Swine Flu outbreak

[MattusMaximus]

So if it turns out to be correct as was reported in another thread that all of the dead so far have been between 20 and 50 years of age and that is unheard of with mild flu strains, you'll just ignore that evidence in favor of all the other evidence?

I plan to wait and see what that means before I draw any conclusions.

What's the source on that?

ETA: Never mind, I found it. Linky. Not too sure about whether to trust that or not. As SG says, the best course of action now is to await more data.

 

[rwguinn]

Rather than count on any number of non-experts on the Internet to provide supposedly authoritative definitions for important medical terms for you, why don't you just go straight to the actual medical & disease experts? That is precisely why I keep telling you to go to the CDC and other reputable sources for your information. Duh

Like 99.9% of the people in the world, when I want a definition, I go to a dictionary.
You, on the otherhand, are obviously a God, and we should bow to YOU method

Right. Doctors and disease experts should change their definitions to fit the uninformed and stupid notions of "common usage" of pandemic. And what the hell does "questioning the motive for the change" mean? Are you implying more conspiracy nonsense? Good grief.



Whatever floats your boat, pal.

I look for information and discussion, I get derision. Enjoy your superiority. Welcome to ignore

 

[Steelmage]

A more level headed report on the virus:

 

[gumboot]

Anyone else heard this report?

A member of the World Health Organisation (WHO) has dismissed claims that more than 150 people have died from swine flu, saying it has officially recorded only seven deaths around the world.

...

"Unfortunately that [150-plus deaths] is incorrect information and it does happen, but that's not information that's come from the World Health Organisation," Ms Allan told Australia's ABC Radio today.

"That figure is not a figure that's come from the World Health Organisation and, I repeat, the death toll is seven and they are all from Mexico."

NZ Herald

 

[The Atheist]

Anyone else heard this report?

The WHO.

 

[Oliver]

Anyone else heard this report?

Didn't heard that one before. But this one:
CNN: Regular flu has killed 13,000 since January

People are nervous about swine flu, but the regular flu kills 36,000 people a year in the United States.

 

[gumboot]

Didn't heard that one before. But this one:
CNN: Regular flu has killed 13,000 since January

Yeah but "swine flu" has another word in it, so everyone knows that makes it worse. See?

Spanish Flu
Avian Flu
Swine Flu
Awesome Flu

All, much, much more deadly than regular ole flu because of that extra word.

 

[Skeptic Ginger]

The evidence is that everyone outside Mexico has had very mild symptoms and recovered in a matter of days.

When evaluating evidence you need to assess the significance and quality of it.

For quality, we really don't know the age pattern of fatalities in Mexico though more and more evidence it is an unusual pattern is turning up.

For significance, one cannot compare apples and oranges. The severity of disease in the US can't be compared to that in Mexico until we have relevant denominators. It's clear tens of thousands are infected in Mexico. We know that because officially it has been reported that the number of cases being counted are those showing up in hospitals. Meaning it is official only a fraction of the cases are being counted.

And the number of cases now being seen around the globe clearly indicates widespread disease in Mexico. That fact also rules out the hypothesis, maybe the infection in Mexico is mainly in young adults which would explain then a concentration of deaths in that age group. If it has spread on flight after flight out of Mexico, it is not going to be confined to a small group in Mexico. Remember, unlike SARS, the cases of flu showing up all over the world do not all have ties to one flight, one time at the same airport, or one hotel.

Also, the cases outside of Mexico are more likely to be getting anti-virals and getting them within the 48 hours. If the cases outside of Mexico weren't treated, the real nature of the infection might be more virulent.

That's OK because heck, we can get the meds. But if case numbers get too high, treatment availability is not certain. Though we have a better stockpile of Tamiflu than when bird flu first threatened us.


I am not interested in fearmongering. I am interested in science based medicine and science based assessments. That means ignoring the media's over stating the risk, but not going to the opposite extreme just because we know the media is hyping things.

Look where the evidence leads, don't try to fit it to an already established conclusion.

 

[Skeptic Ginger]

A more level headed report on the virus:

Sorry, Ron Paul is full of it. I didn't have time to hear the other video of 9 minutes of news. Halfway through it sounded like the same news being heard elsewhere.

As for Paul, to claim the government shouldn't be involved... So is he saying we should disband the public health system? He needs to travel to a few countries where the government is not involved in public health.

The 1976 flu vaccine could have gone either way and the decision made at the time was made on the best information available. Paul's opinion is like saying science based medicine is a failure because 30 years ago they were still taking tonsils out.

Then he goes on to say TB is worse. Sure, because the annual death rate around the world is high every year. That is reason to fund more public health, not evidence we should only fund the worst of it.

The man should be ashamed to call himself a doctor.

 

[gumboot]

When evaluating evidence you need to assess the significance and quality of it.

For quality, we really don't know the age pattern of fatalities in Mexico though more and more evidence it is an unusual pattern is turning up.

For significance, one cannot compare apples and oranges. The severity of disease in the US can't be compared to that in Mexico until we have relevant denominators. It's clear tens of thousands are infected in Mexico. We know that because officially it has been reported that the number of cases being counted are those showing up in hospitals. Meaning it is official only a fraction of the cases are being counted.

And the number of cases now being seen around the globe clearly indicates widespread disease in Mexico. That fact also rules out the hypothesis, maybe the infection in Mexico is mainly in young adults which would explain then a concentration of deaths in that age group. If it has spread on flight after flight out of Mexico, it is not going to be confined to a small group in Mexico. Remember, unlike SARS, the cases of flu showing up all over the world do not all have ties to one flight, one time at the same airport, or one hotel.

Also, the cases outside of Mexico are more likely to be getting anti-virals and getting them within the 48 hours. If the cases outside of Mexico weren't treated, the real nature of the infection might be more virulent.

That's OK because heck, we can get the meds. But if case numbers get too high, treatment availability is not certain. Though we have a better stockpile of Tamiflu than when bird flu first threatened us.


I am not interested in fearmongering. I am interested in science based medicine and science based assessments. That means ignoring the media's over stating the risk, but not going to the opposite extreme just because we know the media is hyping things.

Look where the evidence leads, don't try to fit it to an already established conclusion.

It's an interesting point, but the simple fact is the point I am making is entirely supported by the only concrete evidence we have. As more information comes in, it increasingly looks like the entire scope of infection has been exaggerated - see the WHO report.

I appreciate your point, but for example if we look at the cases in New Zealand all showed only mild symptoms, and all were recovering before they were put into isolation. Quite clearly superior medical treatment is not the reason for the mildness of their symptoms.

As Oliver's article points out, in the time that this flu has globally killed seven people, potentially as many as 150, the regular flu has killed thousands in the USA alone.

If anything the most notable thing about this particular flu is how little danger it poses. That and the name, of course.

 

[Skeptic Ginger]

Anyone else heard this report?

Well the net echos have included it in a few pieces. I see the name shows up on the WHO webpage, but she is unconnected to the influenza branch.

Sounds to me like someone at WHO spouted off and it got printed. I wonder if she'll be reprimanded for bad PR?

Why is everyone trying so hard to downplay this event? Do you really think the Mexican government shut the country down over 7 deaths and a handful of flu cases? Isn't this news report as likely to be wrong as the ones reporting we should all get 6 months of food and lock ourselves in?

 

[Skeptic Ginger]

It's an interesting point, but the simple fact is the point I am making is entirely supported by the only concrete evidence we have. As more information comes in, it increasingly looks like the entire scope of infection has been exaggerated - see the WHO report.

I appreciate your point, but for example if we look at the cases in New Zealand all showed only mild symptoms, and all were recovering before they were put into isolation. Quite clearly superior medical treatment is not the reason for the mildness of their symptoms.

As Oliver's article points out, in the time that this flu has globally killed seven people, potentially as many as 150, the regular flu has killed thousands in the USA alone.

If anything the most notable thing about this particular flu is how little danger it poses. That and the name, of course.

Well cherry pick what you want. My evaluation of the evidence comes from 19 years specializing in infectious disease with a focus on health care worker hazards, infection control and treating exposed workers. This is my area of expertise which I also make my living off being good at. What's your knowledge level in this field?

 

[gumboot]

Well the net echos have included it in a few pieces. I see the name shows up on the WHO webpage, but she is unconnected to the influenza branch.

Sounds to me like someone at WHO spouted off and it got printed. I wonder if she'll be reprimanded for bad PR?

I doubt it, if you follow The Atheist's link you'll note that the most current official WHO update has the same numbers she gave.

Why is everyone trying so hard to downplay this event? Do you really think the Mexican government shut the country down over 7 deaths and a handful of flu cases? Isn't this news report as likely to be wrong as the ones reporting we should all get 6 months of food and lock ourselves in?

I don't think people are trying so hard to downplay this event. I just prefer to trust the cold hard facts as delivered by the WHO. Mexico isn't exactly the paradigm of brilliant medical services. And given that the poor health, hygiene, and high population density makes somewhere like Mexico City a good place for a virus to spread, I think their precautions are sensible even if there are only such a small number of deaths.

Better to temporarily shut things down until you can establish how bad the threat is than to trundle along blithely until bodies are piling up in the streets.

 

[Oliver]

Yeah but "swine flu" has another word in it, so everyone knows that makes it worse. See?

Spanish Flu
Avian Flu
Swine Flu
Awesome Flu

All, much, much more deadly than regular ole flu because of that extra word.

Well, as Jon Stewart said the other day:
Most Mexicans still die due to the bullet flu.

 

[gumboot]

Well cherry pick what you want. My evaluation of the evidence comes from 19 years specializing in infectious disease with a focus on health care worker hazards, infection control and treating exposed workers. This is my area of expertise which I also make my living off being good at. What's your knowledge level in this field?

And how has all of that experience aided you in evaluating the evidence in such a way that you've decided seven confirmed deaths and about ~100 confirmed mild non-fatal infection is unusual and warrants anything other than "keeping an eye on it"?

 

[Skeptic Ginger]

I doubt it, if you follow The Atheist's link you'll note that the most current official WHO update has the same numbers she gave.

I see that. But reporting that these are the only cases vs these are the WHO lab confirmed cases is not correct. So perhaps it is in how she stated it, or in how her comments were recorded. Either way, the interpretation is naive.

I just got the official update of confirmed cases in the US from CDC. Using your logic, we have more cases than Mexico. If you believe that I'd say your common sense is lacking.

Update: Infections With a Swine-Origin Influenza A (H1N1) Virus --- United States and Other Countries, April 28, 2009

As of April 28, the total number of confirmed cases of S-OIV infection in the United States had increased to 64, with cases in California (10 cases), Kansas (two), New York (45), Ohio (one), and Texas (six). CDC and state and local health departments are investigating all reported U.S. cases to ascertain the clinical features and epidemiologic characteristics. On April 27, CDC distributed an updated case definition for infection with S-OIV

I don't think people are trying so hard to downplay this event. I just prefer to trust the cold hard facts as delivered by the WHO. Mexico isn't exactly the paradigm of brilliant medical services. And given that the poor health, hygiene, and high population density makes somewhere like Mexico City a good place for a virus to spread, I think their precautions are sensible even if there are only such a small number of deaths.

Better to temporarily shut things down until you can establish how bad the threat is than to trundle along blithely until bodies are piling up in the streets.

Trusting confirmed facts is one thing. Not knowing what they represent is another. Confirmed cases meet a specific definition. Probable cases meet another and suspect cases something else. We use these definitions for various purposes.

You think only confirmed cases has value in estimating the true number of infections. In the case in influenza, that is simply a false assumption. If you don't believe me, I don't care. I know my field of expertise.

 

[Skeptic Ginger]

And how has all of that experience aided you in evaluating the evidence in such a way that you've decided seven confirmed deaths and about ~100 confirmed mild non-fatal infection is unusual and warrants anything other than "keeping an eye on it"?

I already posted the answer to this. Just in terms of the numbers:

"It's clear tens of thousands are infected in Mexico. We know that because officially it has been reported that the number of cases being counted are those showing up in hospitals. Meaning it is official only a fraction of the cases are being counted.

And the number of cases now being seen around the globe clearly indicates widespread disease in Mexico. That fact also rules out the hypothesis, maybe the infection in Mexico is mainly in young adults which would explain then a concentration of deaths in that age group. If it has spread on flight after flight out of Mexico, it is not going to be confined to a small group in Mexico. Remember, unlike SARS, the cases of flu showing up all over the world do not all have ties to one flight, one time at the same airport, or one hotel."


Think about the logic here. Is it logical to see cases showing up all over with no obvious direct connection if there weren't thousands of cases? Do you think pixies carried the virus from person to person? We can estimate the number of degrees of separation so to speak here. And we can also estimate that for every case found how many would not be.

As for the deaths. I give Mexican doctors a little more credit to know they are seeing an unusual number of fatalities. Do you think they are ignorant peasants or something believing in death clusters erroneously? Do you really think they'd even notice 7 excess deaths over the baseline they are used to seeing?

 

[The Atheist]

When evaluating evidence you need to assess the significance and quality of it.

For quality, we really don't know the age pattern of fatalities in Mexico though more and more evidence it is an unusual pattern is turning up.

If you're trying to find a pattern in seven deaths, I suggest you'll be wasting your time.

Read your own sentence at the start of your post - quality of evidence.

So far, the actual evidence is only startling for the lack of it.

I will, however, repeat that the tiny number of deaths from what was clearly an established outbreak, seems to indicate a very mild influenza. Which just happens to be occurring at the same time as an outbreak of.....

Influenza A, since at least a couple of people with A positive 'flu results here have come back negative for "swine" 'flu.

 

[gumboot]

You think only confirmed cases has value in estimating the true number of infections.

No, I don't. I think they're the only ones that should be used to determine the severity of the virus.

You can take the known infections, make determinations about the nature of the problem, and then extrapolate that out to suspected infections. That's fine. But it's a basic statistical mistake to use the data from suspected infections to determine the nature of the problem.

If the confirmed infections outside Mexico were severe in nature, or had comparable death rates to the Mexican infections, I would be very concerned. But they don't, so I'm not.

It's simply illogical to assume that the probable, suspected, and unknown infections are more severe than the confirmed cases.

 

[FSM]

Thank you skeptigirl for your information. I really appreciate it.

This just came out tonight from my daughter's school:

It is the recommendation of the Comal County Health Department that Comal ISD close all of its schools beginning Wednesday, April 29th until Monday, May 11. The New Braunfels ISD also is closing all of its schools for that time period.

There are at least three highly probable cases of swine flu in Comal County. Other cases are pending. So, out of an abundance of caution and because our school district needs to do its part to help stop the spread of infection, we are complying with the Comal County Health Department recommendation immediately.

The cancellation of school until May 11 also means there will be no extracurricular activities, such as field trips, and no meetings in our schools. For UIL athletic and academic events, get in touch with your child’s head coach or coordinator. The Health Department is asking people to stay home if they are sick.

Comal ISD employees are not to report to work unless notified otherwise by their supervisor. The Health Department and Comal ISD realize the closing of schools may be an inconvenience to your family. The health and safety of our community, our students and staff, is important. Monitor our Comal ISD website for updates and any other information we can provide.

Thank you. For more information, please visit the Texas Department of State Health Services website at http://www.dshs.state.tx.us/swineflu/default.shtm

Could you give me your opinion about what the risk is in my area particularly in light of the bold/italic part that I empasized above? I am not prone to panic, having been through several hurricanes so the information you give me will just be used to make sensible decisions about what sort of contact I should feel comfortable having with people.

Have I told any of you lately how nice it is to be able to have an internet hang out where you can just casually use and abuse some of the best minds in the world?