Ostepath claiming bird flu is plot to make $$$

[gumboot]

Skeptigirl I just want to reiterate that my remarks are specifically in regards to the likelihood of a catastrophic Influenza pandemic. I am not debating the likelihood of an especially deadly strain of Influenza, nor the likelihood of an influenza epidemic.

I have no dispute with the information you have provided (Which incidentally I have read). I am not trying to propose an alternative hypothesis for the evolution of the Spanish Flu.

The bottom line is, in order for any infectious disease pandemic to be catastrophic, a lot of people have to be infected. If you set a figure that 2% of world population would be a catastrophic event, as an absolute minimum 2% of the world's population have to be infected. As the mortality rate of the infectious disease decreases, the percentage of people that need to be infected to reach that 2% also increases.

The only two documented catastrophic pandemics in human history that I am aware of are the Black Death of the mid 14th Century and the Spanish Flu of 1918/1919. I would classify the Black Death as significantly more catastrophic than the Spanish Flu.

My issue, therefore, with the H5N1 virus (or any other future infectious disease) is not that it could be deadly, and not that it could be a pandemic. My issue is with the idea that it will be catastrophic. Not to see there won't be future catastrophic pandemics. There could very well be. But I think it is exceedingly unlikely. I think figures such as billions dead - which some people have claimed are a possible outcome from an H5N1 pandemic - are even less likely.

My reasoning for this is that both the Black Death and the Spanish Flu did not appear in isolation. Certain event-specific conditions pushed the pandemic into the catastrophic category.

Half of the equation is the disease itself. How infectious is it, and how deadly? A highly infectious and very deadly disease is more likely to produce a catastrophic pandemic than a disease that is hard to transmit and has a low mortality rate. H5N1, for example, certainly appears to have the potential to be both deadly and highly infectious.

This aspect deals with spread of the virus between individual humans. Is it spread through body fluid? Blood only? Coughing? Physical contact, etc. This aspect comes into play once a disease enters one member of a specific social group. How quickly will it spread to other members of the same social group. This has to do with the biology of the virus itself, but also the biology of the members of the social group.

For the purposes of this, a social group is considered a group of people with frequent direct contact - people you live with, friends, work colleagues, family, etc.

But the other half of the equation is how rapidly the virus is spread amongst different social groups. This aspect it not a matter of the biology of the virus itself. It is a product of human behaviour and social dynamics.

I maintain, in the example of the Black Death, specific factors (mass starvation and malnourishment) within the biology of the social groups contributed significantly to the catastrophic progression of the pandemic. Once a member of the social group became infected, the weak and sick members of the social group would quickly succumb.

In the example of the Spanish Flu, unique factors (starvation, sickness, stress, tiredness, malnourishment, injury, poor medical treatment, etc) within the biology of one particular social group (WWI soldiers) contributed significantly to the progression of the disease within that social group.

In the modern day, I do not believe specific factors of this nature are likely to be present in all social groups. Most of the western world is relatively healthy, hygienic (except my flatmates ), and has access to reasonable medical care.

However, in the modern world, specific social groups are more vulnerable. For example refugees, people suffering from famine, people living in areas with poor medical care and sanitation, and so forth.

In the example of the Black Plague, unique aspects of the social groups and their interaction also contributed to the catastrophic progression of the pandemic. Medieval European communities were dense networks of villages, and the members of these communities had constant close interaction with other members of the community. The Great Famine resulted in displacement of large populations, and an increase in criminal activities and overall population movement.

In the example of the Spanish Flu, again the soldiers of WWI are a key social group. They were a highly concentrated social group, allowing for high rates of transmission between members. But a normal social group is relatively stable. In contrast, this particular social group completely dispersed and ceased to exist at the end of WWI. The members returned to their former social groups, allowing for high rates of transmission between social groups.

What was significant about this was how significant a percentage of the population it was.

In contrast, there is the modern age.

A large percentage of the modern population move between social groups. However, unlike in the example of WWI soldiers, these travellers do not originate from a single social group. Thus infection of a single large social group is less capable of quickly spreading to infect multiple social groups. In In addition, people are less likely to travel when sick, thus an infected person is less likely to travel. In addition, those social groups which are more vulnerable to infection are also less likely to travel. In the example of the Spanish Flu, the especially vulnerable and highly infected group - WWI soldiers - were the most likely to travel.

Social dynamics of today are very different to Medieval Europe. Social group interaction is significantly decreased. For example, in Medieval times a typical peasant would closely interact with 400 - 1000 people on a daily basis. In contrast, most modern citizens of western nations only interact on a daily basis with a very small group of people (very close friends, people we live with, and people we work with).

Essentially, while there is greater interaction between social groups, there are many more social groups, and they are much smaller. This limits the disease's ability to spread.

A final key factor is advancements in medical science, understanding of pandemics, and infectious diseases, and a generally better understanding of hygiene.

As we saw with the SARS virus, humans are capable of significantly restricting the spread of a virus. When an outbreak occurs, they are capable of quickly limited the spread. This happens both an an inter-group level and an intra-group level. For example governments can limit air travel, or establish quarantines, and individuals can restrict their own movements, to reduce spread between social groups. And individuals on a daily basis restrict the spread of illness between members of the same social group (not going to work when you're sick, not visiting friends, etc).

The specific study of pandemics and particular infectious diseases continually offers up a wealth of new information which will aide in the prevention of future pandemics.

For the reasons outlined above, I argue that a catastrophic epidemic in the modern world is exceedingly unlikely.

-Gumboot

 

[Civilized Worm]

Not quite. Osteopaths can do most anything MD's can. They can, at least in Connecticut, prescribe drugs and perform surgery in addition to doing manipulations.

Chiropractic, on the other hand, is ridden with scam artists.

ETA: And, to respond to the earlier posts, I would agree that a pandemic is inevitable at some point. I don't think bird flu is the next one though. It seems to have largely dropped off the radar, much as SARS did. We may not be so lucky next time.

But osteopathy is woo isn't it?

 

[jhunter1163]

But osteopathy is woo isn't it?

Chiropractic is far more woo than osteopathy. There are chiropractors who believe they can treat everything but rigor mortis. Osteopaths tend to be more like MDs in their treatment practices.

As far as the underlying science, I'm not versed enough in osteopathy to say, but chiropractic bears a strong mark of woo. Read the writings of D. D. and B. J. Palmer if you doubt me (and if you have a strong stomach).

 

[Skeptic Ginger]

I am talking about a catastrophic pandemic, Gumboot.

I'll read the rest of your post after the Daily Show.

 

[Skeptic Ginger]

Too late to edit, so here's the rest:

I am talking about a catastrophic pandemic, Gumboot.

I understand what you believe made the difference in the 1918 influenza pandemic and the plague centuries earlier. I believe you are concluding certain contributing factors were key, while naively failing to recognize the contributing factors specific to the organism and not just the conditions of the population, but the specific susceptibility of the population to a novel organism. And I asked you, not for a more detailed explanation of your opinion, but for evidence other experts agreed with your conclusions.

Two things in particular you are failing to consider are the infectiousness of the organism and the specific population immunity. We don't know how infectious H5N1 will become. We do know it is infecting a particularly broad range of species. This is unusual.

We do know how much specific resistance there is to H5N1 in the human population, virtually none.

You consider the widespread malnutrition during the plague and the specific conditions in WWI as the major factors contributing to those historical pandemics. Widespread malnutrition certainly isn't rare, nor is it absent today. And if you want a comparable variable to throw in the mix which could amplify a new influenza pandemic, then I suggest you take a look at the HIV pandemic. It's rather short sighted to think only conditions in the US and Europe would affect a worldwide influenza pandemic. Current conditions in Africa, India, Asia, and Eastern Europe are poised to amplify a novel deadly influenza strain more than sufficiently to spill over into Western countries.

And since the vast majority of the population will be susceptible, there is no barrier to large numbers of people falling ill except our health care system. That system only has a certain capacity. If exceeded, we may indeed see the next historical pandemic within our lifetimes.

AVIAN FLU TO HUMAN INFLUENZA

A growing concern is the recent identification of H5N1 strains of avian influenza A in Asia that were previously thought to infect only wild birds and poultry, but have now infected humans, cats, pigs, and other mammals, often with fatal results, in an ongoing outbreak. A human pandemic with H5N1 virus could potentially be catastrophic because most human populations have negligible antibody-mediated immunity to the H5 surface protein and this viral subtype is highly virulent. Whether an H5N1 influenza pandemic will occur is likely to hinge on whether the viral strains involved in the current outbreak acquire additional mutations that facilitate efficient human-to-human transfer of infection. Although there is no historical precedent for an H5N1 avian strain causing widespread human-to-human transmission, some type of influenza A pandemic is very likely in the near future.

And, while there is no historical susceptibility to H5 in the human population, that is a two sided coin. One can speculate something is preventing H5 from becoming a human pathogen, or one can shudder because the human population has virtually no resistance to this strain.

Those conditions you are focused on may not be present in the US and Europe today, but they most certainly are present in the third world. It isn't like we have influenza pandemics in the 3rd world all the time and only in 1918 did it effect the Western world. The 1918 pandemic affected the entire planet. Why should only the conditions in Europe and the USA be the critical factors in a worldwide pandemic?

The critical factor facing us today with regard to H5N1 isn't the human condition, it is the fact relatively few humans have any resistance to H5N1. It only needs to adapt to humans. The fuel for a conflagration is in place.

History tells us novel infectious organisms routinely devastate populations. The rabbit calicivirus disease introduced into Australia to control the wild rabbit population is a field tested model. Upwards of 90% of the rabbits died before the rabbits resistant due to genetic variation were able to recover and re-establish the population.

The indigenous peoples of the Americas were devastated by measles and smallpox introduced into the population by Europeans and as much as 95% of the population perished.

Tuberculosis disease per case of tuberculosis infection is still more common among Pacific Islanders and Native Americans because it was introduced into those populations more recently than the European population. It is also more frequent in 3rd world countries because of conditions of poor health and poor public health infrastructure.

I do not expect H5N1 to wipe out 90% of the human race, even though historically, it is possible. But to think it doesn't have the potential or isn't likely to become a pandemic rivaling 1918 or the plague is a conclusion which is naive based on a lack of expertise in the conditions conducive to a major pandemic. The most critical factor isn't malnutrition or life in the trenches. You can find similar conditions somewhere in the world at any point in time. The most critical factor is pre-existing resistance to an organism within the population.

All H5N1 needs to do is adapt to humans. And considering the way it has been progressing, that is looking more and more likely every day. Throw the HIV pandemic into the mix and no one can predict what will happen.