5/22/2009

Now, this flu:

I'm taking a break from the scheduled Interdome "era of good feelings" media channel to bring you a little update on H1N1: the dreaded gripe porcina.

But the reason I am doing so is to present some facts, so I will keep the commentary down to one paragraph, beginning now:

After the hysteria of the discovery of the flu, it was only natural to have the media hype give way to the hype about the media hype. And of course, now it's all a big joke, kind of proceeding like this.

CDC: knock, knock.
Public: Who's there?
CDC: flu pandemic.
Public: PANDEMIC?!?! FUCK!
CDC: flu pandemic.
Public: PANDEMIC!!! FUCK!!!
CDC: flu pandemic.
Public: oh, FLU pandemic? Fuck that.
CDC: flu pandemic.
Public: ....
CDC: flu pandemic?
CDC: flu pandemic???

Once everybody realized what they had been saying all along, that it was a pandemic of the flu, not of ebola or Mexican-Immigrant-Insta-Death, they stopped caring. But it doesn't change the fact that it is a flu pandemic. Still serious business. And yes, there are those statistics out there, that are oh-so-easy to retweet, small number of people get pig sick, everyone wears masks; lots of people get AIDS, nobody wears a condom. Here's another one: someone comes up with a witty twitter post, and everyone retweets it; someone tries to teach you about pandemics, and you still don't wear a condom.

So that little rant about meme pandemics aside, here are some actual statistics about the current pandemic.

We are not yet one month into the pandemic. This means we don't have a lot of data, but we have some. Here's what it shows.

Less than one month in, there have been nine deaths in the US, and 6,552 confirmed cases. This does not sound so bad, especially compared to a disease like AIDS. But this is less than a month in, and the rate appears to be accelerating.

The same thing is true for the world at large. Today, we stand at 86 deaths, and 11168 reportedly confirmed cases.

Here's a graph of what that looks like.


There's also a clicky map here.

This shows us that yes, it appears that we are really in Phase 5 of the WHO epidemic speedometer. No, not a panic, but a real pandemic.

The basic reproduction number, or R sub 0, is "is the mean number of secondary cases a typical single infected case will cause in a population with no immunity to the disease in the absence of interventions to control the infection." From analysis of the cases in Mexico, researchers guess the number for H1N1 to be 1.4 to 1.6. Genetic analysis guesses 1.2. This is higher than seasonal flu, but on the low end of other pandemics (1918, 1957, and 1968 was 1.4-2). It is early to be guessing this number, and Mexico is an interesting situation because of the discrepancies in reported cases of the disease in the early stages of March and April. Yet, some scientists seem to be comfortable enough to publish. So, this is not just the seasonal flu in terms of transmission potential.

Now: mortality. Preliminary findings put the case-to-death percentage at 0.3% to 1.4%, with the number most likely being 0.4%. In the US, the current percentage is 0.1%; in the world it is 0.7%.

Once the pademic reaches stage 6, the WHO implements the Pandemic Severity Index. Using the limited data we have now, if they were to declare today, the world would be in stage 3, one step up from Asian and Hong Kong flu, but not as high as stage 6, which was the severity of the 1918 Spanish Flu, with a case-fatality rate of over 2%.

Okay. Now the point (briefly).

No, we are not going to be dying in the streets. But this is still a real pandemic, and it seems that it will not stop. Barring any consequences like mutation to a very different virulence, or the new symptom of projectile bleeding eyeballs, there are still going to be a lot of sick people in the world over the next year or so. YES: SICK WITH THE FLU. ONLY THE FLU. But even .4% or all of those people dying is a lot of people dying.

Not to mention the incredible strain on the health care systems of the world to deal with 30% of the world getting sick. No, the actual fatality rate is not too impressive, especially compared to the amount of damage we humans are able to inflict on ourselves with war, and the like. But our infrastructure is going to be strained. Can you imagine health insurance companies dealing with 30% of their customers coming in for diagnostic tests over the course of a year? What about those without health insurance? What about those in countries without health systems?

As of now, most countries are even delaying or stopping their reports to the WHO. When so many people are getting sick, and the storm shows no signs of abating, what's the point? Indeed, what is the point to care about H1N1, when it's pace seems unchangeable? What's the news in that?

No comments: