and look what ended up happening there. In that case human to human transmission was far easier than in the case of Bird Flu. So anyone who does not come into regular contact with birds that may be infected with Bird Flu, has nothing to worry about.

As for posting NONSENSE, take a look at yourself. The only nonsense being posted here is from you.

[pandemic_1918]

74. Evolution of Human to Human H5N1 Transmission

Since many who read tis board are well aware of the human to human transmission story with H5N1, I will only hit the high points. H5N1 like human H3N2 or H1N1 is an influenza A viruses. These viruses can change quite quickly and are hard to control because they are easily transmitted. Human viruses can be transmitted prior to symptoms and have a short incubation period.

H5N1 will become a human pandemic strain when it achieves this efficient level of transmission. Right now it is a bird pandemic strain, assuming it has not already reached phase 6 in Vietnam, but as a mild version, or Qinghai, where word of true human transmission may have been suppressed.

H5N1 has been expanding its host range. Last year there was human to human transmission in small familial clusters. The family in Thailand was one example, and there were three at the beginning of 2004 and another over the summer. This is phase 4.

This year in northern Vietnam, the clusters became more frequent and larger. The was transmission from patient to nurse(s), and one entire family became sick at the same time. These clusters started move the pandemic into phase 5.

In addition to the public cases, there were 1000 serum samples collected. After looking at the data, northern Vietnam called an urgent meeting. The samples were then sent to the CDC in Atlanta, and after they saw the data, another urgent meeting was called in Manila on May 5-6.

Since that meeting, WHO has given out more molecular detail and they started talking more about human to human transmission and the change of H5N1 and less about reassortment or all human infections coming from birds.

H5N1 is clearly evolving and getting more efficient at human ti human transmission. A mild version may be transmitting efficiently in northern Vietnam and Thailand, while or more lethal version may be transmitting in Qinghai.

[Media_Lies_Daily]

87. It is believed that the 1918 Pandemic started with a mild outbreak....

...and then hit hard later in the year.

[Media_Lies_Daily]

67. Responses to your post....

"Come on, simple things like respirators didn't even exist in 1918, and you are trying to tell me there is no difference between the health care of then and now?"

The world population in 1918 was approximately 1.8 billion, and except for the major cities and the front lines of WWI, people generally lived much farther apart than they do today. The current world population is almost 6.5 billion, nearly four times that of 1918. China's current population alone is 1.3 billion, almost equal to the world population in 1918. The citizens of most third-world countries have never even seen a real doctor, and have very little understanding of how diseases spread.

America's population was about 100 million in 1918...it is currently 300 million. Based on the fact that nearly 50 million Americans have no health/medical insurance at all, and doctors no longer make house calls, the state of healthcare today is probably not any better than healthcare in 1918. Additionally, unlike 1918 where 90-95% of Americans lived in rural environments, approximately 95% of all Americans now live in urban environments.

Additionally, the mortality rate of the 1918 Influenza Pandemic was not quite 5% with about 50 million dying worldwide, out of a total of 1.2 billion infected. The mortality rate of the current version of Avian Flu has not yet dropped below 60-70%. That means that if two-thirds of the current world population were to fall ill...about 4.3 billion people...approximately 2.8 billion people would die. I personally believe that the mortality rate of Avian Flu will drop once it mutates to a version that is highly infectuous to humans...but even a 30% mortality rate worldwide could be devastating.

Another point to make is the fact that under pandemic conditions, the US hospital system would be quickly overloaded, with doctors and nurses also becoming ill. This would lead to a situation where people would be dying at home and at work, potentially spreading the disease even farther.

"As for the case fatality rate - I have explained over and over again that the fatality rate is not even known. The sample size is just far to small to know whether the current rate is the actual rate."

The mortality rate is the mortality rate regardless of the sample size. WHO and CDC can only work with the numbers given to them by the countries that have been impacted the most, namely Vietnam and Cambodia. Because of a news blackout in Vietnam, and now China, we have no way of knowing how many people have been infected, and/or how many have died. We also have no idea how many people infected with Avian Flu may have been diagnosed with some other disease, something which also happened during the 1918 Influenza Pandemic.

"What IS known is that Bird Flu is BARELY communicable from human to human, IF AT ALL. If no one catches it, it doesn't matter if the mortality rate is 100% - no one dies."

Yes, Avian Flu is barely communicable from human-to-human. But, you seem to be ignoring the fact that the WHO and CDC commentaries have become increasingly more concerned about the idea that the Avian Flu virus may be rapidly mutating toward a version that WILL be easily communicable on a human-to-human basis. Another indication that the Avian Flu virus is mutating is the fact that two years ago the current Avian Flu version was found in pigs, and more recently, it has been found in large jungle cats.

[wschalle]

69. It's not that health care isn't better

It's that health care is no more equipped to effectively handle a pandemic now than it was in 1918.

If we had a supply of 50 million doses of vaccine available, then I'd say we were well-equipped. We don't.

[Karmakaze]

75. Refutation of your post...

the population was smaller, agreed. However the state of knowledge of viral transmission was FAR worse than it is today. They had NO IDEA how the Flu spread, assuming it came from "bad air".

One of the reasons the 1918 Flu spread so far was the end of the war - many troops fighting in areas of infection went back to their respective nations, taking the Flu with them. Had that not happened far fewer people would have been infected, and therefore died.

Nowadays we have knowledge of how these diseases spread and when infections arise they are quickly isolated and the trail of infection stops - for example SARS. Of course Third World countries are at a disadvantage when it comes to the treatment of disease, however they actually have an inherent advantage when it comes to preventing the spread of that disease - people do not travel very far because they do not have the means, unlike wealthy Western nations.

But they would be hit far worse than a Western nation should such a pandemic arise, of that there is no doubt. How much we can change that without raising the living standards of the entire globe is entirely predictable - zero.

Next you refer to the mortality rate. The fact is sample size has a HUGE effect on the mortality rate. The more people that are infected the more easily we can determine an accurate rate - with so few known cases, and the majority in nations with lower quality health systems, we have no way of knowing how many deaths were preventable given adequate treatment, and no way of knowing if these people merely represented the people who for some reason are more at risk from the disease.

For example I am POSITIVE that many times more people have come into close contact with infected Birds than have become ill. Those people who had contact with the virus but did not fall ill may represent a majority. In other words 99 people out of a 100 who come into contact with this virus may not even fall ill, and only 60% of those who do fall ill die. The true mortality rate would then be well below even current Human Flu mortality rates.

We just don't know.

But people keep referring to the worst case scenario as if it is the ONLY scenario, when in fact not only is it NOT the only scenario, it is not even the most likely scenario.

Next you refer to the WHO's concern about Bird Flu and its possibility of mutating. The fact is not only is it possible that it will mutate, it mutates almost constantly - however those mutations that have occurred have not made it any more dangerous to humans, and there is no certainty they ever will - not that the doomsayers would ever tell you that.

Not only am I not ignoring the "increasing concern" it is that very thing I am pointing at as evidence of the hype being propagated. The facts behind the WHO's concern are a hell of a lot less scary than they are making out. Just like during the SARS scare. I have to wonder why they ONLY ever talk about the worse case scenario without balancing it with other more likely scenarios. Scientists never act like that. At least not the kind of scientists I respect.

The fact is EVERYTHING people are saying about Bird Flu is exactly what they were saying about SARS, and they turned out to be wrong, for one simple reason - they cherry picked the "ifs" to create a worse case scenario which was on balance far less likely than all the non-doom scenarios. You are doing it right now.

97 infections, 53 deaths - THAT is what we are talking about. In the same time, Human Flu infected millions and killed hundreds of thousands.

[pandemic_1918]

76. It's Not An If

Flu pandemics have been happening for centuries. The next one is not an if, it's a when.

[Dogmudgeon]

26. Why be scared?

There is no reason to be "scared". There IS a reason to be cautious, and to put pressure on our "leaders" to make sure the public health system is in good shape. Last winter's flu vaccine debacle in the USA was not a good sign.

Bird Flu is worth all that concern for a couple of reasons. First, the genome is unique, so very few people have any immunity to it at all. Second, its morbidity and mortality are very high, with case mortality rates of 50-90%.

So only 80 people have died? Well, those 80 came from a few, very small groups of infected people -- I believe the total cohort size was about 200. The half-million flu fatalities we see each year come from widely disseminated infections in a general population of 6.2 billion people. A morbidity of 10% and mortality of 50% would result in a staggering 310 million fatalities in the space of a year; even a reduction in the mortality rate to 5% (the level seen during the Spanish Flu in 1918) would still result in 31 million deaths, and large numbers of deaths in each subsequent year that a vaccine wasn't available. So we are talking about a flu bug that is 50-500 times as "effective" as the usual H1N1 Type-A Influenzae.

There's easier ways for the WHO to cadge money out of the world's people. Besides which, the level of public health funding in general is far too low. Large numbers of sick people breed astronomical numbers of pathogenic organisms. We don't even have enough money to get generic Kaopectate to poor people dying of diarrhea (at a human cost of >200,000 fatalities per year).

Of course I'm concerned. We are facing multiple challenges in the coming generation, and only the reading population is being reached. Between pandemics, energy resource depletion, and climate change, the difference between a bump in the road and a screaming drop off the edge of a cliff is less about money and more about willful ignorance.

Stay healthy.

--p!

[Karmakaze]

30. The problem is you assume a morbidity of 10%

Yet NOTHING has indicated that Bird Flu is ANYWHERE NEAR as communicable as even SARS was, and SARS only infected around 8000 and killed only 800.

Now tell me, why I should be concerned about Bird Flu?

As for the high mortality rate, the fact is that is NOT a large enough sample to be able to tell the REAL mortality rate. For example in the early months of SARS it had a near 100% mortality rate. In the end though, its mortality rate turned out to be around 10% - a tenfold decrease. Who knows what the mortality rate would have been if even larger numbers of people had been infected?

Another factor to consider is that Bird Flu deaths have mostly occurred in nations with below average health systems - that alone will have a major affect on mortality rate.

I had to quote this part:

"So we are talking about a flu bug that is 50-500 times as "effective" as the usual H1N1 Type-A Influenzae."

No, you are CREATING this "effective" influenza out of whole cloth! The fact is to become this superflu, some RANDOM event has to occur that not only makes Bird Flu far more communicable among humans than it currently is, but has to maintain its current severity.

These are events that are not likely at all - sure they MAY happen, then again they probably won't, just as they didn't for SARS.

Believe me \, I am not trying to say that Bird Flu is NOTHING, but I am SICK of hearing about how Bird Flu is gonna kill us all (even though it hasn't even got close over the least year) and threatening dire consequences unless major changes are made RIGHT NOW.

It is pure propaganda and serves no purpose.

If it wasn't, WHO would be fighting to have that half million who might die this year from normal old flu vaccinated. But that would mean the funding would be spent on actual people - not the bureaucracy.

[Dogmudgeon]

33. My assumptions are far from outlandish

The morbidity for the 1918 Spanish Flu was over 25%. (More on this below.)

You're assuming that the problem is hype. It isn't. An epidemic doesn't need to kill us off to be an major tragedy. An contageous disease that could kill one million Americans would also take a huge toll in money spent, work not performed, and capital devauled. Convalescence for 60-100 million people who may have had such a flu and survived would certainly compound this blow.

You're right about the communicability of Bird Flu being low. But it was zero just 18 months ago. Mutations (polymorphism) leading to communicability are not just common, they are expected. As the pool of organisms grows, so does the probability of mutation. These mutations usually promote morbidity as they reduce mortality. In the case of the 1918 Spanish Flu, morbidity in the USA was over 25% and mortality at about 0.7%. Given a population of slightly over 100 million, that translates to over 25 million people made sick with the flu, and 700,000 deaths. Given a current population of 330 million, you can do the math -- 2.3 million dead Americans won't cause the world to end, but it will be a tremendous blow.

The numbers I used for a model world epidemic of H5N1 were not out of that ballpark. The Spanish Flu killed 20-25 million people worldwide (some estimates go as high as 50 million) out of a population of 1.8 billion. Compare this with my 31-310 million range in a world population of 6.2 billion (actually, I erred here -- the US Census Bureau puts the figure at 6.45 billion at midyear 2005). It is the same range.

You also minimized the impact of SARS. With close to a 10% mortality, it was over 10 times more deadly than the Spanish Flu of 1918. Now do you understand the concern?

Most of the other points you fault me on I have, in fact, covered. But the idea that I have invented an epidemic out of whole cloth is ridiculous. Right now, the Bird Flu IS hundreds of times more effective at causing illness and death as the average case of Influenza-A; and that is precisely why we can extrapolate that the potential danger would be so high. Historically. new illnesses have almost never caused 50% or more in fatalities. It is not a sure thing that Bird Flu will stay relatively powerful, but that's the central tendency of the data we have on other epidemics.

The idea that the Bird Flu is being used for "propaganda", as a money-making scam, and to deny other medical treatment to the poor, is just unrealistic. You seem to be assuming that I am somehow advancing a corrupt agenda. I've already spoken about the need for more (much more) basic public health action and primary care. And there is no propaganda in my argument except that we in the USA have been remarkably lax in our public health measures.

Money is not the problem. The Department of Health and Human Services has requested $7.5 billion dollars for the Centers for Disease Control and Prevention, and its overall funding has been reduced significantly this year. (See the CDC-HHS Budget Web Page.) Global Disease Detection is budgeted for $22 million this year and $34 million in FY2006. This is not exactly a pork barrel!

I think you're mainly really pissed off at how the press has used the threat of Bird Flu to get people to tune in -- what hipsters call "be afraid -- be very afraid!" (usually with a "bwaha" tacked on). I can't do a thing about that except to say that they may be on the right track, but their tactics certainly stink. Your distrust of fear tactics is healthy, but I would challenge you to look behind the hype. I do not advocate fear; simply a well-informed awareness of the vulnerability we humans have in the face of a chaotic universe and given the small-minded leadership we "enjoy". The news-making public schizophrenia of "The end is near!" vs. "It's nothin'!" could become very costly.

As with other challenges ahead of us -- energy and resource depletion, climate change, asteroid/comet strikes, whatever -- the cost of being prepared is not just far lower than the cost of weathering a disaster, it is far lower than most of our spending on "essentials" like war, corporate welfare, the imprisonment of close to 2% of our population, and even the cost of administering IRS audits.

Vigilance against potential disasters isn't some bureaucratic ploy to fleece the public, it is one of the core values of Democracy itself. For instance, if a major problem was coming our way, how do you think the corporate state would handle it? Would they tell us, and prepare for the worst -- or keep us uninformed, and make sure their elites and enterprises could emerge unscathed to "charitably" pick up the pieces?

I'd rather put a little effort into vigilance today than to be a survivor-slave tomorrow.

--p!

[Karmakaze]

38. Apart from the fact 90% of your post is hype...

let me respond to a few points.

"You're right about the communicability of Bird Flu being low. But it was zero just 18 months ago."

Actually the communicability is still pretty much zero. There have been a few cases where human to human infection is SUSPECTED to have occurred, but considering so few people have caught this disease in the time it has been around (about the same time in which the 1918 flu infected 1/5th of the worlds population), The difference from zero is negligible.

Hell, Marburg is an extremely rare yet extremely deadly disease and it has killed more people in the last year!

"As the pool of organisms grows, so does the probability of mutation. These mutations usually promote morbidity as they reduce mortality."

Umm, no. Mutations are random and are just as likely to cause the disease to become less communicable as more communicable. Remember we were told SARS would mutate and become more communicable. What happened? Nothing. In the mutation lottery you can bet on the one in millions chance that the worst will happen, while I will carrying on expecting the millions to one probability that nothing will happen.

I bet you I'll win.

"You also minimized the impact of SARS. With close to a 10% mortality, it was over 10 times more deadly than the Spanish Flu of 1918. Now do you understand the concern?"

If you're gonna hype figures, it's best to stick to the ones like "projected" infections rather than KNOWN ones like the case of SARS. That hype just doesn't work when I can point out that ONLY 800 people died and ONLY 8000 were infected.

Far more people died that year from normal human flu. So, no, I do not understand the concern about SARS or Bird Flu while normal Human Flu is ignored.

"But the idea that I have invented an epidemic out of whole cloth is ridiculous. Right now, the Bird Flu IS hundreds of times more effective at causing illness and death as the average case of Influenza-A;"

It's not ridiculous at all - Bird Flu is nowhere near as effective at killing people as normal Human Flu is. Of course I suppose that depends on your definition of effective, but to me the "more effective" disease is the disease that kills more people.

Now, explain to me again why you are talking about Bird Flu and NOT demanding free vaccinations for Human Flu?

"The idea that the Bird Flu is being used for "propaganda", as a money-making scam, and to deny other medical treatment to the poor, is just unrealistic."

Is it? Unrealistic eh? Because large bureaucracies never do things like lie about figures or spin them to garner more funding by misleading the public?

"And there is no propaganda in my argument"

That whole post is propaganda - you use BADLY extrapolated figures compared against figures that are not truly comparable to bolster an argument that has no foundation except a whole lot of coulds, maybes and ifs.

If that is not propaganda, I don't know what is.

"This is not exactly a pork barrel!

Maybe those figures aren't, but then again if they were, there would be no need to scare the public in order to manipulate more funding out of them, would there?

"I do not advocate fear; simply a well-informed awareness of the vulnerability we humans have in the face of a chaotic universe and given the small-minded leadership we "enjoy"."

You may not advocate it but you are definitely promoting it - all of these things I have said that counterbalance the Bird Flu hype did not appear in your or any of the other scaremongering posts. If you were truly only concerned about educating the public you would put both sides of the story.

No, what I see is a steady stream of "the sky is falling" and very little in the way of balance. Hell one guy even runs around with the du name Pandemic_1918 - just to reinforce that whole "We're all gonna die!" meme.

It's truly sickening.

"Vigilance against potential disasters isn't some bureaucratic ploy to fleece the public, it is one of the core values of Democracy itself."

Then tell me why you are not up in arms over the complete lack of care by these organisations in regards to Human Flu. We HAVE a vaccine for it, we HAVE the ability to save infected patients, yet every year hundreds of thousands die while people like you warn us about a disease that may never happen.

Why is that? Is that not nonsensical? I guess I just don't get the logic of ignoring the actual in favour of the possible.

[Dogmudgeon]

57. I don't think you're getting my points at all

You don’t even appear to understand what flu is. You consistently write about Human Flu, when there is no such thing per se. They call it the Bird Flu because it was first discovered in chickens sold for food in public markets in south China. The “H5N1” business is the recombination of Hemagglutinin and Neuraminidase “codes”. Simply -- an influenza virus is an influenza virus is an influenza virus. The strains are distinguished by viral genetic codes, similar to the human genes that “code for” things like skin color and blood pressure. The immune system “learns” about certain codes from illness or vaccination to confer immunity. Novel codes can’t be “figured out”, leaving the virus undetectable by the immune system, resulting in more “effective” (my terminology) pathogenic action. ANY influenza virus found in one species of animal CAN -- and often DOES -- become active in others.

Human flu in all the literature I’ve read simply means flu that humans have contracted. If there is a flu strain out there with a name like, e.g., Vladivostok Human 2002 H3N9”, I haven’t seen it.

You also don’t seem to understand the use of (well-established) mathematical models to illustrate levels of risk. 30 million deaths world-wide is quite possible in a flu epidemic; 300 million would not be an unexpected death count, either, given a new enough flu strain. However, three billion would be an incredible figure, but not an impossible one. It would have a very low probability of happening, but it could not be ruled out. You also consistently use SARS as an analogy to influenza, in spite of their epidemiological and pathological differences. You switch between statistical data and individual clinical medicine whenever it suits your argument. No one here, least of all me, doubts that individual response to pathogens is highly variable and unpredictable. But it is possible to draw valid conclusions from small groups of patients and extrapolate to humanity in general.

You’ve consistently replaced my points with your own spin and cynicism. Here’s a few examples:

Now, explain to me again why you are talking about Bird Flu and NOT demanding free vaccinations for Human Flu?

I’m not?

... Mutations are random and are just as likely to cause the disease to become less communicable as more communicable.

Which is a point I’ve made repeatedly, including explicitly using the word random to describe the mutation process. I also used the word usually since that really is the usual pattern. If I had failed to include it, you would be jumping all over my omission.

Your example of a mutation lottery is fundamentally correct, but you have left out the most important factor -- the number of “lottery players” increases geometrically in the early phases of an epidemic outbreak. The probability of any given pathogenic feature emerging also increases, and it usually increases quite fast before the organism produces an epidemic or pandemic. Again, the issue of individual vs. group morbidity is the important distinction.

The other issue, the things that limit an epidemic, serve as mechanisms of natural selection as well as limitations to contagion. But we can’t depend on the limitations to contagion to always work. The randomness of natural selection is at work here, too.


Is it? Unrealistic eh? Because large bureaucracies never do things like lie about figures or spin them to garner more funding by misleading the public?

If you don’t want to believe a bureaucracy, I can’t blame you, but it’s no more realistic to believe that everything they say is a lie than to believe that everything they say is the truth. Besides, these are the very bureaucrats you want to spend more money on the “Human Flu”.

When they do what you want them to, do bureaucrats suddenly turn into Heroes of Science?

The only way to resolve the believability issue is to seek out qualified opinions. The CDC is not a secretive organization, and public-health peer review is unusually open and active for this branch of medical science. Even a lay person is permitted to make comments, providing they understand what they are commenting on. (The WHO works in a similar fashion.)

That whole post is propaganda - you use BADLY extrapolated figures compared against figures that are not truly comparable to bolster an argument that has no foundation except a whole lot of coulds, maybes and ifs.

If that is not propaganda, I don’t know what is.

You haven’t even established that my arguments are wrong. You should save the propaganda analysis for when you actually can make a case for it.

As for your pique at my figures, I have used the simplest ones possible -- well-known epidemic data and single-variable algebra. Your failure to give any concrete examples of my supposed misuse of numbers tells me you probably don’t understand how they are used, and are just looking for an argument. I’ve been completely open about how I derived them, and if I err anywhere, I invite criticism and correction (and usually get it).

Those “coulds, maybes and ifs” are used because we lack clairvoyance. In actual scientific risk analyses, they are presented as contingencies -- “IF we keep ignoring public health issue X, THEN there will be an outbreak of Y, with a probability of Z.” We actually do know most of those numbers -- and ignore the problems anyway. And what we DON’T know, we usually don’t fund.

Sorry, but scorn does not cut it as informed criticism.

You may not advocate it but you are definitely promoting it - all of these things I have said that counterbalance the Bird Flu hype did not appear in your or any of the other scaremongering posts. If you were truly only concerned about educating the public you would put both sides of the story.

“Counterbalance”? You mean, like “Fair and Balanced” Fox News?

Epidemiology isn’t an opinion-based discipline, it’s biology and mathematics. There are no “both sides of the story”, only rates of probability of sickness and death. What you choose to do with those numbers is up to you. I advocate greater involvement to prevent and/or control any potentially destructive public health concern. No dramatization is required -- my “scaremongering” involves saying “here’s what will eventually happen if we keep ignoring the problem -- let’s do something about it.” And I certainly DO NOT ignore ongoing issues like lower-morbidity H1N1 flu strains.

I hope some of your disdain for the bureaucracy extends to the way the Bush Administration botched the flu vaccines for this past season. THAT is the kind of thing I’m worried about -- our lackadaisical attitude toward public health. We scrutinize documents critical to Bush down to the smallest serif, but ignore things like the danger of single-source vaccine manufacturers.

No, what I see is a steady stream of “the sky is falling” and very little in the way of balance. Hell one guy even runs around with the du name Pandemic_1918 - just to reinforce that whole “We’re all gonna die!” meme.

It’s truly sickening.

Then you’re being sickened by your own interpretation of the news you see -- which is probably the over-simplified gossipmongering that passes for TV and cable news these days.

As far as I know, Pandemic_1918 is an epidemiologist -- in the private sector. He is no mere fearmonger, since, if you’d actually read his posts, he presents solid information about our lack of preparedness in dealing with newly evolving diseases. Now, before you get all stoked about how he’s trying to make a buck by ignoring “the human flu”, keep in mind that his company could make even more money by manufacturing zit creams, boner pills, or extra-absorbent tampons.

Then tell me why you are not up in arms over the complete lack of care by these organisations in regards to Human Flu. We HAVE a vaccine for it, we HAVE the ability to save infected patients, yet every year hundreds of thousands die while people like you warn us about a disease that may never happen.

Why is that? Is that not nonsensical? I guess I just don’t get the logic of ignoring the actual in favour of the possible.

First of all, I have been up in arms for some time now, about our attitude of “there is no problem so large that it can not be ignored.” This attitude is leaving us vulnerable to oil depletion (and price fixing), climate changes, random “common” disasters like tsunamis and volcanoes, and especially the widespread impacts these disasters would have.

“People like me” are used to the abuse from cynics who are so worldly-wise that they can’t believe it when stupidity bites them in the ass. When disaster strikes, it’s the fault of the Government and the Corporations being too cheap to do anything. And when disaster is avoided, it’s the fault of the Government and the Corporations scamming us out of money. Cynicism is elevated to high principle, and anyone with a well-thought-out point to make is a dupe, an enabler, or a propagandist.

You really and truly seem to not understand the underlying logic. There is no “ignoring the actual in favor of the possible” because it’s all the same stuff! Strain H1N1 has a 5% morbidity and a 0.01% mortality, and H5N1 may come in at 20%/50%, but each are influenza viruses. Allocating funds for H5N1 goes to the same scientists as H1N1 funds -- and we’re badly botching the job of dealing with H1N1, too. And it’s not even because of funding levels.

Moving funding from research to treatment is what you seem to suggest in many places. As I pointed out, that may come to $34 million dollars in direct funding for identifying new diseases. The bottleneck isn’t the money, it’s the boneheaded decisions being made by government and the pharmaceutical industry. Again, it’s not an issue of current epidemics vs. possible epidemics, it’s an issue of epidemics vs. boner pills.

You may have your attention on the larger issue of the way money dictates responding to high-risk situations, and not the other way around. Remember the tsunami that hit Indonesia (especially Banda Aceh) in December? Scientists knew what was happening within minutes of the earthquake. Yet no alarm was sounded because of the small residual possibility that there really was no tsunami, and because a mass evacuation of coastal areas in the Indian Ocean would be expensive. And now, the blame is being placed on the scientists whose warnings were ignored, and the official story being promoted is that there is no tsunami-monitoring system in the Indian Ocean area!

Bird Flu is NOT some kind of diversion that takes money away from a larger group of sufferers of more common illnesses. Scientists have known for fifty years or more that we have been unprepared for serious epidemics. Ebola, Marburg, AIDS, Lassa, and novel Influenzas have all been preceded by vigorous epidemiological debate on the emergence of such disease organisms in human populations.

Case in point: AIDS. We ignored hundreds of early AIDS cases, and as soon as it became established that AIDS was epidemic within the gay and IVDA communities, we ignored it for another five years, since it was only “bad people” who were affected.

And yes, there were “AIDS skeptics” who made the same, identical, arguments you’re making -- that AIDS was being hyped. That it was drawing money away from other diseases. Check a book from the mid-1980s by Michael Fumento, The Myth of Heterosexual AIDS. It’s the same argument over a different pathogen. And in reality, Fumento wanted the Free Market to deal with AIDS, so all of his carefully posed arguments were made irrelevant, being based on models of scarcity and assumptions of corruption.

If you think hype is sickening, I hope you have a strong stomach for negligence. There are, and always have been, very few disasters that some prudent advance planning couldn’t avert or ameliorate, and almost always for less than a penny on the dollar.

Your criticism of the ongoing negligence of active problems is spot-on, but your dismissal of advance planning advocacy as propaganda is wholly and completely wrong. They are two sides of the same tarnished coin, and negligence in providing current public health needs has its twin in unconducted biosurveillance and public health planning. They can not be attended to -- or ignored -- separately.

--p!

[pie]

68. Your post clears up the mechanics of viral natural selection

I was wondering how a strain of H5N1 that is easily transferable
from bird to human -- and from human to human -- would be 'chosen'
in the course of natural selection.

The salient feature presented by such a virus, of course,
would be that it in fact has become easily cross transferable.
We won't know it has hit the jackpot until it is spreading like
wild fire. The proof will be in the pudding.

This mutation need only present one time in a heavily populated area to get the party started. Finally I am beginning to understand what all the fuss is about.

"Your example of a mutation lottery is fundamentally correct, but you have left out the most important factor -- the number of “lottery players” increases geometrically in the early phases of an epidemic outbreak. The probability of any given pathogenic feature emerging also increases, and it usually increases quite fast before the organism produces an epidemic or pandemic."

[Karmakaze]

80. A very good attempt at knocking down the straw man...

The first two paragraphs are just plain silly. I refer to Human Flu in exactly the same way you do: "Human flu in all the literature I’ve read simply means flu that humans have contracted."

You KNOW that is what I meant, but instead try to use a simple straw man to attack what I am saying. It failed.

But let's play this game anyway:

You also don’t seem to understand the use of (well-established) mathematical models to illustrate levels of risk. 30 million deaths world-wide is quite possible in a flu epidemic; 300 million would not be an unexpected death count, either, given a new enough flu strain. However, three billion would be an incredible figure, but not an impossible one. It would have a very low probability of happening, but it could not be ruled out. You also consistently use SARS as an analogy to influenza, in spite of their epidemiological and pathological differences. You switch between statistical data and individual clinical medicine whenever it suits your argument. No one here, least of all me, doubts that individual response to pathogens is highly variable and unpredictable. But it is possible to draw valid conclusions from small groups of patients and extrapolate to humanity in general.

Hmm so 30 million deaths are possible. Did I ever say ANYWHERE, that they are not? No. So do these mathematical models say that Bird Flu WILL mutate into such a disease? No they don't. So what is your point?

As for the differences between SARS and Bird Flu, I am not referring to SARS in the medical sense but in the political and propaganda sense to illustrate how THE EXACT SAME THINGS WERE SAID ABOUT SARS. The fact that the outcome was NOTHING LIKE WHAT PEOPLE LIKE YOU WERE SAYING, was what I was trying to show. I did it well, because you CAN NOT refute that SARS did not infect the entire world and kill 30 odd million of us.

You’ve consistently replaced my points with your own spin and cynicism. Here’s a few examples:

"Now, explain to me again why you are talking about Bird Flu and NOT demanding free vaccinations for Human Flu?"

I’m not?

OK, so point out where you demanded free vaccinations for Human Flu?

I sure haven't seen it.

... Mutations are random and are just as likely to cause the disease to become less communicable as more communicable.

Which is a point I’ve made repeatedly, including explicitly using the word random to describe the mutation process. I also used the word usually since that really is the usual pattern. If I had failed to include it, you would be jumping all over my omission.

Your example of a mutation lottery is fundamentally correct, but you have left out the most important factor -- the number of “lottery players” increases geometrically in the early phases of an epidemic outbreak. The probability of any given pathogenic feature emerging also increases, and it usually increases quite fast before the organism produces an epidemic or pandemic. Again, the issue of individual vs. group morbidity is the important distinction.

The other issue, the things that limit an epidemic, serve as mechanisms of natural selection as well as limitations to contagion. But we can’t depend on the limitations to contagion to always work. The randomness of natural selection is at work here, too.

Good one! You admit that there a likelihood that no mutation will ever occur that will make this disease more communicable, then you go ahead and refer to the "early stages of an epidemic outbreak"! That's chutzpah. :)

For there to even BE an early stage to a Bird Flu epidemic, there has to be some way for the epidemic to occur. No mutation, no epidemic.

If you don’t want to believe a bureaucracy, I can’t blame you, but it’s no more realistic to believe that everything they say is a lie than to believe that everything they say is the truth. Besides, these are the very bureaucrats you want to spend more money on the “Human Flu”.

I never said I wanted more money spent on Human Flu, I asked why people like YOU were not DEMANDING more money be spent on Human Flu. I personally recognise that while Human Flu kills a lot of people, that there is not much that can be done to prevent it - death happens, from one cause or another, and we can't always prevent it.

Scaring the entire world over Human Flu won't work to increase funding for organisations like WHO because we are all to familiar with it, even though it kills hundreds of thousands each year. So organisation like WHO find these rare diseases and concentrate on making them out to be much worse than they are. That is why we hear about Bird Flu, and not Human Flu.

You haven’t even established that my arguments are wrong. You should save the propaganda analysis for when you actually can make a case for it.

I have established that your arguments are no more likely than the arguments you DON'T make (even you admitted that above), and it is those arguments that show that Bird Flu is less of a concern than Human Flu, which no one is truly concerned about, not even WHO. When someone constantly promotes a possibility that is not even the most likely outcome, there has to be a reason for it. Spreading misinformation is the very definition of propaganda, and misinformation does not only mean that you don't tell the truth, it can also mean that you don't tell the ENTIRE truth.

As for your pique at my figures, I have used the simplest ones possible -- well-known epidemic data and single-variable algebra. Your failure to give any concrete examples of my supposed misuse of numbers tells me you probably don’t understand how they are used, and are just looking for an argument. I’ve been completely open about how I derived them, and if I err anywhere, I invite criticism and correction (and usually get it).

I already pointed out why your numbers were misleading - they have NO BEARING on the actual state of Bird Flu. I could spout off numbers about the deaths of millions of people from an asteroid strike, but unless I also tell you that the chances of that strike are exceedingly small, then all I am doing is misusing the numbers to create a false impression.

The current confirmed infection count is 97, of those 53 died. All of those people had close contact with infected birds, and in a few cases with people actively sick from their contact with infected birds.

That is after over a YEAR of this Bird Flu hype.

Those are the ONLY numbers that have any meaning. You can extrapolate possible deaths that MIGHT occur IF a mutation occurs all you want, but all they are based on is slim possibilities. That is propaganda.

“Counterbalance”? You mean, like “Fair and Balanced” Fox News?

See, more propoganda - I disagree with you, you can not prove your argument nor disprove mine, so you resort to trying to build an association between me and a hated figure. Standard Propaganda 101 tactics. Thanks for proving my point.

Epidemiology isn’t an opinion-based discipline, it’s biology and mathematics. There are no “both sides of the story”, only rates of probability of sickness and death. What you choose to do with those numbers is up to you. I advocate greater involvement to prevent and/or control any potentially destructive public health concern. No dramatization is required -- my “scaremongering” involves saying “here’s what will eventually happen if we keep ignoring the problem -- let’s do something about it.” And I certainly DO NOT ignore ongoing issues like lower-morbidity H1N1 flu strains.

Of course there are "both sides of the story"! One side of the Bird Flu story is that MAYBE a major epidemic will break out - the other side of the story is that MAYBE nothing will happen at all. By ONLY ever presenting one option, you are merely promoting a lie - that there is NO OTHER SIDE TO THE STORY.

And then there you go proving my point again:

my “scaremongering” involves saying “here’s what will eventually happen if we keep ignoring the problem -- let’s do something about it.” And I certainly DO NOT ignore ongoing issues like lower-morbidity H1N1 flu strains.

I added emphasis to show where you did it again without even thinking. The word that SHOULD have appeared there if you were being intellectually honest is "may" - "here's what MAY eventually happen".

You may not ignore Human Flu, but you certainly don't go around warning people that hundreds of thousands of them may die this year from it. Why is that?

I hope some of your disdain for the bureaucracy extends to the way the Bush Administration botched the flu vaccines for this past season. THAT is the kind of thing I’m worried about -- our lackadaisical attitude toward public health. We scrutinize documents critical to Bush down to the smallest serif, but ignore things like the danger of single-source vaccine manufacturers.

There is that veiled 'associate with a hated figure' tactic again. Yes have plenty of disdain for the Bush admins handling of the Flu vaccine issue - in fact much more than WHO over the Bird Flu and SARS issues - at least WHO isn't getting people killed when they play their games.

Bush and the single source vaccine manufacturers are likely responsible for a spike in the number of deaths from Human Flu in the US this year. We won't know for certain for some time, but it is highly likely.

How scaring people over SARS and Bird Flu has anything to do with that is beyond me.

Then you’re being sickened by your own interpretation of the news you see -- which is probably the over-simplified gossipmongering that passes for TV and cable news these days.

As far as I know, Pandemic_1918 is an epidemiologist -- in the private sector. He is no mere fearmonger, since, if you’d actually read his posts, he presents solid information about our lack of preparedness in dealing with newly evolving diseases. Now, before you get all stoked about how he’s trying to make a buck by ignoring “the human flu”, keep in mind that his company could make even more money by manufacturing zit creams, boner pills, or extra-absorbent tampons.

There is yet another tactic - you claim I don't read his posts. Then how is it that I have proved them all to be misleading? Anyway, he may be an epidemiologist - in fact I suspected he was, because such a person has the most to gain from increased funding for "preventing" diseases such as Bird Flu, and is thus not likely to want to CALM fears of such diseases.

As for an epidemiologist making money from zit creams, i think that is highly unlikely. After all what has zit cream got to do with the study of infectious diseases?

You really and truly seem to not understand the underlying logic. There is no “ignoring the actual in favor of the possible” because it’s all the same stuff! Strain H1N1 has a 5% morbidity and a 0.01% mortality, and H5N1 may come in at 20%/50%, but each are influenza viruses. Allocating funds for H5N1 goes to the same scientists as H1N1 funds -- and we’re badly botching the job of dealing with H1N1, too. And it’s not even because of funding levels.

At least you said MAY this time. The fact is H5N1 MAY also come in at 0.001%/50% - in fact that is far more likely because that is close to what it already is, although probably still inflated.

Only 93 people out of 6.5 billion have been infected with Bird Flu in the last year. There is NO indication that that rate of infection will change. Those are the facts. Anything else is merely speculation.

Conjure up all the "logic" you want, facts are facts.

Now I'm gonna skip a whole bunch because it doesn't really say anything that this last paragraph won't cover:

Your criticism of the ongoing negligence of active problems is spot-on, but your dismissal of advance planning advocacy as propaganda is wholly and completely wrong. They are two sides of the same tarnished coin, and negligence in providing current public health needs has its twin in unconducted biosurveillance and public health planning. They can not be attended to -- or ignored -- separately.

I am not in fact criticising the ongoing "negligence" for I don't really believe there IS negligence of the type you seem to be referring to. The fact is Human Flu spreads because it mutates - there is nothing we can do about that, except create and disseminate vaccines. We do do that, but not the way I would like to see it done.

However that has no bearing on the fact that its is the general ACCEPTANCE of these facts that I am referring to - no one is scared out of their wits about Human Flu - we get it, we deal with it, we moan about it. Yet that is far more deadly a disease than Bird Flu right now simply because it kills far more people.

So what do the scaremongers do? they gloss over the ACTUAL figures in favour of figures PROJECTED from POSSIBLE scenarios and propagate them as if they are the REALITY of the situation. They inflate a disease that should not concern anyone when compared to Human Flu, so that it can be used for propaganda purposes.

Now let me just point out the biggest flaw in the argument you just made: You say you are not inflating the worst case scenario for propaganda reasons - then you turn around and say you are saying these things to draw attention to the lack of preparedness.

You admit this is not the only outcome of Bird Flu, nor is it the most likely outcome of Bird Flu, and that you are only saying these things to draw attention to a lack of preparedness.

I'm sorry my friend, but you just admitted that your whole post was propaganda.

[NNN0LHI]

82. You mean the chance of actually having a pandemic is exceedingly low?

Thats what I thought all along too, but I didn't want to say nothing. And one guy tells everyone to wash their hands when people ask what they can do about it. People are going to have some real pruney hands when this is all over.

Don

[pandemic_1918]

83. No - It's a When Not an If

Just about everyone who has look at past pandemics and the current situation with H5N1 agrees that is a when not an if and H5N1 is getting very close, and may have already begun with milder cases in northern Vietnam or more serious cases in Qinghai.

[Karmakaze]

92. Serious cases in Qinghai? The RUMORED ones?

Come on, be honest, so far there have been NO confirmed deaths in Qinghai, although I doubt that there are none, simply because people are coming into contact with infected birds.

The point is, there is no proof that any such deaths have occured, but you are using them as evidence of yet another rumor, that the virus is getting more serious?

Bad science right there.

[Media_Lies_Daily]

96. Gee, didn't China say the same thing about SARS, until they.....

...absolutely had no other choice than to ask for help from the outside world? If I remember correctly, SARS had been present in China for more than six months before China told the rest of the world.

What are the chances that China is treating Avian Flu the same way? IMHO, and based on how they've dealt with the outside world for decades, I'd say the chances are pretty good.

[Media_Lies_Daily]

85. "Exceedingly low"?? IMHO, I think the chances are pretty high....

...especially if the Chinese are covering up just like they tried to do with SARS. The Avian Flu will escape them, just as the SARS virus did. Lucky for them...and us...that the SARS virus was not nearly as communicable as it could have been.

[Karmakaze]

93. And yet SARS was MANY times more communicable than Bird Flu

So YES the chances are very low, even exceedingly low, that Bird Flu will manage to do what SARS didn't.

The point is, THERE IS NO EVIDENCE that Bird FLu is any more dangerous than SARS, and we saw what all this hype around SARS amounted to.

[Media_Lies_Daily]

97. "No evidence that Bird Flu is any more dangerous than SARS"??...

...Interesting response given what we know of the mortality rate of both diseases.

Unless I've missed something, the mortality rate of SARS was about 10% while being fully communicable human-to-human. The mortality rate of Avian Flu is about 70-80% to date, and as you've stated, is not yet fully communicable human-to-human.

Apparently, you have a MUCH different way of viewing the "available evidence" than those that are dealing with it on the front lines.

As far as the "hype around SARS", you seem to forget that the affected areas had to resort to massive quarantines and a total stoppage of air and sea travel until they could get the disease under control. Hong Kong had actually removed people from affected neighborhoods and sent them to camps completely removed from population centers. At one point, entire neighborhoods in Beijing were completely sealed off from all traffic into and out of those areas. Do you think all of those afected governments would have willingly taken such a massive hit to their economies if it had not been absolutely essential that they do so? Thanks to their combined efforts, and that of the WHO, we didn't have to seal with it in this country.

[Henny Penny]

46. well said sir!

[pandemic_1918]

41. SARS Mortality Rate

The SARS mortality rate was 15-20% for the countries keeping accurate records. It did not change when calculated properly (as the number dead / number dead + discharged). It was never 100%. In fact the early erroneous numbers were low because initial numbers from China were 5 deaths in 305 and later numbers from China and Taiwan were suspect. Moreover, initial calculations by the CDC and WHO used the diagnosed as the denominator, and that assumed all would recover, so it was artificially low and then steadily rose as the hospitalized patients began to die.

Other countries had a constant case fatality rate when calculated correctly.

[Karmakaze]

47. You are right and wrong..

I just rechecked my numbers and you are right, the early numbers for mortality of SARS were around the 6% level once it reached into the hundreds of infections - I can't find the very earliest data when there were dozens of infections, which is the time period I was referring to, but I will assume they were also around the 6% level.

However, the final mortality rate was around 9.5% not 15 to 20%

as for the "denominator" the WHO figures were ALWAYS given as 'number infected' and 'deaths', thus the number of recoveries was irrelevant. In fact these early numbers (and therefore the calculated mortality rate) was thrown off by the fact that a quick test for SARS had not yet been invented, so many people were listed as one of the possible or probable infections, who did not in fact have the disease.

This of course is all irrelevant except in so far as it shows a pattern of fear mongering in regards to a disease that was not very threatening.

Pulling out mortality rates is purely a propaganda move, because mortality rates are NOT the major determinant in how dangerous a disease is. SARS was 5 times more deadly that the 1918 Flu - yet the 1918 Flu killed tens of millions while SARS just about managed to kill 800.

Why is this? The answer is because even though 1918 Flu had a far lower mortality rate, it was far, far more communicable. So the 8000 infections of SARS have to be compared with the hundreds of millions of infections from the 1918 Flu.

Another factor is health care - we are far more able to keep people alive who have severe diseases now, than we did in 1918 - perhaps the 1918 mortality rate would be far lower if they had our cerrent technology, then.

This is why I keep referring to Human flu. Even though its mortality rate is less than 1% it has killed far more people than SARS and Bird Flu combined in just the last few months. Yet this disease seems to concern no one.

Why is that? Is it because we recognise that preventing these deaths would be an enormous cost, and not very cost effective for organisations such as WHO? They can ask for 100 million dollars and spend it all fighting Human Flu, or they can ask for 100 million dollars and only spend half of it fighting Bird Flu. Is it any wonder all we hear about is Bird Flu?

[pandemic_1918]

51. Case Fatality Rate of 15-20%

In places where the data was not suspect (Toronto, Hong Kong, Singapore), the case fatality rate was 15-20%. In China the initial cases in Guangdong had 5 of 305 dead or 1.6%. This could have been an early version (SARS CoV did evolve), but the early numbers out of China were when China was denying there was any SARS. Once they acknowledged SARS, the rate went up to about 30%. However, at the end there were many discharges, and it is unclear of these discharges had SARS or were misdiagnosed. Taiwan changed the definition and cremated patients before they could be tested, so Taiwan had a higher case fatality rate for SARS-like than SARS.

Bottom line is simple. If you don't change the definition or the virus doesn't change, the case fatality remains the same (15-20). Hanoi had a small sample size and the rate was lower.

Your overall numbers were impacted by early and late numbers out of China which were well into the suspect category. Reliable numbers show a stable case fatality rate which can be calculated for a small number if outcomes are known.

The outcomes for H5N1 in Vietnam and Thailand for 2004 are known and it was about 70%.

[gkhouston]

98. yes, we're far more able to keep people alive

on an individual scale. A pandemic would likely swamp our health care resources in very short order. It ain't gonna be the end of the world, but it ain't gonna be pretty, either. We're not prepared.

[wschalle]

43. SARS is not a proper reference.

Sars was a virus in the same family as the common cold. The two don't evolve the same way.

Also, if H5N1 does become a pandemic strain, it certainly won't do so by RANDOM chance. It will be natural selection. Mutations that are not beneficial will be outcompeted by the mutations that are beneficial, or by the parent strain. If you consider the sheer number of chances this virus has to evolve, factoring in the number of swine infected, the viral load of each case, and the number of species interacting with each other, it's absolutely inevitable that this virus will cause a pandemic. At this point, it's only a matter of when.

Also, if a pandemic does break out, the real burden will be on the department of health and human services, not the CDC. The CDC is a front -line defence against the spread of disease, and its function is to contain emergent strains of virii. Once the virus is widespread, the cat is out of the bag, so to speak, and the CDC is out of the picture. The WHO does not have the resources even to contain Marburg HF efficiently, so it certainly won't have the resources to contain the Flu. China won't even allow the WHO in to assist in specimen collection for the current outbreak.

[Karmakaze]

48. Oh bull!

it's absolutely inevitable that this virus will cause a pandemic.

Complete bull. There is NOTHING inevitable about evolution. The fact is evolution is NOT that straight forward (ie the strongest always survives). What if the strongest is never randomly mutated in the first place? Many genetic failures survive the evolutionary process merely because nothing better had the chance to evolve.

In fact it is just as likely that a mutation will occur that will make Bird Flu LESS of a threat as it is likely that a mutation will occur that makes it MORE of a threat.

As for all that "contain the pandemic blah blah blah", the fact is that if we can not contain Human Flu, leading to the death of upwards of half a million people each year, we are not going to be able to contain Bird Flu should it become as communicable as Human Flu.

The only thing that would help in such an event is a vaccine. So such a vaccine should be developed as soon as possible. Other than that, there is nothing that can be done. Scaring people over a small possibility that there is nothing they can do anything about anyway, is just pointless.

And just a little sick.

[wschalle]

50. Bingo...

Fucking bingo.

The only thing that would help in such an event is a vaccine. So such a vaccine should be developed as soon as possible. Other than that, there is nothing that can be done. Scaring people over a small possibility that there is nothing they can do anything about anyway, is just pointless.

Exactly. The point isn't to scare them, it is to bring home the reality that pandemics have happened before. People don't know what kind of devestation that can bring until they've witnessed it. The kind of complacency that has developed in america is astonishing. In just 90 years, people have completely forgotten what a real epidemic is.

The public is the only thing that will get our government motivated, besides money. The only way to get the public motivated is to inform them of what could happen. If everyone on this board were to send a letter and make a phone call to their senator, maybe the factories to produce the vaccine would get built, or even planned.... Maybe the pandemic preparedness plan would be updated. Maybe more research would be funded to figure out a way to stop the flu.

Once the pandemic hits, there is ONE, and only ONE factory in the US that would be able to produce the vaccine. That factory couldn't produce enough vaccine to supply even a fraction of the population. And yes, the factories should be built anyway, to ensure a supply of vaccine for the normal flu.

My point is that we have to do SOMETHING. All you've been railing about is that there is a POSSIBILITY that this flu won't kill millions of people, and that even if it does, there is nothing we can do about it, so we shouldn't bother. Thats a really shitty attitude.

Feel free to lay down and die, but I for one am not going to take the possibility of millions of deaths from a fucking FLU lightly.

[Henny Penny]

54. welcome to DU wschalle...

and keep the info coming! Some of us understand that even ostriches might be vulnerable to this.

[Karmakaze]

60. Just plain nuts...

You talk about getting the government motivated - to do what exactly?

What can scaring the shit out of people get the government motivated to do? Do you really think people being scared is gonna change how long it takes to create a vaccine? So what else is it gonna do?

The fact is the worst case scenario you describe is about as likely as an asteroid hit. If it happens there is nothing we can do about it that we aren't already doing. So why the fuss?

IF such a thing should come to pass we will do our best and just have to live (or die) with the results. NOTHING we do now can change that.

But it is HIGHLY unlikely such an event will come to pass. So not only is this POINTLESS it is PREMATURE - there is no pandemic that will kill us all, there is not likely to BE a pandemic that will kill us all, so running around like a chicken with your head cut off is not going to accomplish anything.

"All you've been railing about is that there is a POSSIBILITY that this flu won't kill millions of people"

Ahh no. I have been saying that there is a HIGH PROBABILITY that this flu won't kill even hundreds of thousands of people, let alone millions. As for it being a shitty attitude, I believe scaring people over something that is not likely to happen is even shittier than recognising that disease kills, and there is very little we can do about it that we don't already do.

I for one am not going to take the possibility of millions of deaths from a fucking FLU lightly.

Funny, in the last 10 years there have BEEN millions of death from "fucking flu" - not Bird Flu, not SARS, just ordinary old Human Flu. You don't seem to give a toss about that.

The ONLY mention these deaths have gotten on this thread were because I pointed them out, and as sort of an afterthought in posts such as yours ("And yes, the factories should be built anyway, to ensure a supply of vaccine for the normal flu.")

Really - MILLIONS DEAD - and nothing - EIGHTY DEAD - and it's the end of the world.

[pandemic_1918]

63. It's When, Not If

Just about anyone who has looked at the bird flu situation agrees that the question is when, not if and most understand the difference between annual flu cases which attack mostly very old and very young, and a pandemic which could be significant worse than 1918 which killed more in the US than all US wars combined.

[Media_Lies_Daily]

28. You've missed the most vital piece of information....

...the total number of humans infected by Avian Flu does not exceed the total number of dead by more than a handfull or two. That's a pretty high mortality rate...close to 90%. Additionally, the number of people infected by this form of Avian Flu is very small. If the number of people infected was very large, we would have a very large number of dead.

Up until now, humans could only be infected by close proximity to, or the eating of the flesh of chickens and ducks. Avian Flu has also been found in pigs about a year ago, and jungle cats most recently, resulting in fatalities to both species.

It appears that rudimentary human-to-human infections are taking place now in Vietnam, and possibly China. THAT is definitely not a good thing. That means that the virus is mutating to take the form that will become the most efficient infector of humans.

[Karmakaze]

31. 200 does not a sample make!

In the early days of SARS the mortality rate was nearly 100% - by the time it ended the final mortality rate was only 10% - but this was in a sample of 8000 odd.

Maybe if the sample size had been doubled the mortality rate would have halved? Who knows? The fact is - so few people have even been infected with Bird Flu that the true mortality rate is impossible to determine.

Sure it's high now, but in a year's time we might find out it is no more than SARS, and maybe even no more than normal human flu.

In the meantime, up to half a million people will have died from normal human flu - while WHO etc were spending all this time and effort and money on a disease that may be NOTHING - just like SARS.

[pandemic_1918]

42. Avian Influenza Case Fatality Rate is Easy to Calculate

The case fatality rate for avian influenza was the same for last year in Vietnam and Thailand at the beginning and middle of the year (about 70%). This year the virus changed a bit and the version in southern Vietnam is close to 100% and around 20% in the north. These numbers are 10X 1918.

There were many cases in Vietnam and Thailand that were missed. Most of the index cases in family clusters were never tested, even though they died with bird flu symptoms and were from areas that had current or previous bird flu deaths.

[Karmakaze]

45. Bad maths...

If a disease has a true mortality rate of 1% and only one person catches it, they could still be the 1 in 100 person who would die from it.

So based on the result that one person catches this disease and dies, the mortality rate as calculated from that sample would be 100% - even though we know the true mortality rate is only 1%. This of course cuts both ways. If a disease had a mortality rate of 99% but only one person caught it and survived then that sample's mortality rate would be 0%.

So claiming a known mortality rate for a new disease that has infected so few people is intellectually dishonest.

I suspect you KNOW that such a small sample can not be used to calculate mortality rates, so your use of one makes me question whether you are trying to inform or trying to scare. It sure seems like the latter to me.

The next trick you pull out of the propaganda bag is the old "well some people who died were never tested and had the same symptoms" canard. That is likely true. What is also likely true is that many people were infected and DIDN'T die and were also not tested. So trying to use unrecorded deaths as an excuse is just as intellectually dishonest.

The fact is only a small number of people have been infected and an even smaller number have died, and there is very little evidence that human to human transmission has occurred, but such events are even MORE rare.

[pandemic_1918]

53. Sample Size and Constant CFR of 70%

The consistent 70% case fatality rate for Vietnam at the beginning and middle of 2004 and Thailand at the beginning and middle of 2004 and the unofficial cases in Thailand at the beginning of 2004 were all around 70%.

That's the data. Not ad hoc absurdities on what ifs.

[Karmakaze]

61. Based on a meaningless sample size

And the what ifs I refered to were things like "IF it mutates".

I was saying these same things during the SARS scare - get back to me in a years years time, and we will see who was right.

I was proved to be right about SARS, and I fully expect to be proved to be right about Bird Flu too.

[pandemic_1918]

64. SARS and H5N1

The differences between SARS and H5N1 have been listed (and SARS will also be back).

Your data analysis needs some work.

[Karmakaze]

72. The differences between the diseases are immaterial

because they both relied on one thing - random genetic mutations

So, you can keep your advice. You need it.

[pandemic_1918]

77. Evolution

Evolution works and H5N1 has humans in its cross-hairs.

[Karmakaze]

94. Uh huh...

Wow, its aiming for us? What, like some sort of intelligent design? Is that what your saying?

Give me a break. Evolution works all right, but there is no design to it, and H5N1 is just as likely to mutate into a totally benign to humans virus as one that will kill millions. If not more so.

[Media_Lies_Daily]

95. Are you being deliberately obtuse, or are you being argumentative....

...out of a complete ignorance of the subject being discussed?

I've been reading pandemic_1918's posts since they first appeared at DU, and unlike your comments, I have always found those posts to be very informative and knowledgeable. His remarks are also consistent with the comments being made by top medical researchers around the country.

Unfortunately, he or she seems to have attracted posters like yourself who seem intent on driving him or her off. Why is that exactly? Do you personally feel threatened by the information being posted?

[redqueen]

99. Correction - his comments are consistent with top medical researchers

around the WORLD.

The CDC seemed slow to pick up ... the WHO was not.

[toddaa]

59. 1918 and WWI

I'm curious. I've seen some anecdotal evidence suggesting that the virulence of the 1918 epidemic was related to the method in which troops were transported back and forth during WWI and the way in which we current warehouse chickens. Basically, the theory goes that the greater the population in a confined space, the more lethal the disease.

My very uneducated opinion is that we have created a monster simply by industrializing chicken breeding.

[Media_Lies_Daily]

88. And it doesn't help that we have been moving to a more urban....

...lifestyle since 1918.

1.8 billion humans populated the earth in 1918...there are 6.5 billion humans today.

To a large extent, we are also "warehousing" humans in the 21st century.

[iconoclastic cat]

20. Just wait...have you read The Stand?

Hell, we already have Randall Flagg as VP...

[slackmaster]

22. Captain Trips

:scared:

[Media_Lies_Daily]

27. Herr Busch must be Trashcan Man..."My life for you!!"....

The scene with the nuke being set off in Las Vegas is oddly appropriate, don't you think?

[pie]

32. How does SARS differ from an ' H5N1 class' virus?

Is it likely that H5N1 will morph into
a 'SARS class' virus?

[Dogmudgeon]

34. They are different kinds of viruses

Apples and Oranges, so to speak.

Bird Flu (just one form of influenza with an H5N1 genome) could morph into a worse bug, or a less lethal one. Generally speaking, the trend is toward lower mortality and morbidity. But that's not a certainty, since polymorphism happens quickly and there would be a lot of different "models" to compete in the environment of a sick bird or human body.

So, no, Influenza won't turn into SARS, though each may be bad diseases.

--p!

[pie]

35. Very good.

[wschalle]

44. SARS vs. H5N1

SARS is a coronavirus, in the same family as the common cold.
Pictures: http://www.virology.net/Big_Virology/BVRNAcorona.html

Influenza A is an orthomyxovirus.
Pictures: http://www.virology.net/Big_Virology/BVRNAortho.html


The two viruses spread and reproduce differently.

[Dogmudgeon]

55. Thanks for those links!

I didn't have links handy for those "apples and oranges" myself. That's a good resource; a newbie, though, should bring along a medical dictionary!

There are, of course, commonalities among all viruses, but I'm not sure the differences are well known at all. Since virology and epidemiology are progressing so quickly, a lot of information has been presented without enough explanation. I'm surprised, and grateful, that much of it actually has reached the public.

--p!

[Name removed]

37. Deleted message

Message removed by moderator. Click here to review the message board rules.

[wschalle]

56. Pandemic info site online

http://www.pandemich5n1.com

The site is basically to get as much H5N1 info together, so that it is easily accessible.

[NNN0LHI]

65. Highly pathogenic forms of avian influenza have hit the US twice:

Highly pathogenic forms of avian influenza have hit the US twice: an unknown strain struck flocks in 1925, and an H5 virus infected birds in Pennsylvania in 1983-84. The latter was contained by quarantine, disinfecting bird facilities and culling. "It's a pretty rare event," says Halvorson.

http://www.nature.com/news/2004/040209/pf/040209-3_pf.html

US bird flu under microscope

Published online: 10 February 2004; | doi:10.1038/news040209-3 Highly pathogenic forms of avian influenza have hit the US twice:

[pandemic_1918]

78. First H5N1 was 1959 in Scotland, 1996 in Hong Kong

The subtypes of influenza is based on antisera created in ferrets by humans. The first H5N1 was from a chicken in Scotland. The first H5N1 isolated in Asia was in 1996 from a goose in Guangdong.

H5N1 is one flight away from the US.

[mjmilloy]

71. More translations from boxun.com

Hi,

I have dedicated my blog on infectious disease to the H5N1 Qinghai sit'n. Yesterday I posted three human-powered translations of news from boxun.com. It's at:

http://www.epidemi.ca/

[Henny Penny]

79. welcome mj.

I have bookmarked your site.

Interesting....coverup or disinformation..... lets hope the latter.

[Media_Lies_Daily]

84. Thank you very much for your site...I am already familiar with Dr. Niman..

...and I appreciate the other sites you linked. Your news column is also very good.

Is it your opinion that the Chinese are trying to hide an Avian Flu outbreak, just as they tried to hide the SARS outbreak?

[countryjake]

81. Not to change the subject, but have any of you disease-savvy folks....

heard any info about that potentially fatal fungus they're dealing with in British Columbia? It's called cryptococcus gattii & has now mysteriously jumped from Vancouver Island onto the Mainland. I saw a tiny blip about it this past Thursday, but info is extremely scarce & hard to find.

Thanks for sparking this highly informative thread on the avian flu; knowledge is the smartest form of protection, I think.

A pandemic among humans aside, my heart aches for our bird population! Here in the Pacific Northwest, de-contamination procedures have already been recommended for a couple of years at the major chicken-production plants, with vehicles & tires being sprayed & shoes & clothes worn by workers also being scrutinized, tho with the probable costs of such measures it makes one wonder if they're truly doing that. Door-to-door searches of small backyard flocks was done late in 2003, with sickly fowl being taken away & literature was given out warning of methods of transmission, with suggestions of keeping strangers away from your birds, netting & covering outdoor yards & runways, & immediately reporting any sick fowl. Now this was all done in response to a different outbreak occurring in Southern CA, Texas, & British Columbia...a different disease, supposedly, but it makes me wonder if perhaps the authorities know something they'd rather not tell the general public, since that home search was a fairly drastic & expensive measure to take. They're keeping a close eye on small-time bird-raisers & have even noted addresses of small caged-bird owners, such as parrots, doves, & cockatiels, in this rural area.

[Media_Lies_Daily]

86. Here's a google news search on "cryptococcus gattii".....lots of links....

cryptococcus gattii
<http://news.google.com/news?q=cryptococcus+gattii&hl=en&lr=&tab=wn&ie=UTF-8&scoring=d>


Looks like you're correct about the jump to the mainland.


And here's a google search on the name itself:

<http://www.google.com/search?q=cryptococcus+gattii&hl=en&lr=&tab=nw&ie=UTF-8&sa=N>

[Media_Lies_Daily]

90. Kick.

[Media_Lies_Daily]

91. Kick again.

[pie]

102. Where did this H5N1 come from?

Is it the result of recent mutation or recombination?
Has it survived all these years in
non-lethal form?

[pandemic_1918]

103. H5N1 From Scotland and Guangdong

The earliest H5N1 isolate is from a chicken in Scotland in 1959. First H5N1 in Asia is from a goose in Guangdong in 1996.

[pie]

105. More recent than I had thought

thank you

[pandemic_1918]

106. H5N1 Isolates at GenBank

Here are the H5N1 isolates at GenBank

http://www.ncbi.nlm.nih.gov/Taxonomy/Browser/wwwtax.cgi?mode=Tree&id=102793&lvl=3&lin=f&keep=1&srchmode=1&unlock