A Medical Emergency

Yes, the H1N1 flu is a medical emergency. If you don't believe it, go to the Flu Map at Weather Underground. There are only four states not reporting widespread flu activity: Connecticut, New Jersey, South Carolina, and Hawaii. As Jeff Masters comments:

I doubt the flu map has looked like this since 1968, the last time a flu pandemic swept the globe. ... [A] typical peak flu outbreak occurs in February or March, and at most twenty states are colored red.

The good news is, of course, that it is not at this point a particularly virulent strain. Just don't say that to the families of the now over 1,000 people who have died as a result of the H1N1 flu. No matter how you spin it, it is a major health concern that is not done yet. If it holds into the regular flu season, it could be a difficult illness and a long winter.

Worried?

Thanks to Cory for this important link. In this era of panic and uncertainty over the swine flu, follow the link and find out if you have pig flu.

H1N1 Flu- Update

Well, we are past the first week of the swine flu. Hard to believe that it has only been a week! You could tell earlier this week when first Arlen Specter, then 100 Days of Obama and this morning Justice Souter were all the top Yahoo! News stories. You could also tell last evening when the Health Ministry of Mexico said the cases are "leveling" off, which I guess means they are not increasing as quickly.

There are really two perspectives to take on the swine flu issue. First is that it is important to keep it all in perspective. Cory Doctorow found this information the other day:

It's estimated that about 28 per cent of Canadians and Americans contracted the Spanish flu. Worldwide, an estimated 2.5 per cent of the sick died of complications, which made the pandemic one of the most lethal flu outbreaks in recorded history. Certainly it was one that imprinted itself upon human consciousness for several generations.

But there's another way to look at those statistics. You might observe, for example, that they mean that even during the worst ravages of the 1918 flu, 97.5 per cent of those infected survived and recovered. Or that 72 per cent of the population -- even in the absence of the sophisticated public health planning and infrastructure that Canada and the U.S. have since built -- was not infected during the pandemic.

So, even if we had a repeat of the 1918 flu, the chances were seven out of 10 that you wouldn't catch it and if you did, the odds were better than nine out of 10 that you'd survive.

That was during the worst pandemic of the modern era and one which occurred in the days before the instantaneous communications of radio, television and the Web enabled quick public health responses.
--Vancouver Sun
--HT to Cory at BoingBoing

That would still be a lot of people in 2009 USA-84 million sick; 2.1 million dead. The odds are against such numbers in this age of public health and better health care, antibiotics, and generally much better sanitation. But a major flu outbreak would still have significant consequences- impacts on many aspects of life that could conceivably change the world we live in at least for a short period if not longer. That is the second perspective. Awareness of the potentials for serious issues while remaining calm.

The planning that has gone on in many local and statewide agencies for a possible flu pandemic will more than likely have a positive effect on the outcome. More people in more places are at least minimally prepared. That is good news. But that doesn't mean there would not be some significant effects.

Two areas that strike me:
1) Threat to the economy.

Look at the relatively quiet streets of Mexico City, empty football stadiums, take-out-only restaurants, no Sunday Masses at the churches, locked stores. Add to that the potential dive in air travel and you can see how the economic foundation can be undermined quite quickly. Then consider lost wages and potentially higher medical bills- even for only 10 - 15% of the population. The costs can mount quickly and could be difficult even in healthy economic times.

2) Threat to community.

Look again at the relatively quiet streets of Mexico City, empty football stadiums, take-out-only restaurants, no Sunday Masses at the churches, locked stores and you can see another difficulty. An odd, almost criminal-looking anonymity takes over the scene as people go everywhere wearing a mask. (The banks sure could have trouble telling who is a robber and who isn't.) Isolation does not build community. Nor does fear of even friends who may be carrying some disease. The 75 - 85% of us who won't even get the flu will still know someone who did. We may even know someone who dies from it.

Grief, fear, uncertainty could become the words to describe us.

But for now- things are actually relatively quiet. The "experts" are saying the H1N1 virus may not be as dangerous as expected. They are thinking it doesn't have the "staying power" nor the right genetic make-up to keep it exploding. I will keep watching the news, but will no longer be holding my breath....

Until the next time.

A Shift of Perspective

Bruce Sterling at Beyond the Beyond at Wired.com give an interesting response to the current news on the Swine H1N1 Flu:

People freak out over "pandemics," even though we've got one of the worst pandemics in history, AIDS, raging through the carcass of the body-politic right now. Every once in a while you see a street demo or a charity show about AIDS. Carla Bruni is pretty big on fighting AIDS. Otherwise we just drop dead of AIDS in hecatombs, and the pandemic has become our business as usual. AIDS is an extremely fearsome disease, practically 100% lethal, yet it's hard work to get people to remain properly afraid of it.

*There is always some flu around and flu is always killing some people. Even when a raw mutant flu manages to kill off more people than a shooting-war, flu has never ravaged whole cities as cholera or the Black Death can do. As awful pandemics go, flu is like the snotty-nosed little sister of awful pandemics.

*So if you catch the new swine flu, you're very likely not gonna die.

*But since it is a flu, you're gonna kinda WISH you could die.

*You're not ACTUALLY gonna die unless your lips are turning blue, you have bad chest pains, you can't swallow water, you can't stand up, you're having seizures and you don't know where you are or what your name is. As this document suggests, you're gonna want to watch out for those symptoms.

While this doesn't take way the pandemic threat or its implications (more on Friday), it does give us a perspective to start with.

--HT to Cory at Boing Boing

Another place to go for a quiet and relatively sane approach to the whole issue of "pandemics" is at LiveScience with a video from Dr. Marc Siegel with the Truth About Pandemics. I think overall that we have to keep a calm approach to all this and we will lessen the psychological impact of even a serious pandemic.

A New Black Swan

Surprise, surprise- Swine flu.

Did you know it was out there? Did the government know it could be a pandemic threat at any minute? What about that really possibly dangerous bird flu?

This could be an example, I believe, of what Nassim Taleb called a Black Swan- something that appears to come out of nowhere and changes the world. Whether or not it truly is a Black Swan will have to wait for further developments. But it does seem to prove the idea that the BIG BAD THING you are looking for to get you usually won't. It's the BIG BAD THING that you have no idea is out there that will.

So- is the "swine flu" going to cause a pandemic? It has been interesting in a scary way to see what has already happened in just a few days. Last Thursday we had never heard of it. By Friday evening it was top news. Yesterday the government declared a public health emergency.

Obviously the Mexican government and officials are very worried. The Catholic Church canceled all masses yesterday and a sold-out soccer match was held- with no spectators.

One of the things that could keep this from being a disastrous black swan is that we have been preparing for a flu pandemic for a few years now. Some of what has already been put into place since Friday is a result of that preparedness. That does not, however, lessen the potential for a major problem if this ends up as The Pandemic. The economic and personal costs could be enormous. Public health plans, including I am sure, quarantine regulations, are at some state of readiness.

Again, it shows us the potential fragility of the social order and social networks that we take for granted. The question I have seen asked on a number of web sites: "Is this the big one or the "flu that fizzles." A few weeks from now this may look like Chicken Little crying that the sky is falling. Or it could turn into truly horrific and culture changing event.

I'm praying for Chicken Little myself.