Re: Mortalities from a Flu Pandemic Hard to Predict

[Guest guest]

In einer eMail vom 02.01.2006 06:34:16 Westeuropäische Normalzeit schreibt jackalope_lepus@...:

... about the mortality going down:

Yes, but that's only as the virus walks through more and more victims.

But when it spreads by airplane to many places at once, it has no time

to go through several victims. Once it reaches the 10th victim, this one might

already have got it from the virus' grand-grand-mother , so only 3 virus-generations.

I've seen predictions that once the virus reaches USA, it will be in any big town with

an airport only a few weeks later ! That's much faster than in 1918.

In 1918 the virus became less lethal, but it didn't start with 50% and it took

months just to half the lethality.

So, what the H5N1 suddenly gets the infectivity of the 1918-thing but keeps

the 50% lethality and spreads by airplane all over the world ?

Let's assume the lethality goes down from virus-generation to virus-generation

as it did in 1918. How many deaths would we get ? I assume it could be billions.

>So scientists are making educated guesses. Fauci says the >public, and policy makers, need numbers in order to make plans.

exactly.

So, Mr. Fauci, don't you think it's your _duty_ to provide us with

your "educated guess" ? Please give a number ! We do understand

that this is difficult and there are problems and it's uncertain etc.

but please give it nevertheless. Nobody will kill you when it turns out

that your guess was wrong.

>He says they want to be told there's "a 5-percent chance of this or a >10-percent chance of that, or a 2-percent mortality is a worst-case >scenario." >But Fauci adds, "The one thing that you learn with infectious >diseases, particularly with influenza -- because influenza is a >particularly bad actor in this regard -- [is that] it is really quite >unpredictable.">>Fauci says public health officials are preparing for the worst. But >in this case, that means a mortality rate closer to 2 percent than 50 >percent.

so, 2 percent is worse than 50 percent ??

>>http://www.npr.org/templates/story/story.php?storyId=5056105

please help to extend the list of anticipated probabilty estimates at

http://magictour.free.fr/pandemic

please look for published statements of experts, from which we can reasonable

conclude their estimate (they rarely give direct estimates!)

write emails to experts and ask them for their estimates

[Guest guest]

In einer eMail vom 02.01.2006 07:05:03 Westeuropäische Normalzeit schreibt rboylern@...:

>First off, we're dealing with a disease that is essentially confined to regions in Asia >right now. We don't know a whit about human to human transmission yet or about

we do know a little whit. All family clusters had been examined. We know the

genetic code. We can predict some mutations.

>how that would affect the nature of the virus. How could numbers be predicted.

just a prediction or an estimate is always possible. People are even betting

on the superbowl-winner and such, which is even more uncertain.

> Dr. Fauci is probably more correct in using the 1918 model where only about 2% died. >That's my guess. People do want numbers, but we won't have them until we >understand this disease more which is not something that happens overnight in >spite of all our technology and science.

so when will we get numbers ?

I dare to predict that scientists will _always_ use excuses like

"we don't know yet"

two possibilities:

(1) Fauci et.al. do have some estimate which is at least more profound than

the average people's estimates

or

(2) all the research so far was invain

which one do you choose ?

[Guest guest]

In einer eMail vom 02.01.2006 07:45:08 Westeuropäische Normalzeit schreibt rboylern@...:

>You're right, we do have some limited information already; but it's very limited. Dr. >Fauci and his colleagues are wise to say "we don't know" when they really don't >know and I doubt if he or any of them have any "inside" information they're hiding >from the public. From what I know of Dr. Fauci, he would not do such a thing. He >did not do this with AIDS which, by the way, remains at pandemic levels.

what they are hiding is the interpretation of the information.

They can't do it very well, but certainly better than most of us.

When they don't give us their numbers, then we have to come up

with our own numbers. And this is even less profound.

[Guest guest]

In einer eMail vom 02.01.2006 08:53:30 Westeuropäische Normalzeit schreibt rboylern@...:

>I'm not so sure there's all that much to be interpreted at this point. We know these >basic facts: the infection is largely confined to poultry; we're not sure yet whether >it's spread by migratory birds; some people have contracted it from close contact >with infected poultry, about half of them have died. We don't know if all cases are >being appropriately reported, especially in the People's Republic of China. There is >no cure. There is no vaccine available for human use. What have I left out?

_how_ not sure are we about the migratory spread

_how much_ don't we know about inappropriately reported cases in China ?

there is some cure. But it doesn't always work(how often?) and it could be

expensive (_how_expensive?)

There is some vaccine(how much?)

There are many nuances of "we don't know" ...

And those nuances can be taken into account to make an overall estimate.

Fauci would be more qualified to perform this task than I.

But when he refuses, I(or others) will have to do it.

[Guest guest]

In einer eMail vom 02.01.2006 09:12:32 Westeuropäische Normalzeit schreibt rboylern@...:

>If you were to write down a list of questions for Dr. Fauci what would they be?

just one question, else he'll be trying to evade.. :

what's your subjective,informal,momentary estimate of the expected number

of H5N1-deaths during the next 5 years ?

(mathematical expectation value, so averaged and

probability-weighted over all scenarios)

suggestions to improve this question ?

see also

http://magictour.free.fr/pandemic

http://www.psandman.com/gst2005.htm#guenter

[Guest guest]

Sometimes I think Dr. Fauci is the only one who makes any sense in all of this. He certainly helped the nation and the world calm down about AIDS when that disease was at its worst in the US and Europe. The man is sensible and straightforward. He's worth paying attention to.Lee <jackalope_lepus@...> wrote: Mortalities from a Flu Pandemic Hard to Predict by Jon Hamilton When public officials talk about bird flu, they often quote a scary statistic: Half of all the people known to be infected with the virus have died. But scientists say that figure has little bearing on what's likely to happen in an actual pandemic.In fact, flu experts have pretty much ignored the 50-percent figure when estimating how many people might die in a bird-flu pandemic. That's because such a high

mortality rate goes against all of our experience with flu viruses, says Dr. Fauci, director of the National Institute of Allergy and Infectious Diseases."We have never in our wildest dreams seen that in our history, where you have something that spreads rapidly throughout the world and kills 50 percent of the people," Fauci says. "Even with the infamous 1918 pandemic, we didn't even come close to a 50-percent mortality. It was more like 1.5 to 2 percent."Of course, that was high enough to kill tens of millions of people worldwide.Fauci says one reason flu doesn't kill more people is that even a strain as lethal as the current bird flu usually gets weaker as it spreads."It is highly, highly likely that it will decrease its mortality and its virulence for humans, because from an evolutionary standpoint, it makes no sense for viruses to kill all their hosts," Fauci says.That would amount to

viral suicide.Another problem with the 50-percent figure is that it includes only the people who got so sick they were actually tested for bird flu."There probably are milder cases of illness, as well as people who have no symptoms whatsoever," says Dr. Tim Uyeki, a medical epidemiologist at the Centers for Disease Control and Prevention. Uyeki says death rates from viruses like West Nile and SARS seemed very high at first. But they began to fall once doctors began finding the people who got milder cases. And Uyeki says there is already some evidence that the current bird-flu virus, known as H5N1, doesn't make everyone it infects severely ill. When H5N1 surfaced in Hong Kong in 1997, it appeared to kill about a third of the people it infected. But Uyeki says a study of poultry workers there told a different story. "Among market poultry workers," he says, "about 10 percent had antibodies to H5N1

virus, suggesting that they had been infected. But these were people who never were identified as severe cases, had never been hospitalized." So the actual death rate in Hong Kong may have been much lower than it seemed. But if 50-percent mortality is too high, it's hard to know what the right number is. One reason is that the H5N1 virus isn't acting the way most viruses do, says Dr. Frederick Hayden of the University of Virginia. "This virus so far has not shown any diminution in virulence for birds or for mammalian hosts," Hayden says. "If anything, we're seeing evidence of increased pathogenicity."So scientists are making educated guesses. Fauci says the public, and policy makers, need numbers in order to make plans.He says they want to be told there's "a 5-percent chance of this or a 10-percent chance of that, or a 2-percent mortality is a worst-case scenario." But Fauci adds,

"The one thing that you learn with infectious diseases, particularly with influenza -- because influenza is a particularly bad actor in this regard -- [is that] it is really quite unpredictable."Fauci says public health officials are preparing for the worst. But in this case, that means a mortality rate closer to 2 percent than 50 percent.http://www.npr.org/templates/story/story.php?storyId=5056105 . Never place a period where God has placed a comma. - Gracie . Be who you are and say what you feel, because those who mind don't matter and those who matter don't

mind--Dr.Seuss

[Guest guest]

First off, we're dealing with a disease that is essentially confined to regions in Asia right now. We don't know a whit about human to human transmission yet or about how that would affect the nature of the virus. How could numbers be predicted. Dr. Fauci is probably more correct in using the 1918 model where only about 2% died. That's my guess. People do want numbers, but we won't have them until we understand this disease more which is not something that happens overnight in spite of all our technology and science.sterten@... wrote: In einer eMail vom 02.01.2006 06:34:16 Westeuropäische Normalzeit schreibt jackalope_lepus@...: .. about the mortality going down: Yes, but that's only as the virus walks through more and more victims. But when it spreads by airplane to many places at once, it has no time to go through several victims. Once it reaches the 10th victim, this one might already have got it from the virus' grand-grand-mother , so only 3 virus-generations. I've seen predictions that once the virus reaches USA, it will be in any big town with an airport only a few weeks later ! That's much faster than in 1918. In 1918 the virus became less lethal, but it didn't start with 50% and it took months just to half the lethality. So, what the H5N1 suddenly gets the infectivity of the 1918-thing but keeps the 50% lethality and spreads by airplane all over the

world ? Let's assume the lethality goes down from virus-generation to virus-generation as it did in 1918. How many deaths would we get ? I assume it could be billions. >So scientists are making educated guesses. Fauci says the >public, and policy makers, need numbers in order to make plans. exactly. So, Mr. Fauci, don't you think it's your _duty_ to provide us with your "educated guess" ? Please give a number ! We do understand that this is difficult and there are problems and it's uncertain etc. but please give it nevertheless. Nobody will kill you when it turns out that your guess was wrong. >He says they want to be told there's "a 5-percent chance of this or a >10-percent chance of that, or a 2-percent mortality is a worst-case >scenario." >But Fauci adds, "The one thing that you learn with infectious >diseases, particularly with influenza -- because influenza is a >particularly bad actor in this regard -- [is that] it is really quite >unpredictable.">>Fauci says

public health officials are preparing for the worst. But >in this case, that means a mortality rate closer to 2 percent than 50 >percent. so, 2 percent is worse than 50 percent ?? >>http://www.npr.org/templates/story/story.php?storyId=5056105 please help to extend the list of anticipated probabilty estimates at http://magictour.free.fr/pandemic please look for published statements of experts, from which we can reasonable conclude their estimate (they rarely give direct estimates!) write emails to experts and ask them for their estimates . Never place a period where God has placed a comma. - Gracie . Be who you are and say what you feel, because those who mind don't matter and those who matter don't mind--Dr.Seuss

[Guest guest]

You're right, we do have some limited information already; but it's very limited. Dr. Fauci and his colleagues are wise to say "we don't know" when they really don't know and I doubt if he or any of them have any "inside" information they're hiding from the public. From what I know of Dr. Fauci, he would not do such a thing. He did not do this with AIDS which, by the way, remains at pandemic levels.sterten@... wrote: In einer eMail vom 02.01.2006 07:05:03 Westeuropäische Normalzeit schreibt rboylern@...: >First off, we're dealing with a disease

that is essentially confined to regions in Asia >right now. We don't know a whit about human to human transmission yet or about we do know a little whit. All family clusters had been examined. We know the genetic code. We can predict some mutations. >how that would affect the nature of the virus. How could numbers be predicted. just a prediction or an estimate is always possible. People are even betting on the superbowl-winner and such, which is even more uncertain. > Dr. Fauci is probably more correct in using the 1918 model where only about 2% died. >That's my guess. People do want numbers, but we won't have them until we >understand this disease more which is not something that happens overnight in >spite of all our technology and science. so when will we get numbers ? I dare to predict that scientists will _always_ use excuses like "we don't know yet" two possibilities:

(1) Fauci et.al. do have some estimate which is at least more profound than the average people's estimates or (2) all the research so far was invain which one do you choose ? . Never place a period where God has placed a comma. - Gracie . Be who you are and say what you feel, because those who mind don't matter and those who matter don't mind--Dr.Seuss

[Guest guest]

I'm not so sure there's all that much to be interpreted at this point. We know these basic facts: the infection is largely confined to poultry; we're not sure yet whether it's spread by migratory birds; some people have contracted it from close contact with infected poultry, about half of them have died. We don't know if all cases are being appropriately reported, especially in the People's Republic of China. There is no cure. There is no vaccine available for human use. What have I left out?sterten@... wrote: In einer eMail vom 02.01.2006 07:45:08 Westeuropäische Normalzeit schreibt rboylern@...: >You're right, we do have some limited information already; but it's very limited. Dr. >Fauci and his colleagues are wise to say "we don't know" when they really don't >know and I doubt if he or any of them have any "inside" information they're hiding >from the public. From what I know of Dr. Fauci, he would not do such a thing. He >did not do this with AIDS which, by the way, remains at pandemic levels. what they are hiding is the interpretation of the information. They can't do it very well, but certainly better than most of us. When they don't give us their numbers, then we have to come up with our own numbers. And this is even less profound. . Never place a period where God has placed a comma. - Gracie . Be who you are and say what you feel, because those who mind don't matter and those who matter don't mind--Dr.Seuss

[Guest guest]

If you were to write down a list of questions for Dr. Fauci what would they be?sterten@... wrote: In einer eMail vom 02.01.2006 08:53:30 Westeuropäische Normalzeit schreibt rboylern@...: >I'm not so sure there's all that much to be interpreted at this point. We know these >basic facts: the infection is largely confined to poultry; we're not sure yet whether >it's spread by migratory birds; some people have contracted it from close contact >with infected poultry, about half of them have died. We don't know if all cases are >being

appropriately reported, especially in the People's Republic of China. There is >no cure. There is no vaccine available for human use. What have I left out? _how_ not sure are we about the migratory spread _how much_ don't we know about inappropriately reported cases in China ? there is some cure. But it doesn't always work(how often?) and it could be expensive (_how_expensive?) There is some vaccine(how much?) There are many nuances of "we don't know" ... And those nuances can be taken into account to make an overall estimate. Fauci would be more qualified to perform this task than I. But when he refuses, I(or others) will have to do it. . Never place a period where God has placed a comma. - Gracie . Be who you are and say what you feel, because those who mind don't matter and those who matter don't mind--Dr.Seuss

[Guest guest]

In einer eMail vom 03.01.2006 00:42:54 Westeuropäische Normalzeit schreibt rboylern@...:

>The prediction, from what I understand from Dr. Fauci, is that if the virus mutates >into a form that can be transmitted from person to person, it will more than likely be >of a less virulent type because of all the "mysteries" of how viral DNA interacts with >species-specific DNA. Right now the virus doesn't seem to have that capability, so >we're in a sort of limbo about what could actually happen.

that would be interesting to examine. I didn't understand it this way and I can't

see a logical reason for this, but then, I'm no virologist.

If someone can find a referrence for this "more than likely" that would be

soothing. I also saw people arguing that this were unlikely, just because

it hadn't happened before.

[Guest guest]

Yes, we'd all like to understand a lot more; but even virologists get puzzled from time to time as viruses change and new viruses appear. The virus that causes AIDS is still filled with mystery. Just when you think you have the answer something happens that changes everything. This is the down-side of science, but it is also the challenge of science to find out what changed things and how the changes happened. I would be nice if it were all neat and tidy, but actually it's very messy; and this causes the public to become frustrated and angry because we've come to expect totally definitive answers from science when all we can actually get are some possible most-likely-correct answers and a lot of questions still be be answered.sterten@... wrote: In einer eMail vom 03.01.2006 00:42:54 Westeuropäische Normalzeit schreibt rboylern@...: >The prediction, from what I understand from Dr. Fauci, is that if the virus mutates >into a form that can be transmitted from person to person, it will more than likely be >of a less virulent type because of all the "mysteries" of how viral DNA interacts with >species-specific DNA. Right now the virus doesn't seem to have that capability, so >we're in a sort of limbo about what could actually happen. that would

be interesting to examine. I didn't understand it this way and I can't see a logical reason for this, but then, I'm no virologist. If someone can find a referrence for this "more than likely" that would be soothing. I also saw people arguing that this were unlikely, just because it hadn't happened before. . Never place a period where God has placed a comma. - Gracie . Be who you are and say what you feel, because those who mind don't matter and those who matter don't mind--Dr.Seuss

[Guest guest]

Puzzled? Scientists are disagreeing with each other as to whether

there will ever be a pandemic!

Flu/files/Experts%20on%

20Flu/

I am archiving the fight. I hope to figure out who is right someday.

> Yes, we'd all like to understand a lot more; but even virologists get

puzzled from time to time

[Guest guest]

He is indeed worth paying attention to. But I hope to find other flu

experts who are also good. Hard to tell tho who is really good.

> Sometimes I think Dr. Fauci is the only one who makes any sense in

all of this. He certainly helped the nation and the world calm down

about AIDS when that disease was at its worst in the US and Europe.

The man is sensible and straightforward. He's worth paying attention

to.

[Guest guest]

Greetings,

the mortality rate should indeed be hard to predict. Experts and

Scientists do expect it to drop from the current %50

One reason for optimisnm here is that we can calculate that for every

one of the 138 or so known infected and 70 plus dead, there is an

unknown number of infected out there which has survived and was not

known or detected.

That consideration alone should bring the factual mortality rate down

from the current %50.

There is also talk of some folks being infected without showing

symptoms or falling ill at all.

Blessings,

Master E.