Here We Go!!!! My kid has swine flu...

Just got back from the doctor, and my 13 year old tested positive for swine flu.

THE GOVERNMENT has issued orders to all doctors to no longer treat patients with Tamiflu unless they are bad enough to be admitted to the hospital. They don't want to run out.

Thankfully, my doc gave it to her anyway, so I am hoping I don't have to worry about her getting that bad.

So, I will be giving periodic first hand accounts of the progression of this thing so that FReepers can hear it first hand, rather than relying on the media to tell you how it is.

Her throat started feeling scratchy on Wednesday evening, but she was fine. By 12:30 today, she had a fever of 102.8. She just took her first dose of Tamiflu, which by the way cost 120.00, and that was after our discount. They won't be making any money off of this, will they??!!!!!!

While I might seem lighthearted about this, I am worried. I have two younger children, and my own health problems as well. Being spooked by the media hasn't helped.

If you don't mind, any of you so inclined please say a little prayer for my girls.

http://www.singtomeohmuse.com/viewtopic.php?t=3577&start=0

Brief Summary of current Flu Pandemic Status and Likely Short-term Outcomes

How does Swine flu differ from “regular” flu?

The swine flu aka H1N1 Pandemic flu is not “mild” as the CDC (THe US Center for Disease Control) and WHO (The World Health Organization) have been saying (but have now changed the message to “moderate severity”). Some authorities are saying that the only difference between swine flu and regular seasonal flu is that people have no immunity as it is a novel flu virus, and therefore more people will become infected. While this is true, there are more reasons why swine flu is different from seasonal flu, and people who say this is the only difference are either ignorant or purposely misleading.

The swine flu is attacking people in the warm summer season which regular flu does not; it is attacking a large proportion of children, young adults and middle aged adults seriously, and killing a larger number of them. It is attacking pregnant women particularly severely. The symptoms are much more severe than with seasonal flu, including severe lung damage.

The CFR – Case Fatality Rate – appears to be much higher than seasonal flu (since there are no accurate numbers, the precise CFR is not known), as more people are dying in the spring and summer than regular flu, more young and middle aged people, as well as people with no underlying medical problems. Deaths from seasonal flu are almost exclusively the very old and infants. The CDC’s internal (and leaked) figures show much higher rates of death for the non-elderly than regular flu.

Death Rate of Regular Seasonal flu and Swine Flu compared

In 2003 the CDC starting claiming that 36,000 people a year died from regular flu. This number is constantly compared to the current pandemic to persuade people not to “panic” or be concerned. Where did this number come from?

According to twenty years’ worth of “cause of death” reporting data from the National Center for Health Statistics of the Centers for Disease Control and Prevention, influenza is the official cause of death for an average of 1,263 people in the United States each year. Indeed, the CDC’s most recent official tally of death by influenza indicates that only 849 people died of influenza in 2006. These very low numbers would seem to contradict the often cited figure of “36,000 flu-related deaths per year” in the United States, which appears on the CDC’s own web site.”

The 36,000 number comes from statistical modeling; comparing pneumonia or other similar deaths in the winter and summer. It is not derived from numbers of people known to have died from flu, or people tested for flu, or even generalized lists of people dying from flu. Additionally, 95% of flu deaths are of people above the age of 65, and most are even older. They are people who are already near death from others causes, seem to get sick with “something” and die.
On the other hand, the people really dying from swine flu are mostly younger people, many of who are perfectly healthy. It is true that swine flu is easier to catch as no one has ever had it before and therefore has no immunity to it.

“Underlying Medical Conditions”

The media and government authorities are quick to point out that so far most people who have died from swine flu (deaths that are made public) have “underlying medical conditions”. Often these conditions are not mentioned. In fact, some people who die with swine flu are not counted because the victim had other health problems. The CDC has mentioned some of the underlying conditions that people who have died have, and they include immune disorders, kidney disease, lung impairment, chronic or congenital disabilities of various kinds, and more. It is also very noteworthy that pregnant women are in much more danger of getting seriously ill and dying. But approximately 1/3 of deaths are previously healthy people who just got the swine flu and died.

What Are The Real Numbers?

Unfortunately the WHO and the CDC are not transparent with numbers or a lot of information. They appear to have inflated the numbers of cases in the US to help bring down the CFR (case fatality rate – of the total sick, how many die) since the more people who are sick, the lower the death rate), and they do not count deaths quickly or accurately for the same reason. Tests are not accurate, to varying degrees, and often reports say something like “so and so died, not of swine flu, but of another medical cause, although they happened to have swine flu” so the person is not counted as a pandemic fatality. When Mexico first started having many swine flu deaths in early spring, the WHO refused to accept their numbers and started over from zero, after Mexico had counted and tested at least 150 deaths. In poor countries people are dying in the villages and not being counted, this is a given.

Currently in Argentina the CFR may be around 4%. And that is not even counting deaths of poor people outside of cities. Many people in the US, Canada and Australia are in intensive care in hospitals, on mechanical ventilators with round the clock nursing. Without this advanced medical care, most of these very ill patients would not survive.
First hand reports paint a different picture than news – reports from Paraguay, Thailand, Argentina and Mexico – among other places – indicate a much higher number of sick and dead, as well as hospital overcrowding and even collapse.

Hospitals, Doctors and Nurses

In Australia and countries in South America where it is the regular flu season as well as in England, there are so many people sick that hospitals are over-crowded, non-essential surgeries are being cancelled, there is a shortage of nurses due to sickness, doctors’ offices are over-crowded, and there are not enough Intensive Care beds for the patients who need them because of flu. Emergency medical personnel’s response time is much slower as they are swamped. There are reports that in Argentina and other SA countries some hospitals have been overwhelmed. All the prospective models for pandemic have shown that hospitals will collapse when a pandemic reaches a certain point, as already hospitals have a hard time dealing with a sick public. Emergency rooms are already full.

Figures have shown that 10% of the fatalities in Argentina have been health care workers; in the last few days many of the deaths in India have been health workers, and emergency responders and some doctors have died in the UK and Australia. Nurses in California protested after a nurse in Sacramento died; the nurses were not being given proper PPE (Personal Protective Equipment such as gowns, masks, and gloves.)

Also, many nurses and doctors have stated that when a pandemic becomes very dangerous they will not work but stay home rather than risk working in unsafe hospitals and risk getting sick or dying. Hospitals do not have enough PPE- personal protective equipment – to avoid contracting flu, and the US government is irresponsibly not mandating the use of PPE such as N95 masks for health care workers.

What About Anti-Viral Medicines?

The only anti-virals that work for the swine flu are Tamiflu and Relenza. There is another class of anti-virals but they do not work for this flu. In the last couple of weeks there have been scattered cases around the world in several countries of Tamiflu-resistant swine flu. This can be ascertained by people who do not get well despite receiving Tamiflu, but more definitively by checking the genetics of flu samples for the gene that causes the resistance. Just in the last day or two it is known that there have been Tamiflu resistant cases of swine flu in southern Texas. If swine flu becomes resistant to Tamiflu, there will be no pharmaceutical drug to stop it. There is not very much Relenza manufactured, and it cannot be used for children or people with breathing difficulties such as asthma; as it is an inhaled powder that can cause breathing difficulties.

Also, since one of the main regular seasonal flu viruses is already Tamiflu resistant, if this and swine flu “mix and match”, which is very possible, the swine flu may pick up the resistance gene easily, as it is dominant (since almost all seasonal flu H1N1 became resistant to it in one year). So it is very possible and a cause for concern that swine flu will become resistant to Tamiflu. If and when this happens, it will accelerate the spread and the deaths.

Aren’t They Making Vaccines Now?

There are many companies working on making swine flu vaccines. Apparently they are not growing well in eggs, the regular methods of making flu vaccines; only 30 to 50% antigen is being grown in the eggs, so it will take longer to make the desired amount of vaccine. Also, they will not be testing the vaccine for safety due to the rush of trying to make enough for the pandemic; they will only test to see if the volunteers created antibodies to flu. Some of the vaccines may contain adjuvants, which are small amounts of toxic irritants added to vaccines to stretch the virus material when it is scarce; they aggravate the immune response of the body and there is controversy about their safety. Up until now they have not been allowed by the FDA (Food and Drug Administration) in vaccines but are allowed in Europe for older people, who do not react as well to vaccines (plus won’t live as long for long term side effects to manifest).

Additionally, much of the vaccines will have the controversial preservative Thimerasol, a type of mercury that some people think is a cause of autism (others consider it perfectly safe). People will have to ask if their vaccine is Thimerasol free.

Also, people will need two doses of pandemic vaccine, a few weeks apart, and it will be a couple of weeks after that they develop immunity (to whatever degree that the vaccine confers immunity; it is never 100%, seasonal vaccine is considered to be around 70% when the seasonal flus have not changed from the target; the swine flu vaccine may not have as much protective potency). There will not be enough for the entire population of the US, and there are tiered layers of priority recipients of the proposed vaccines. The figures vary and the messages from the CDC are contradictory and change daily, but apparently there won’t be enough for most people in the US until at least spring. By that time, the flu virus may well have mutated and the vaccine may not work for it; just as a new vaccine needs to be made every year because flu viruses mutate rapidly.

What About Bird Flu – Is that Still a Danger?

H5N1, or bird flu, is still circulating and killing people primarily in Indonesia and Egypt, as well as other Southeast Asian countries. The numbers are very difficult to ascertain as the governments cover up figures to protect their economies, just as is happening here with swine flu. There is definitely a danger that H5N1 and swine flu could “mix” by one person catching both at the same time. The different flus could exchange genetic material and create a new hybrid flu, which could possibly have the higher fatality rate of H5N1 and the easy transmissibility of swine flu. This is something many virologists are nervous about. Or H5N1 could develop by itself and become more easily transmissible, as well as develop Tamiflu resistance. So this is still a potential danger.

Don’t Most People Get Well?

So far, most people who get swine flu get well, but even at this point in the pandemic more people do die than with regular flu. There are two reasons why pandemic flu is different and more dangerous than regular seasonal flu. With seasonal flu, 5 to 15% of the population get sick, very few are seriously ill, and fewer yet die (and the vast majority of deaths are in the elderly). With pandemic flu, because it is a newly developed strain of flu, no one has any immunity to it, so it spreads very rapidly and widely. The estimates are that 30 to 40% of the population will get it within one year (roughly). (There is a possibility that people who were alive in the 1918 pandemic may have some immunity as it is a similar virus but those people are very old and few in number.) With huge numbers of people sick all at once, there is much more potential for infrastructure breakdown and supply disruptions (more on that later), and hospitals being overwhelmed.

The other difference is that swine flu is more lethal and causes more severe symptoms in many people than regular seasonal flu, including much more severe lung damage. People are getting relapses – feeling better, then worse.

Similarities with the 1918 Pandemic and Swine Flu Pandemic

The 1918 pandemic had an early spring wave of illness that started in March, just as this did. The first wave did not hit all over the world; some places had more respiratory illness, some less, and only some people died; often those already sick with other ailments. People at the time did not know that it was the first wave of a deadly pandemic until later in the fall. More people died - especially younger people and vigorous adults - than with regular seasonal flu, just like this one.

In late August and early September of 1918, a more severe wave of flu popped up in different places in the world at the same time, and within a year had killed tens of millions of people around the world (the estimated figures are 50 to 100 million). The case fatality rate is not known precisely, it seems to have varied between 2 to 5%. Some areas had very high fatality rates – entire villages were wiped out – and other places had milder levels of fatalities. There was a third wave in the spring that was worse than the first wave but not as bad as the second wave. The only country in the world with no deaths was American Samoa, as they refused to let any ships dock and bring the disease in.

During the 1918 flu, there were so many dead that in some areas the corpses could not be buried, and so many children lost their parents that “orphan trains” headed west, stopping at stations for people to pick children to take home. Many doctors and nurses died and hospitals could not contain the sick. At least 25% of pregnant women who caught the flu died.

All authorities are currently warning that in the fall there will be much more swine flu spreading. Whether there will be increasingly severe illness and death is not known but at the very least, the more cases, the more sickness, the more deaths. If the virus mutates and becomes more deadly, then deaths and the possibility of infrastructure disruptions is even more likely.

How Does Swine Flu Cause Death?

There is a possibility that there are several strains of swine flu circulating – some are more severe, some less. The genetic details are carefully hidden by governments and scientific organizations for their own economic reasons. But there is news that the swine flu is mutating rapidly and is a totally novel strain of flu with some swine, some avian and some human elements. Some mainstream experts think it may have been tinkered with in a laboratory as it is very unusual, and there may be several strains circulating. Additionally there is the possibility it can become more virulent by natural mutation, as has happened in the past.

Swine flu, unlike regular seasonal flu, can cause multiple organ failure including kidney failure, heart failure (which can be caused by regular flu as well), liver failure and of course lung failure. Cyanosis is sometimes caused by swine flu; blood vessels break down causing a bluish or blackish color to the skin, as happened in the 1918 pandemic. Swine flu often causes diarrhea, vomiting, sore throat, stomach pain, severe headaches, exhaustion, eye pain, nausea, lack of appetite and dehydration, as well as severe body aches. It does not always manifest with a fever. Shortness of breath and coughing are of course standard. (Some of these very severe symptoms are also common in H5N1 patients.)

The difference with swine flu is that people can quickly deteriorate and lose lung function altogether. There are many hundreds of patients on mechanical ventilators, often for weeks, in order to keep them alive. Some have been put on heart lung bypass machines as well. People who receive these treatments (if they survive, usually about a 50% survival rate roughly) often have lifelong chronic problems. Once more people get sick all at once, hospitals will not be able to take care of everyone who needs intensive care, and more people will die as a result.

Some cases of swine flu have had meningitis – the virus can attack the brain and cause neurological problems as well. The US media has rarely described any swine flu symptoms in detail, but in the South American media there have been descriptions of children having convulsions and vomiting blood. In 1918, many of the survivors of the flu had lifelong chronic ailments, including severe neurological impairment. Another similarity with the 1918 flu is that some people have gone from being well to extremely sick in a very short time frame.

Why Would a Pandemic Affect Food, Water or Electricity?

In the last ten or twenty years, the phrase “Just In Time” economy has pretty much eliminated warehouses. Food, parts, supplies are all trucked in as needed, from far away, to giant warehouses in the middle of the country. A breakdown in personnel due to illness will greatly disrupt this constant flow of parts, supplies and foods. All government modeling has agreed that a breakdown of infrastructure is a very real danger in a pandemic. Electric generating plants have fuel – coal, gas, or oil – brought in by truck or rail weekly; few plants have more than a week or two of fuel on site. No companies have many extra workers who know how to run things, so with a possible 30 to 40% absenteeism rate (this is expected at the height of a pandemic, due to sickness, death, fear of sickness or death, or workers staying home to take care of ill family members), many companies would not be able to function.

If electricity supply is disrupted, this can affect entire grids, as has happened before in the last few years. If many electric workers are sick, making repairs and restoring electricity would take longer. Without electricity, most stores cannot sell goods, and water will not run, nor will water treatment plants work. Without electricity, no one can sell or pump gasoline. Although some cities have gravity fed water (with large water tanks on legs or on hills), it takes electricity to purify the water, and to pump it up into the tanks. Without water, toilets do not work. Internet would also be affected by electricity disruptions. Food supplies can be affected by electricity problems as well; for instance, lack of refrigeration, and cash registers don’t work. Supermarkets refill their shelves every night and have about three days’ of food in them at the most, no warehouses close by as food is trucked in from huge depots hundreds of miles away. It has been determined that large cities such as New York have two or three days’ of food. Everything comes in from far away.

Additionally, since many parts and supplies are now manufactured in other countries – many in China and South East Asia– the pandemic there will affect factories and disrupt supplies here. Most pharmaceutical drugs as well as medical supplies such as masks are made in other countries, as well as tools and parts, and household goods from shoes to toothbrushes. With any disruptions in electricity and/or water, fire departments and police departments will not function properly, causing numerous other problems easily imagined; aside from problems due to absenteeism.

Why Isn’t the Government Advising People to Prepare Realistically?

Many people think that because they don’t see the message to prepare for a pandemic on the TV or in the regular media, and the local or State Public Health departments say nothing, or their schools send no memos home, and the State and Federal governments haven’t made any alerts, that there is nothing to worry about.

Actually, the WHO, the CDC and other official entities have clearly stated that economic and political concerns are actually more important when making pandemic preparation decisions, than individual lives lost. That is the bottom line – the fragile economy must not be disturbed under any circumstances, and any lives lost as a result are acceptable collateral damage. If people buy rice and beans instead of racking up their credit cards buying useless junk and eating out, if people change their habits and save money instead of squandering it, or prepare to stay home, this will disrupt the economic train (which is going off a cliff anyway). If people are going to wait until an official government announcement, they may as well wait until people they know are seriously sick and dying.
The US government (as well as the WHO and other nations) have been “planning” for influenza pandemic for several years – many millions of dollars have been spent, meetings held, and plans made. Yet now, the US government is acting as though they are just making plans this minute. Their previous plans include (but even their plans are not all in accord with each other) advising families to have weeks of food, water and other necessities on hand, medicines to care for the sick, cash on hand, and a full gas tank. Federal pandemic plans have also mandated the use of the military for quarantining infected cities, and the restriction of travel.

What’s Happening Now? And What Will Happen Next?

First of all, in the last few weeks, there has been a tremendous acceleration in the number of countries with swine flu – only a few have no reported illness (most likely because they haven’t tested anyone), and more and more countries are reporting deaths. The acceleration is also speeding up – in fact the WHO did say that this pandemic has spread with “unprecedented” speed. Countries with H5N1 in humans – such as Egypt and Indonesia – have rapidly spreading cases of swine flu, with reports of people with each illness in the same locality or even same hospitals, thus increasing the chances of a co-mutation happening. In the last few days, deaths in India have gone from one or two up into the dozens, and what may be happening in villages is unknown. They have closed movie theatres, schools and many public places in the last day to try to halt the spread. Argentina has officially almost 500 deaths, with hundreds of deaths awaiting testing. Argentina has closed schools and public gatherings in an attempt to slow the pandemic. Other countries such as Paraguay have closed schools in an attempt to slow the spread.

In the US, several states, including some of the hardest hit, appear to have stopped publicly reporting deaths. The states report directly to the CDC, which updates the national death toll once a week. Unfortunately the method is confused and inaccurate, so the real picture either in this country or other countries is unknown; one thing for certain is that the actual cases and fatalities are much greater than any official numbers.

As to what will happen in the next few months, it is extremely unlikely that the swine flu will peter out and go away. Most likely, and there is practically no disagreement on this, it will spread ever more widely and cause many more cases of severe illness and deaths. This will happen even if it does not mutate and become more fatal, or mix with H5N1. If either of those happen, then it will correspondingly become even more dangerous. The possibility of Tamiflu resistance is becoming more likely, with more cases of Tamiflu resistance showing up in more countries this week. Many people have survived because of the early administration of Tamiflu; without this anti-viral drug, many more will die. No one knows for sure if there will be a second and third wave of flu as there was in 1918; and swine flu has not stopped in the Northern Hemisphere even as it spreads in the Southern.

When more public schools open in the fall, the swine flu will undoubtedly spread much more widely, as it is a fact that school children are vectors for flu, and then take it home to their families, who spread it among the community. Many countries have closed schools to try to stop the spread; the UK has proposed not even opening schools this fall (in Britian many schools were closed in the beginning of the pandemic; when they re-opened there was an immediate spike in cases), and France has stated it will close schools if there is widespread flu. Unfortunately the CDC is opposed to school closures. The schools in the US will only close locally, either when there are so many teachers sick that classes cannot be taught; or when deaths of children are so high that parents refuse to send their children.

In 1918, the novel flu virus gradually lost virulence and replaced the regular seasonal flu; but for the next several years after the pandemic, the flu season was worse than before, with more illness and deaths, so that could happen with the swine flu. No one can say for sure what the future holds; but one thing is certain – any individuals or households who pro-actively prepare themselves for food shortages, possible infrastructure disruptions, and local severe illness are much more likely to pass the next year or so unscathed, than those who do not.

Conclusion

• Hope is not a plan – some areas may be less disrupted than others, some areas more. No place on earth will escape illness and deaths (even American Samoa has had deaths).

• For the reasons cited above, so far the evidence suggests that the best case scenario is sickness and death rate similar to the “Spanish Flu” of 1918, the worst case could be a pandemic of much greater fatality rate; especially if H5N1 comes into the picture.

• In 1918, more people lived in rural areas, more people produced their own food, cooked from scratch, stocked pantries, and lived in general a more self-sufficient life, and depended on locally produced goods. Many areas had no electricity and wells were often wind powered.

• With many people depending on the government for all their needs, with the potential for infrastructure disruption as well as the current economic depression, there will be a great potential for social disruption and lawlessness not seen in the 1918 pandemic.

• The probability of collateral damage is great – if fires cannot be put out, if too many police are sick or absent, law enforcement can break down, if hospitals are overwhelmed people can die from conditions that would otherwise be treated, if supply chains break down shortages of many necessities will likely occur – all these could impact collateral deaths.

• Anyone expecting others to take responsibility for their wellbeing and safety will be in for a rude shock, in the very near future.

Link to an excellent Self Sufficiency Manual:
http://www.singtomeohmuse.com/parent/wiki%20files/Becoming_Self-Sufficient[1].pdf

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