What is CFR? I keep seeing this and don't know what it means.
Sorry - I've been spending a lot of time on FluWiki and CurEvents the last few days.
CFR is Case Fatality Rate, the percentage of deaths of those who contract a disease. There is another term for what percentage of the population contracts a disease, can't remember that term.
Many people are assuming that the CFR will reduce tremendously if/when H5N1 is easily transmissable H2H, but others disagree. It's all pretty much either informed or ill-informed speculation from what I can tell. But I'm an uneducated less than layman.
I'd rather not get it than hope that I'll be one of the ones that doesn't die. And even the survivors of the 1918 flu often suffered from all kinds of health problems afterwards.
Another detail I just remembered is that apparently the attendees were told that Tamiflu does jack.
I just got FW. Here's the relevent comments and the link again: (the format of FW is "funny" right now; also, there are other very informative comments on the thread. I'm just copying the ones that kind of hit me over the head.)
http://www.fluwikie2.com/pmwiki.php?n=Forum.Checkmate
Anon in NH at 16:31
I am waiting for a call from a friend who is at a high level of state government. He is going to debrief me as to a meeting his department had today. His wife, who did not have tons of details, told me that, Things are not good, and there is going to be an announcement in the next 10 days.
Whether that announcement will be made by our states leadership or at the federal or international level, I do not know.
I have no further information at this time, and I must be away from the computer for the next hour or two.
I will post more as I learn it, probably later tonight.
Anon in NH at 18:18
okcinder at 17:57 I may have missed something earlier on. Do we have any reason to believe that Anon in NHs friends information is bird flu or disaster related?
It is. Sorry. I just assumed that was obvious given the thread Im posting to. There has been a lot of activity at the state level per this friend. Essential workers in his dept. signed up two days ago on a hush-hush list to receive packages containing antibiotics for themselves and family members. That same day, the meeting to which I referred earlier was announced for today. The meeting was held. The five-second summary, Its not good, and there will be an announcement in the next 10 days is a direct quote from my contacts immediate family member. As I said before, Ill post after I hear from him directly. I have no idea what type of announcement or at what level/from what direction it is to come.
It just dawned on me that this information meshes with something posted last week I believe (by Nann?) that her relatives who work at Boston hospitals were told there would be an announcement in the coming days. Cant remember what thread at this point.
Stay tuned.
Anon in NH at 20:32
Hi, All,
Spoke with my contact, and the long and short of it is this: The federal government is apparently going to announce updated pandemic management recommendations in the next week or two in a coordinated announcement to the public and states. States will be expected to bring their pandemic plans into compliance with the federal recommendations. The recommendations sound like a sweeping endorsement of the IOM recommendations (discussed at length in threads here a couple of weeks ago courtesy of anon_22).
The specific recommendations my friend mentioned that are being endorsed by the feds are:
1. Early school closure
2. No international travel
3. Cancel public events
4. Prophylactic treatment with antivirals (see note below) of household members of the sick
5. Social distancing
6. Voluntary quarantining
7. Leaning away from directing strategic stockpiles of antivirals to health care workers and first responders
Other highlights of the meeting include
Goal: The goal of adopting the above recommendations is to decompress the peak and hopefully allow a degree of more managed chaos in health care and other infrastructure. The downside is it means people are going to need be ready (and I quote) to hunker down for a longer period of time than if the peak were short and steep.
Antivirals: As far as using antivirals prophylactically, that recommendation is in direct contradiction to another announcement that was made at the meeting stating that Tamiflu is not effective against H5N1. According to my contact, the meeting attendees were told Relenza may be effective. (Of course, we here all know theres even less Relenza availability than there is Tamiflu, so thats a moot point.)
Vaccine Development: Apparently, H5N1 is supposedly killing the embryos in which the vaccines are to be cultured rendering that method of vaccine development ineffective. I dont know enough about this to make heads or tails of this info or to tell if what he was saying was totally off the mark. I did confirm with him in no uncertain terms that the meeting attendees were explicitly told that there would be no vaccine available. I know there have been comments on the wiki relating to the fact that testing for H5N1 cannot be done effectively using poultry embryos, but I havent paid close enough attention to that topic and didnt have any insightful questions to ask him to get more detail. Sorry.
Planning Assumptions: As near as I can tell from what my friend told me, the planning assumptions are ridiculously low. My contact stated 1% CFR. I told him that was crazy. He responded by citing the mantra, Will swap virulence for efficiency. He knows I dont buy that, but I didnt want to push him on it and risk alienating him. (For anyone in NH, the good news is that only 4,000 are going to die. Phew!)
Mask Use: Heavy emphasis on use of N95 masks, or, in a pinch, surgical masks with pantyhose over them. Supposedly this has been shown to be as effective as N95s. As you all know, thats not exactly a claim to fame.
Duration: Those in attendance were told to expect multiple waves that could last up to three years. That number startled me. I pressed him on this point to clarify whether he meant that subsequent seasonal flu seasons would be especially bad in the years immediately following the pandemic. He was firm that he was told the pandemic could last up to three years with time to restock between waves.
Trigger: Heres the rub, folks. All of these measures will hinge on WHO announcing efficient H2H. I think we all agree a pandemic could be halfway around the worldliterallybefore that happens. For that reason, let me reiterate the critical point that NS1 made at 19:36
The only way we will know that PF51 has started will be when R0 rises, and the only way well know that number is in retrospect from watching the size of clusters and the deaths of HCW (post-facto). Information control will be the norm, so our back channels like FluWiki lookout posts will be the only hope of having advance notice.
nd that, folks, is all she wrote. Hope this helps.