It's an emergency — official

May 25, 2005 8:02 PM

Nature starts a weblog about the flu pandemic.
Now the virus is in coastal cities on both sides of South America. It hit Europe two weeks ago, ripping through Paris in just 11 days. In the French capital alone, there were 2.5 million cases and 50,000 dead. That's par for the course — infection rate 25% and mortality 2%, similar to the 1918 pandemic. Extrapolate these numbers, and we're going to have over 30 million dead worldwide. In poor and densely populated countries like India, it could be worse.

Where's next, I asked. Based on passenger data — which had to be prised from the airlines — one epidemiologist was willing to make a guess. "Within two weeks, there." He traced his finger from San Diego to Los Angeles, up to San Francisco. Within another three to four weeks, it'll be the turn of the conurbations along the eastern seaboard.

It's fiction but it might become reality soon.
posted by kika (38 comments total)

Right fuckin' on! That means the job market is gonna improve! And cheap housing!
posted by keswick at 8:23 PM on May 25, 2005

Imagine you're an emergency room doctor and you have to care for people with a potentially fatal transmissable virus. Do you take an extended vacation or do you risk your life to do your job?
posted by mert at 8:28 PM on May 25, 2005

Were we ready? Ready, my ass!

If you want people to take you seriously, you could write a better conclusion than this.

Really, I think people write stuff like this because they think that if they get it down on paper, it won't come true.
posted by fungible at 8:42 PM on May 25, 2005

I don't know that a publishing a bogus account of a health scare is necessarily a solid road for a major journal to be going down. Perhaps they would do better in highlighting deficits in preventative health measures in genuine articles, if alerting the community about those risks is their true aim.
posted by peacay at 8:52 PM on May 25, 2005

Mmmm fearmongering.
posted by nightchrome at 9:02 PM on May 25, 2005

So from what I gather now, unless the US takes on something akin to the Manhattan Project (carte blanche, massively expensive) there's no way we can get away with this not turning into a pandemic? What's this "scare the shit out of you" Nature article's goal?

I'm all for preparedness, but weren't we lead to believe the West Nile virus was going to be killing old people left and right? It seems to me that medical technology has improved to the point where we might not see a pandemic on the 1918 scale, at least history shows several probable pandemics turning out to be nothing. A lucky streak or the result of a medically advanced society? We shouldn't sit back and watch as Vietmese die, crack open a beer and mutter that it won't happen here, but attacking it in a total war like fashion (i.e. diverting resources from other researchers and production facilities to this flu) might be foolish in the long run. Any medical professionals care to cut through the hype and tell us what's going on? Should I be ordering some antiviral medication over the Internet?
posted by geoff. at 9:03 PM on May 25, 2005

Here's the thread from 2 weeks ago regarding the dire warnings about pandemic preparedness (err....lack thereof)
posted by peacay at 9:13 PM on May 25, 2005

I'm all for preparedness, but weren't we lead to believe the West Nile virus was going to be killing old people left and right?

Please distinguish between the headline writers for the New York Post and public health officials.

Anyway, look out.
posted by docgonzo at 9:20 PM on May 25, 2005

I don't think natural random population control is such a bad idea. You won't learn birth control so the germs're gonna getcha.
posted by davy at 9:36 PM on May 25, 2005

That means the job market is gonna improve! And cheap housing!

Sad but true. But its a two edge sword. Read up on the Black Death to get an idea of the kinds of changes one would expect to see.
posted by stbalbach at 9:36 PM on May 25, 2005

Oops didn't see earlier threads.
posted by geoff. at 9:51 PM on May 25, 2005

osterhom is worried of course he had his panties in a bunch about anthrax a couple years ago too ...
posted by specialk420 at 10:38 PM on May 25, 2005

They're just getting ready for the "Shock and Awe" of I-Told-You-So scenarios.
posted by Balisong at 10:48 PM on May 25, 2005

I'm ready! My Y2K cans of beans et al are all tucked in the bunker!
posted by blacklite at 12:32 AM on May 26, 2005

infection rate 25% and mortality 2%

Is that all? Well, darn...I was hoping this would be Captain Trips and I'd be off the hook.
posted by alumshubby at 3:10 AM on May 26, 2005

When I first read the FPP, I didn't know you were referring to a magazine. Nature starts a weblog? I thought the phrase was "Nature abhorrs a vacuum." I was thinking.

Scary reading, but I'm with peacay about a major journal going speculative like this.
posted by emelenjr at 6:22 AM on May 26, 2005

Pandemicfilter again?
posted by graymouser at 6:44 AM on May 26, 2005

infection rate 25% and mortality 2%

New York City Urban Area: Population, 21M, infected, 5 million, 420,000 dead.

The number of dead may be much higher. If the mortality rate is predicated on advanced medical support, it will be much high. The number of hospital beds is about two orders of magnitude smaller than the number of infected, the number of critical care beds is four to five orders of magnitude smaller.

Never mind the fact that the much higher density would also increase the infection rate.

Compare the loss of life to such events as 9/11, Hiroshima and Dresden.

US population: roughly 300M. 75M infected. 6M dead. That's the population of the City Of Chicago, twice.

The argument about the mortality rate and presence of medical support applies here as well.
posted by eriko at 7:47 AM on May 26, 2005

Extrapolating death rates from 1918 is just stupid. We now have antibiotics to fight the secondary infections, anti-emetics, anti-diahorrea drugs and IVs to fight dehydration and a whole host of other medical advances. Also decent heating systems and better nutrition. Unless it's a way more virulent form (which has not been shown) it's not going to kill very many westerners. As for other parts of the world- I seriously doubt it'll overtake malaria and other existing diseases as a cause of mortality. Total fear mongering.
posted by fshgrl at 7:57 AM on May 26, 2005

And won't most of the dead be the weak/old anyway? In the long run, this could actually be better for humanity..
posted by eas98 at 8:14 AM on May 26, 2005

So, eas98, the old and infirm are worth less?
posted by pjern at 8:23 AM on May 26, 2005

infection rate 25% and mortality 2%

New York City Urban Area: Population, 21M, infected, 5 million, 420,000 dead.

You have to catch it to figure in the mortality stats I think, so 5 million cases = 100,000 dead at 2%.
posted by biffa at 8:40 AM on May 26, 2005

In a pandemic, if you're going to catch it, do you want to catch it early, when the hospitals have just started to panic and don't know what they're dealing with or how to treat it, or do you want to catch it later, when the virus has mutated a bunch and might not be affected by older treatments?
posted by kimota at 9:14 AM on May 26, 2005

We now have antibiotics to fight the secondary infections

Yeah. WE do. In the west your right. But Africa and India and China don't. Not in the amounts they would need.

The significant difference between now and 1918 is world wide transportation networks - shit can spread to every corner of the globe in 24 hours. As can aid and warning. So. Yeah. There is at least some reason to be concerned. And some reason not to.

Do as a wise man would - prepare for ill and not for good.
posted by tkchrist at 9:36 AM on May 26, 2005

How to reduce spread of communicable disease

Note, this applies to more than the flu.

Wash your hands regularly.

Face masks might help, maybe, if they are properly fitted and the germ in question can't fit through the material

For pity sake, don't go to work if you are sick! For that matter don't send sick kids to school!

Thank you.
posted by ilsa at 10:01 AM on May 26, 2005

It's true that making predictions based on 1918 is pretty tricky - while any pandemic will spread much more quickly and efficiently, we (at least in the west) are certainly far better off in terms of public health infrastructure, sanitation, medication, etc. than we were almost 100 years ago.

What keeps me up at night, and is the unknown variable in all this, is the perception of the pandemic. Regardless of how lethal the avian flu might turn out to be, any sort of widespread panic is going to roil things like markets, economies and even governments in ways that could cause far more damage than the flu itself.
posted by jalexei at 10:02 AM on May 26, 2005

Actually we don't. There's only one company that has the proper antiviral and we didn't bother to stock 'em b/c, well, we just don't worry about that sort of thing here. The US is way behind other countries on this. Barack Obama sponsored a bill to have the gov't stockpile the necessary antiviral.

I posted a comment today to an old MeFi thread about this, not realizing somehow that it wasn't the new one. Paranoid am I? Probably. But I wasn't about SARS, I wasn't about Y2K ... just this, I swear.
posted by Lady Penelope at 10:05 AM on May 26, 2005

So where's a good place to get Tamiflu, just in case? I'd just go to a doctor, but all the ones I've met seem hesitant to prescribe anything, even for something I'm infected with.
posted by rolypolyman at 10:14 AM on May 26, 2005

"Fear... Fear attracts the fearful..."
posted by keswick at 10:28 AM on May 26, 2005

I'm not, for the record, afraid. But tracking the science behind this, I think we should and can be proactive. It's completely possible for us to safeguard ourselves against the kinds of pandemics we've been exposed to in the past. Why wouldn't we?
posted by Lady Penelope at 10:43 AM on May 26, 2005

Rolypolyman, you too? Maybe it's because I keep asking for that blessed percocet ...
posted by Lady Penelope at 10:43 AM on May 26, 2005

Why wouldn't we?

Procurement and storage costs? Opportunity costs?
posted by Kwantsar at 10:54 AM on May 26, 2005

It's a drop in the bucket of our national expenditures, especially compared to Iraq, and it's arguably a more imminent threat than Hussein was.
posted by Lady Penelope at 11:14 AM on May 26, 2005

Hey, you want to talk about emergencies? We've only got three drugs on the market that help you get an erection, and only ONE to help prolong coitus for men who ejaculate prematurely. So I'm afraid antiretrovirals will have to wait. When will people learn to sit back and allow the free market to effectively allocate our research dollars?
posted by haricotvert at 2:11 PM on May 26, 2005

Extrapolating death rates from 1918 is just stupid.

... and this startlingly insightful comment is based on just what, exactly?

We now have antibiotics to fight the secondary infections, anti-emetics, anti-diahorrea drugs and IVs to fight dehydration and a whole host of other medical advances. Also decent heating systems and better nutrition.

... and none of this helped many SARS patients; the mortality rate from that outbreak was about 10%. Remember that many of those deaths were in Hongkong and Toronto, with some of the most technologically advanced healthcare infrastructures in the world.

Unless it's a way more virulent form (which has not been shown) it's not going to kill very many westerners.

... that has been shown. The virulence of the H5N1 strain during the southeastasia outbreak has been around 75%. More recent strains have seen about a 50% mortality rate, in line with the usual evolutionary trend of maximising transmission by lowering virulence.

As for other parts of the world- I seriously doubt it'll overtake malaria and other existing diseases as a cause of mortality.

Absolute mortality numbers are expected to be many times higher for pandemic influenza than for malaria. Plus, pandemic influenza is expected to take a much higher than average toll amongst urbanites and health care workers, impacting the welfare of those left, including malaria sufferers.


Total fear mongering.

Total ignorance.
posted by docgonzo at 6:15 PM on May 26, 2005

But if you don't go to work when you're sick they'll fire you and you'll soon be broke and homeless, let alone without health insurance, if you're not dead of disease; and if you don't send your kids to school when they're sick they'll fail their grade, and if they miss enough the Authorities will decide you're encouraging truancy and make you go to court (which might mean missing work, which might get you fired), where they'll harrass you for being an "unfit parent" and maybe take your kids away (to put them in foster care where they'll likely be beaten, starved and molested). Those few Mefites out there who qualify a "working poor", especially those who were themselves raised by parents who were "working poor", especially those who live in cities full of poor people who'll work cheap and social workers who like to throw their weight around, will know exactly what I'm talking about here. I do because I've just described my family when I was a kid, and several other families I knew.

The fact is that a whole lot of Americans don't have savings or health insurance, and if they suddenly lost their jobs they'd be shit out of luck for several weeks at least. Try explaining to your landlord, or the mortgage people, or the car lot, that you lost your job because you were too sick to go to work and that you're flat-ass broke now and can't pay 'em anything, but if they give you a break you'll make it up as soon as you can. Point to your positive credit history till then and swear on the Bible, maybe it'll help.

"Don't go to work when you're sick." Yeah, right.
posted by davy at 7:13 PM on May 26, 2005

"Don't go to work when you're sick." Yeah, right.
posted by davy at 7:13 PM PST on May 26 [!]

I haven't had health insurance for a couple years. I found out that the phrase works much better if it is worded like, "Don't ever get sick"

It works fine by me, so to hell with all those that find the time in their day to get sick.
posted by Balisong at 7:43 PM on May 26, 2005

Me (ravingly): "Don't go to work when you're sick." Yeah, right.

balisong: I haven't had health insurance for a couple years. I found out that the phrase works much better if it is worded like, "Don't ever get sick"

That's an apt wording.

balisong: It works fine by me, so to hell with all those that find the time in their day to get sick.

See folks, that's a fine example of that "sarcasm" thing there.

By the way, since my "SO" got promoted into an office of her own I get sick less often than when she was in a demicube out on the floor -- she's around fewer people with kids in school or preschool to cough the resulting germs all over her. Juvenile educational establishments are great places to catch contagions from; e.g., if it weren't for them head lice (as distinct from crabs or body lice) would be rare in the US. (As rare as body lice anyway -- when was the last time you heard of anybody with that?)
posted by davy at 10:55 AM on May 27, 2005