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PANDEMIC ALERT LEVEL
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Tracking the next pandemic: Avian Flu Talk

How scared should we be?
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roni3470 View Drop Down
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    Posted: September 14 2006 at 12:33pm
I have spent a significant time reading articles and posts and tracking the avian flu.  I also have taken precautions to prepare by getting extra food/water and medical supplies...so I am ready and please do not think I am not taking this seriously.  However, considering that experts do not know if it is going to happen this year or anytime in between 10 years from now, I am wondering how soon this is actually going to happen. Now I know no one can say for sure.  But just as an opinion...on a scale from 0-100, what percentage would you give on the high path form coming into the US this year?  Next year?
 
Thanks in advance!
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I am not prepping just in case there is an avian flu pandemic. I live in Calif. so am prepping in case of an earth quake, a terrorist attack. I also live by Aerojet and anything can happen there with their periodic basts of whatever it is they are exploding. I keep a close eye on the expiration dates of my preps and use them as they come due. I am not in the least feeling that I have done this in vain as nothing is going to waste. The news has been nill lately re: avian flu but I really think this is just a lull. As the flu season picks up, who knows what will happen? Whatever it is, I am as prepared as I can be. 
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I figure, if there can be a TB Pandemic, and there is, then a BF varient Pandemic is possible also.  There will be big snow storms...ice storms,
who knows what else.... so we feel good to have a bit extra.
 
It could be 3 yrs...5 yrs  The TB Pandemic is my consern, it's here, it passes through the air.
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   Looking at historical data from the last 300 years the annual risk of pandemic flu is 3.33%. The annual risk of a major pandemic is 1% and of a minor pandemic is 2.33%. In years that no pandemic potential strains are present the risk is much lower and in years in which a potential pandemic strain is circulating the risk goes up by some multiple. For the past 10 years the H5N1 high path strain has been circulating. It seems that if this strain goes efficient H2H  the result will be a major pandemic. In retrospect it appears the probability of major pandemic was high in 1997 and then dropped for 6 years then has been on the increase since 2003. We seem to have had a near miss in 1997 in Hong Kong when 18+ persons contracted H5N1 flu. This potential pandemic was averted by a major public health initiative. In 2003 a near miss minor pandemic seems to have occurred in the Netherlands with an H7N7 flu strain which infected 89 persons. Since 2003 the high path H5H1 strain has returned progressively spreading now to a total of 55 countries [note that the disease has reportedly been eradicated in some countries]. As the spread has occurred there have been progressively more human infections and more clustering. The more this occurs the higher the probability of pandemic. No pandemic for 10 years of the virus says we have been lucky or the virus has a way to go or we have already averted the pandemic once or twice. I think all three factors are likely. Even with all the bad problems in Indonesia I think this winter in the northern hemisphere is a much more dangerous time than the past 6 months. I think the probability of a major pandemic in the next year is 10 to 20 times the basline 1% and by far the most likely time in the next 12 months is December to March. So I will give you a figure 10 to 20% in the next year.  ER Doc
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roni3470 View Drop Down
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Wow!  That is the best, most sensible answer I could have hoped for...thanks so much!!!!!!!!!!!!!
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Originally posted by Frisky Frisky wrote:

   Looking at historical data from the last 300 years the annual risk of pandemic flu is 3.33%. The annual risk of a major pandemic is 1% and of a minor pandemic is 2.33%. In years that no pandemic potential strains are present the risk is much lower and in years in which a potential pandemic strain is circulating the risk goes up by some multiple. For the past 10 years the H5N1 high path strain has been circulating. 
 
In retrospect it appears the probability of major pandemic was high in 1997 and then dropped for 6 years then has been on the increase since 2003. We seem to have had a near miss in 1997 in Hong Kong when 18+ persons contracted H5N1 flu. This potential pandemic was averted by a major public health initiative.
As the spread has occurred there have been progressively more human infections and more clustering. The more this occurs the higher the probability of pandemic. 
 I think the probability of a major pandemic in the next year is 10 to 20 times the basline 1% and by far the most likely time in the next 12 months is December to March. So I will give you a figure 10 to 20% in the next year.  ER Doc
ER Doc, I think that is a good start at estimating probabilities, but I disagree on a couple points.  The probability of suitable mutations for H2H is obscured by so many unknowns that one possibility is that the likelihood keeps increasing, while another possibility is that this is not true either because the viral change is going down a dead-end strategy for adaptation, or that there is a needed mutation which is impossible for some unknown reason.  So like some other avian flus it could fizzle out as a pandemic possibility, returning the annual probility to the baseline 1%.
 
Secondly, some of the events you allude to may have no bearing on the probability, as they are independent events that do not change the probability of further mutation or adaptation.  For example, the varying public health efforts in different countries can make the danger seem high when there is no underlying increased virus threat.  In Indonesia for example I think the death rate is mainly related to a worse public health education and animal health response than has been previously seen.
 
My personal hunch is that the current annual risk of pandemic capable of killing a much higher percentage than the annual flus, and reaching all communities is only 5-10%  Because of the dire consequences, that is enough to have a much greater response than most communities have, with need of much higher funding from State and Federal funds.
Dlugose RN AAS BA BS Cert. Biotechnology. Respiratory nurse
June 2013: public health nurse volunteer, Asia
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frisky,
 
i work closely with many doctors. i am a RRT. i work in the er, icu, the floors, you name it. we respond to all the codes. my hospital has come up with a rapid response team system. so we are involved in that. one of us carries a beeper in all shifts.
 
my question to you, is what will you do? will you show up to work or protect your family? you cant do both. i have been in the trenches for years. i actually taught a lot of the er docs at my hospital to intubate.
i used to work at a trauma hospital across town ( 8 years) ago. they were residents at that time. we have a good relationship, the best. if they call me to the er, i go in assess the situation and do it. you and i will probably know before most people if the bf is here. you get a gut feeling for these
things. i work with sick and dying people every week. i rarely get sick. you learn as you go.
 
frisky,
you have my respect. i hope you and yours do well.
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A new free 225 page document "Influenza Report 2006" available online at http://www.influenzareport.com is a must read reference.  It has a lot of technical information, but written in a easy to read style that most will find very informative.  On the likelihood of pandemic soon it says:
 
H5N1 is to be the candidate virus for the next devastating influenza pandemic, why has it not yet acquired the ability to spread easily between humans? Over the past years, H5N1 has had both the time and opportunities to mutate into a pandemic strain. Why hasn.t it? And if it hasn.t in nearly 10 years, why should it do so in the future? It is true that of the 16 influenza H subtypes, only three (H1, H2 and H3) are known to have caused human pandemics (1918, 1957, 1968, and probably 1889 [Dowdle 2006]), and it has even been hypothesised that H5 viruses are inherently incapable of transmitting efficiently from human to human. Shall we one day discover that H5 viruses are not good for human pandemics, because not all possible subtypes can reassort to form functional human pandemic strains? We don.t know. Apart from stepwise mutations that transform an avian influenza virus into a human influenza virus, reassortment is the second way in which new pandemic viruses are generated. The two pandemics that were triggered by this phenomenon occurred in 1957 and in 1968. Both were relatively mild and fundamentally different from what happened in 1918. There is some preliminary experimental evidence that reassortants of the 1918 virus might be less virulent than the co-ordinated expression of all eight 1918 virus genes (Tumpey 2005). Does that mean that pandemics resulting from reassortment events of a human and an avian virus are milder than pandemics caused by a virus which slowly accumulates mutations in order to .migrate. from water fowl hosts to human hosts? We don.t know. The revival of the 1918 catastrophe might also never happen. But the 1918 influenza pandemic did occur, and good planning means being prepared for the worst. As it is impossible to predict whether the next pandemic will result in ~20 or ~2,000 deaths per 100,000 people, the international community should prepare for the 2,000 figure.
Dlugose RN AAS BA BS Cert. Biotechnology. Respiratory nurse
June 2013: public health nurse volunteer, Asia
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Another way of looking at this is to consider previous influenza pandemics. There were three in the past century:  1918, 1957 and 1968. That's a 39 year span after 1918, an 11 year span after 1957 and now a 38 year span after the last pandemic in 1968.   
 
This admittedly small sample seems to indicate that on a reoccurring/cyclical basis we are "due" for another pandemic soon.  Hopefully it will be as relatively mild as the 1968 "Hong Kong Flu" was.....
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  I plan to work 12 hours a day 6 or 7 days a week during a pandemic. The kids and significant others all in their 20's are going to a family ranch along with a number of same age cousins. That age especially considering pregnancy issues needs to sit this one out until vaccine becomes available or the virus mutates to a mild form.  ER Doc
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: September 15 2006 at 5:28pm
Originally posted by Frisky Frisky wrote:

  I plan to work 12 hours a day 6 or 7 days a week during a pandemic. The kids and significant others all in their 20's are going to a family ranch along with a number of same age cousins. That age especially considering pregnancy issues needs to sit this one out until vaccine becomes available or the virus mutates to a mild form.  ER Doc
 
Frisky I just have to say...Thank you, bless you!! You are the embodiment of a true hero and I'm proud to know you. Well in the way that I know you. Thanks again. Clap
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"However, considering that experts do not know if it is going to happen this year or anytime in between 10 years from now, I am wondering how soon this is actually going to happen. "   (from roni)
..................................................................................................................
 
Hear was the thinking about H5N1 9 years ago.... see how things have changed.
Excerpts-
 
"The worry, in general, is that a bird flu will jump into a human but that jump is a rare event - thus not to be feared. That's a mutation and produces "patient one".
 
However, once that event occurs, the spread from human to human is to be feared! That's the epidemic. Only one person need be infected by the bird flu for it to take hold (the mutation and shift to a new species) and that is much more likely to occur in Asia and on a poultry farm..."
......

"Is "avian flu" likely to become a pandemic?
 
 
Probably not. (Notice I said "probably"). A pandemic would result only if the avian flu could pass from one human to another. "
....................................................................................................
 
Now we hear the term....passing efficiently from H2H.
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we didn't dream it....here it is in print.
 
 
In the 21st century, emerging
zoonotic diseases have the
potential to devastate the global
human population, the effect of
which could be to “rock” the
earth for a century or more.
 
 
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frisky,
 
if i can deal with my brother i will be in there. that is what i do.
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If there is less than a 10% chance bird flu could become a pandemic this year, the I think I would say I feel adequately prepared for it.  If it were more like 50%, then I would think I needed a lot more preparation.  Thanks to all who responded!
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Roni, anybody who cares about their family should be concerned, to some degree, about a possible pandemic.  For what it's worth, we have 2 months worth of "grub" put away, just in case.  I do feel a bit sheepish, we have a small house and I've given all our storage over to non-perishable food stuffs.  But you never know. 
I'm as big a Sci-Fi buff as the next guy, but I really don't think we'll see a "Super Flu", a la Michael Crichton.  Welcome to the Forum!
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roni....there are 2 equations here,first odds verse leathality...10% odds are good ,but 72%leathal is bad . i dont worry about a fire in my house (we have a .01% risk) but i still prepared well, fire extinguisers and alarms... becouse the low risk of a fire is offset by the high chance of death in a house fire...i dont believe one can overprepare (generaly speaking of course)but we statisticly always underprepare....
The only thing we have to fear, is fear itself......FDR
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While we in this country have the ability to devolp a team and provide the medical response thats needed .Its in    the poorest countries of the world is where the battle is is being fought.,  Are lives depend on their ability to defeat the virus and contain it.. They have no money no infacsture to provide the needed medical care. 

They dont even have the basics  masks separte rooms with separate ventaltion. 
 
 . 
Sars was basically one Apartment in China with everyone on alert and the whole world watching. 
 
 There is no real accounting of deaths and actual cases of the virus.  Countries that post significant deaths risk finacial ruin due to lack of tourism and exporting products.  so how do you trust them.
Honesty is not always affordable it is a luxury for these countries 
 
 
I am truthfully very afarid.  I have already sold my condo to move to a house with some land near a water sourse.    I fear for those who live in
apartments in large cities. and their safety.
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I am okay with the every day day to day reading, researching, watching, etc.  I get a little stressed when I think about my towns lack of planning or lack of wanting me to help them plan. That is my biggest stresser now.
 
But I think if TSHTF I will go into complete meltdown.  Do I quit my job that I have had for 25 years, when shoudl I quit, will the boss let me take a leave of absence (he can be a jerk!), how will I pay my bills, will my kids for once listen and stay home, how will I know what is going on if the internet and TV go out (I am a information junkie!), will my town step up to the plate and take care of everyone, I have a million things I am scared about....but what can I do. I feel i have done the best i can without putting the house up for sale and moving to an island. So yes I guess I am scared.
I used to have more posts :-(
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well, I have stockpiled a good 2 month source of food supplies and have an alternate fuel source for cooking.  I still have some storage of water and supplies for my babies and my dog I need to get but I do a little at a time.  I have thought of things I would not have before by reading this site, such as an LED flashlight and short wave radio.  Extra batteries, arts and crafts for the kids.  So I am so grateful that i found this site and have learned so much and taken all the advice to heart.  I still don't think it will hit this year, but I do know it will hit, so better be prepared...and I will just cycle my supplies around and around so they always stay current.  Thanks everyone!
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I've also prepped as much as I can but I'm still very scared.  I don't want the 'world to change'.  Our recent scare with DH and the heart arrhythmia was a prime example of what worries me most.  We were able to call 911 and get immediate treatment at the hospital.  Even if we SIP and never leave the house until they get a vaccine, other stuff can happen and we won't be able to get the help we need.  Just need take deep breaths now and again and sometimes it even helps.
 
GG
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Mass Evacuation to Rural Communities...
 
(we have all wondered about this)
 
 
One way to prepare is to know what plans your state is making...
.............................................................................................................
 
 
 
 
For additional information please contact us via email, or phone 518-486-7921.
 
There is no charge for this program. Reservations are requested – please use contact information above.
 
Local Site:
University at Albany School of Public Health
George Education Center Auditorium
University at Albany East Campus, Routes 9 & 20 (near Interstate 787 & downtown Albany).
 
To purchase a videotaped copy of this satellite broadcast, please visit the Public Health Foundation bookstore.

Mass Evacuation to Rural Communities
November 9, 2006
 
Brian Gerber, PhD - Assistant Professor, Division of Public Administration, School of Applied Social Sciences, West Virginia University
Donald W. Rowe, PhD - Public Health Liaison, University at Buffalo School of Public Health and Health Professions
 
Program Description:
The presenters will share results of a recent survey regarding potential behavioral responses of large populations to disaster events - including terrorist attacks - and will discuss key concerns for rural communities to consider as they plan for mass exodus from urban centers. They will also share new efforts underway by the recently funded Advanced Practice Center in western New York.
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Great bad enough we have our own people to thing about but now there will be an influx from other cities.  Why have a mass exodus from urban centers into smaller areas with bird flu.  these people will just be spreading the disease.
 
 
I used to have more posts :-(
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GG Hugs,
 
You are not alone in your fear of isolation and medical crisises!  I have pasted something I believe does work altho I have not yet had a chance to test it during a real attack.  Personally I have had heart pallipitations and have bouts of stress to where I needed to counter a racing heart and this hand mudra works.  It is claimed to be as fast and effective as a nitrglycerine pill.  I suggest you practice the hand formation because it's awkward at first.  To me it is a bit freaky how instantly it calms you down.  Again I have no personal experience with it under a serious medical emergency.  My wife is a yoga instructor and taught me this hand mudra and I have researched it and experimented with it and based on my experience of the powers of eastern medicine it is hard to ignore the potential here.  Any time your're stressed close your eyes, take a deep breath, do the mudra and you'll instantly feel your heart relax.  There is nothing to loose with this and who knows?  I wish you and your husband the best with his recovery.
 
 
Your Health in Your Hand -Acharya Keshav Dev
People fold their fingers in various Mudras (Gestures). It is little known, however, that Mudra Science is Tatva Yoga-Yoga based on science of elements. And, believes Acharya Keshav Dev, these mudras can help cure many diseases.
MRIT SANJIVINI MUDRA MRIT SANJIVINI MUDRA
 

In the case of severe heart attack, this life giving divice Mudra provides instant relief within a few seconds.
Helping hand for Cardiacs.
First Aid for Heart Problems.
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Ying Yang
Accept responsibility for your choices and actions. Failure to choose is in itself a choice for non-action.
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Cruiser - Thanks so much for the link.  I saved it and will study.  I do believe that relaxation techniques really do help.  I know that biofeedback can show you how much you are really relaxing.  I had a friend that had back pain from an accident. Dr's tried lots of pain killers and finally sent her to a pain clinic that specialized in the biofeedback.  It worked great for her.  Many of the 'natural healing' methods have been proven to work.  DH is going good so far.  Has an appointment for a stress test and the cardiologist wants him to wear a monitor for 24 hours but all tests so far just show the extra beat thing - no heart attack or heart damage!! 
 
Thanks again
GG
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: September 28 2006 at 6:22pm
Cruiser.... I also read about wringing out two small wet towels and putting them in the microwave until quite warm...or the kind filled with rice...anything to warm the arms...wrap the warm towels...one around
each arm...to stop the chest pain.  From a Doctor, he said it was a little remembered remedy from the old days.
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