Bird Flu - how real is the threat?

[Morrison's Lament]

My mother is a bit prone to woo-woo now and then, but she's learning. At the moment she's terrified of bird flu and her friends have bonded together to write up an emergency plan of action including stocking up on rations and sealing their homes...

I've been trying to inject some reason into this mentality of hers, such as pointing out the low statistical likelihood of her actually becoming an early victim even if it did mutate (she lives in Iceland, after all).

What I'd like to know is how right am I to be skeptical of this latest panic? I tune this stuff out, I mean I was living in Beijing when SARS broke out and my family stayed out of the country and all my neighbours wore masks while I shook my head and went about my business eating delicious cheap noodles and watching pirated movies.

Am I being understandably skeptical or dangerously cocky? There's just something all too familiar about these "panic reports" in the media. Ever read Barry Glassner's "Culture of Fear"? This bird flu stuff almost seems on par with y2k and mad cow at this point - yet another thing to worry about for no good reason...

--- G.

 

[logical muse]

Well, as anyone around here will tell you, I am so far from being a woo that when I get excited I just yell "Hoo!". So bear that in mind when I say that...

Not every media-fueled disaster scenario has zero credibility. There has been a precedent for this bird flu scare, the 1918 flu pandemic which killed an estimated 20 million - 50 million people. The H1N1 virus from 1918 was also of avian origin.

If you are concerned, you can do a bit of research. Here's a link to get you started:

CDC: 1918 Flu Pandemic

As for mad cow and y2k, didn't John Titor come back from the future to sort those out for us?

 

[Morrison's Lament]

I've done some research, and there seems to be a three-way split between alarmists, lesser alarmists and hard core skeptics.

I realize Titor (peace be uppon him) saved us from some previous threats, but dare we count on him forever?

--- G.

 

[Morrison's Lament]

Seriously, I realize flu pandemics happen regularly but haven't things changed a bit since 1918? My mom says: "Yeah, people travel faster meaning it will be worse!" but my instinct tells me: "On the other hand, we are now aware of a million new medical concepts that weren't even conjecutre at that time!"

--- G.

 

[logical muse]

What I'd like to know is how right am I to be skeptical of this latest panic?

Apart from Sylvia Browne, no one knows with any certainty what will happen.

 

[Morrison's Lament]

And where can I find this Ms. Browne????

--- G.

p.s. I have a website that will sell you placebo for 20% less than competing sites

 

[logical muse]

And where can I find this Ms. Browne????

--- G.

p.s. I have a website that will sell you placebo for 20% less than competing sites

Good question! You could try here. Oh wait, I had a look and she's still not there...

As for your generous placebo offer, just how effective is it, compared to placebo?

 

[JLam]

Whatever happens, I sure hope that the bird flu doesn't turn out to be as bad as SARS. That terrible disease only spared about 92% of the people who contracted it. HORRORS!

 

[Dustin Kesselberg]

The Bird flu is as much a threat as Sars,Mad cow disease and Africanized bees were.

 

[Dymanic]

I've been trying to inject some reason into this mentality of hers, such as pointing out the low statistical likelihood of her actually becoming an early victim even if it did mutate (she lives in Iceland, after all).

Just out of curiosity, what do you estimate that statistical likelihood to be? (I'm not sure I grasp the significance of being an 'early victim' versus a 'late' one, btw).

My mom says: "Yeah, people travel faster meaning it will be worse!"

Looks to me like Mom may have a point there.

but my instinct tells me: "On the other hand, we are now aware of a million new medical concepts that weren't even conjecutre at that time!"

It's not hard to see why your instincts might tell you that, but you might consider the fact that of the people known to have been infected with bird flu so far, about half have died -- right in the face of everything modern medical could bring to bear.

We have some antiviral drugs which may be of some help (possible problem there with resistance bred into the bug from use of the drugs on poultry) provided there are adequate supplies (definite problem there). We also have wonderful antibiotics -- which, unfortunately, are utterly useless against viral infections such as the primary viral pneumonia caused by highly pathogenic strains of influenza. When breathing becomes critically difficult (which is the whole deal, really -- influenza is primarily a lung infection, and the lungs tend to fill with fluid) we can put a patient on a ventilator (but the supply problem with ventilators is even worse than with antivirals; WAY worse, in fact). We'll eventually come up with an effective vaccine, but probably not sooner that about six months into a pandemic (in other words, not until the peak of the first wave had already passed). Beyond that, there isn't much modern medicine can really do for a person infected with influenza (when the numbers of patients start running into tens of thousands, you can forget about the fancy stuff anyway; just keeping them warm and hydrated is a big enough challenge).

Ever read Barry Glassner's "Culture of Fear"? This bird flu stuff almost seems on par with y2k and mad cow at this point - yet another thing to worry about for no good reason...

I certainly don't dispute that mainstream media is rife with sensationalism, but I just don't follow the logic that says that it is therefore safe to ignore everything they get their hands on. The most chilling stuff I've seen on pandemic flu wasn't in the media at all (it was in a microbiology textbook).

I've instructed my mother to do just what yours is doing. Buy some extra canned food -- what's the big deal about that?

 

[Morrison's Lament]

Just out of curiosity, what do you estimate that statistical likelihood to be? (I'm not sure I grasp the significance of being an 'early victim' versus a 'late' one, btw).

My reasoning is as follows:

Bird flu requires a human host (preferably one already infected with human influenza) in order to mutate into a human-transmittable disease. The vast majority of infections are taking place in Asia (particularly poorer Asian countries) and the vast amount of people and chickens there (coupled with less hygiene, more intimate living quarters, etc.) lead me to believe that if this thing is going to mutate Asia is it's best bet. This is of course speculation, but it seems logical to me at this point.

Looks to me like Mom may have a point there.

She does

It's not hard to see why your instincts might tell you that, but you might consider the fact that of the people known to have been infected with bird flu so far, about half have died -- right in the face of everything modern medical could bring to bear.

We have some antiviral drugs which may be of some help (possible problem there with resistance bred into the bug from use of the drugs on poultry) provided there are adequate supplies (definite problem there). We also have wonderful antibiotics -- which, unfortunately, are utterly useless against viral infections such as the primary viral pneumonia caused by highly pathogenic strains of influenza. When breathing becomes critically difficult (which is the whole deal, really -- influenza is primarily a lung infection, and the lungs tend to fill with fluid) we can put a patient on a ventilator (but the supply problem with ventilators is even worse than with antivirals; WAY worse, in fact). We'll eventually come up with an effective vaccine, but probably not sooner that about six months into a pandemic (in other words, not until the peak of the first wave had already passed). Beyond that, there isn't much modern medicine can really do for a person infected with influenza (when the numbers of patients start running into tens of thousands, you can forget about the fancy stuff anyway; just keeping them warm and hydrated is a big enough challenge).

I know influenza is a bitch to treat, so I wasn't suggesting a cure would be readily found. It's just that I'd like to hope we have infinitely better options on the table to prevent spread and infection than we did in war-raveged Europe in 1918. Infrastructure was practically nonexistant at that point, you got sick and it was your family's problem to take care of you, get infected, go out for medicine, spread the infection, etc. The response to an outbreak at this point would not only be immeasurably quicker (since we have people actually monitoring the mutations and doing extensive testing all over the world this time) but much more efficient.

But then there's the airplanes...

I certainly don't dispute that mainstream media is rife with sensationalism, but I just don't follow the logic that says that it is therefore safe to ignore everything they get their hands on. The most chilling stuff I've seen on pandemic flu wasn't in the media at all (it was in a microbiology textbook).

There are countless terrible possible threats from space rocks to natural disasters and pestilence that might smite us all (or a large portion of us) at any point, I'm not debating that.

What concerns me is the constant "threatwatch" (Colbert spoofs this rather well on his show). It seems we are constantly being told about new things to worry about when practically speaking I think I have much more to fear from heart disease and driving through traffic than from some hypothetical global catastrophe that might or might not happen and even then might or might not affect me.

It's not that I don't understand the concept of worrying about bad things, I'd just like to know where my priorities should lie so I can avoid spending all my days in abject fear of the latest possible horror that could befall us all.

I've instructed my mother to do just what yours is doing. Buy some extra canned food -- what's the big deal about that?

Nothing at all, people have to make their own priorities. And the jokes on me if everyone starts dropping dead, I accept that fact

--- G.

 

[casebro]

The media is the boy who has been crying wolf over Bird Flu, SARS, Ebola, swine flu,Y2K,CJD, Flesh eating bacteria, nuclear holocost, sreaming yellow hoards, world wide starvation, global warming, the coming ice age, fundimentalism, liberalsim, pornography, demon rum, drug addiction, short skirts, Communism, birth control, Hispanics, Genetically engineered food, rap music, assault rifles, anti-biotics, promiscuity, NAFTA, Japanese cars, second hand smoke, flouride, anthrax, long hair, cholesterol, high interest rates, loud music, caffeine, vaccines, gambling, pollution, extinction of a valuable species, etc, etc, etc. All of which have caused a slight effect on our lifestyles, none of which have brought about the fall of society as we know it. Sooner or later it WILL happen, and we will go extinct. I just don't see any reason to put more credence into this particular one, then in any of the previous ones.

We don't yet know what will bring society down. We do know that 'doom and gloom' (tm) sells news...

 

[Dymanic]

Bird flu requires a human host (preferably one already infected with human influenza) in order to mutate into a human-transmittable disease.

Close. What it requires is a host co-infected with human and avian flu. Doesn't have to be a human; could be a pig.

The vast majority of infections are taking place in Asia (particularly poorer Asian countries) and the vast amount of people and chickens there (coupled with less hygiene, more intimate living quarters, etc.) lead me to believe that if this thing is going to mutate Asia is it's best bet.

Most epidemiologists agree, and Iceland seems like a great place to be during a flu pandemic. (For that matter, I wouldn't mind going there even if there wasn't a pandemic). In 1918, the northern coast of Iceland was one of only two places in the world where quarantines were successful at protecting people from the disease. Assuming that your mom lives in Reykjavik though, her statistical chances are probably not much different from anyone else's over (say) nine months following first outbreak -- that is, unless she is able to increase those chances by doing just what you're all set to talk her out of. She and her friends recognize that during a major pandemic, assistance may not be readily available through normal channels; emergency services and medical care facilities will be overrun -- and understaffed, since maybe a third of their personnel will either be down with the flu themselves or claiming to be (while actually hiding, or home taking care of their own sick relatives). Self-sufficiency is the key to survival in a widespread catastrophe (just ask anyone from New Orleans). Mom and her friends are setting up an autonomous support network, and preparing to practice what may be the single most effective measure available: micro-quarantine.

Go Mom, I say.

I'd like to hope we have infinitely better options on the table to prevent spread and infection than we did in war-raveged Europe in 1918.

Don't you really mean "...they have infinitely better options on the table"? Aren't you really assuming that someone else will take whatever action is required to protect you? And just what 'options' do you suppose they might have on the table? Nukes? If the wonders of modern technology were so effective at preventing the spread of influenza, why does seasonal flu typically kill about 36,000 people every year in the one of the most modernized countries in the world (the U.S.)?

It seems we are constantly being told about new things to worry about when practically speaking I think I have much more to fear from heart disease and driving through traffic than from some hypothetical global catastrophe that might or might not happen and even then might or might not affect me.

I don't get this 'worry' thing. Heart disease is a real threat. You can worry about it, or you can watch your diet. Traffic accidents are a real threat. You can worry, or you can keep good tires and brakes on your car, pay attention while driving, etc. Ever since the sixties (I guess it was), great emphasis is placed on how stuff makes us feel; I submit that of greater real import is what we are willing to do.

 

[Dymanic]

The media is the boy who has been crying wolf...

Do you happen to remember how that little story ended?

 

[Ed]

Buy her a Norweigen Blue for Christmas. Hand it to her with a mask on your face.

 

[casebro]

Do you happen to remember how that little story ended?

To continue my alegory (story told while drinking ale?) , the flock will suffer if doom and gloom come to pass. That doesn't mean the meadia are right this time, or ever will be right. Based on the past record, what would you predict?


In the meantime, did the media warn us ahead of time of 9-11? or the deaths in Iraq? or the quagmire in Viet Nam?

 

[diane]

Do you happen to remember how that little story ended?

We went to war with Iraq.

 

[Dymanic]

That doesn't mean the meadia are right this time, or ever will be right. Based on the past record, what would you predict?

I really think you are focusing on the wrong thing here. I don't think any special insight is required to see how a reporter might be motivated to exaggerate things, and since reporters are, as a general rule, not experts in microbiology or epidemiology, the amount of emphasis they place on this issue wouldn't seem particularly relevant even if their motives could be regarded as pure.

Those who are experts in these fields are very concerned, and have been for some time; certainly long before bird flu gained mainstream media attention. If you feel that the risk has been overstated by these folks, you must realize that you are no longer engaged in the trivial exercise of dismissing the ravings of sensationalist reporters; to counter such claims, you now need to begin to do science. Do you feel that you have an adequate grasp of the details of viral reproduction to enable you to offer your own estimates of the degree of risk posed by the avian flu virus?

 

[casebro]

Those who are experts in these fields are very concerned, and have been for some time; certainly long before bird flu gained mainstream media attention. If you feel that the risk has been overstated by these folks, you must realize that you are no longer engaged in the trivial exercise of dismissing the ravings of sensationalist reporters; to counter such claims, you now need to begin to do science. Do you feel that you have an adequate grasp of the details of viral reproduction to enable you to offer your own estimates of the degree of risk posed by the avian flu virus?

Don't you think that all those other 'false wolfs' (SARS, Ebola, swine flu....mini skirts...) had their own experts? In fact, I'll bet many of them are the same CDC scientists...the same guys who tried to get gun violence declared a disease...Yup-per, that ole CDC is sure protecting us...quiet! - whats that I hear from the watch lad in Atlanta...wolf WOLF WOLF...

 

[Loon]

Something else I heard* is that a major reason for the deaths in 1918 was that people were too ill or weak to feed themselves and there was nobody to care for them. Nowadays, we have lots of people to care for the infirm.

*I totally trust that the person who told me read it or heard it somewhere herself.