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Swine origin influenza A (H1N1) virus and ICU capacity in the US
PLoS Currents ^ | Aug 22 2009 | Marya D. Zilberberg, Christian Sandrock and Andrew Shorr

Posted on 08/23/2009 2:17:41 PM PDT by Brugmansian

We calculate that 46 million people will contract the infection, resulting in 2.7 million hospitalizations, 331,587 episodes of ARF-MV and nearly 200,000 deaths, suggesting that the US may require the ability to provide MV at a volume approximately 33% over the current annual use . . .

(Excerpt) Read more at knol.google.com ...


TOPICS: Business/Economy; Culture/Society; Government; News/Current Events
KEYWORDS: flu; h1n1; icu; influenza; swineflu
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ARF=Acute respiratory failure

MV=Mechanical ventilation

Note they are basing the model on a 0.5% fatality rate. This is the number the IHT and others have reported Hiroshi Nishiura and his fellow epidemiologists at Utrecht University are about to publish in PLoS. The study is based on US and Canadian deaths. 0.5% would make this flu as deadly as the 1957-58 Asian flu.

1 posted on 08/23/2009 2:17:41 PM PDT by Brugmansian
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To: Brugmansian
"0.5% would make this flu as deadly as the 1957-58 Asian flu. "

I've thought all along that this wasn't something to be trifled with or mocked, in any way. It's certainly deadly serious business, and possible very deadly serious business. Just think what the pandemonium will be if the strain mutates and becomes just incrementally more lethal - say a fatality rate at 1.8% to 2.2%. It would be a disaster.

2 posted on 08/23/2009 2:23:38 PM PDT by OldDeckHand (No Socialized Medicine, No Way, No How, No Time)
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To: Brugmansian

lol what to do?


3 posted on 08/23/2009 2:24:05 PM PDT by dalebert
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To: Brugmansian

how do we protect our families?


4 posted on 08/23/2009 2:25:52 PM PDT by dalebert
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To: dalebert

Protect yourselves by stocking up on sauerkraut...I kid you not. Make sure its not the pasteurized kind. Better yet, make your own. It takes about 6 weeks to get good fermentation going.


5 posted on 08/23/2009 2:30:00 PM PDT by crymeariver (Good news...in a way)
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To: dalebert

Here’s a good place to start:

http://singtomeohmuse.com/viewforum.php?f=1&sid=36473aac02d812652f1bd981fc4a4d89


6 posted on 08/23/2009 2:31:09 PM PDT by Tucker822
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To: OldDeckHand

IMHO, the real danger is not mortality, but the morbidity. In our sustems based society, what happens if %25 of the population is ill leading to an abseenteeism rate of ~ 40% (sick + those staying home to take care of the sick kids & spouses + the worried well).

Supermarkets have about 18 hours of food for normal demand, gas stations have ~ 2 days of supply. Everything from ATMs to downed powerlines need a human in the loop and we currently run at 99% capacity in most systems as there is no profit on redundancy and slack.

In Colorado, we had a small dress rehearsal a couple of years ago when we had back to back weekend blizzards. Food stores had great difficulty re-stocking. As an indicator of the inconnectivity, there were new stories about travelers stranded at Heathrow when Denver shut down.

My favorite failed system thought? The Methamphetamine distribution “system”. Oh yeah, note to self: Buy more 00 Buck...


7 posted on 08/23/2009 2:32:26 PM PDT by redlegplanner ( No Representation without Taxation)
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To: dalebert

Immediately, start your family on D-3 supplements. This is a Fat soluble vitamin and is stored. Some good multi-vitamins and extra C.

Start putting away two weeks of food, stock up on a few good masks and hope for the best.

If Japan (who have tons of people stuffed into a smaller area) can make it through the bird flu, we can too.

Tons more people died of secondary infections than the actual flu in 1918. We have the best medical care on Earth. We’ll be fine.


8 posted on 08/23/2009 2:32:56 PM PDT by netmilsmom (Psalm 109:8 - Let his days be few; and let another take his office)
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To: OldDeckHand

BS, it is another phony crisis. Believe it if you want, I don’t and the end of the flu season this year will bear out my beliefs. Ya’ll better learn fast that every thing that can be made into a crisis for taking your money and freedom will be done, including this phony a**ed flu epidemic and the phony death rate.


9 posted on 08/23/2009 2:33:21 PM PDT by calex59
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To: redlegplanner
"IMHO, the real danger is not mortality, but the morbidity."

Yes, I agree completely and should have included that in my post. Higher fatality rates will probably indicate more people struggling with more severe and debilitating symptoms, and as you point out greatly increased morbidity.

There are some similarities between the trajectory of this flu and what happened in 1918 - early outbreaks in the spring, with manageable outcomes then a lull in the summer, then it struck with a vengeance in the late-fall. I don't think we are going to see anything remotely as bad as then, but even with disease that's only fractionally as dangerous will cause problems in the modern era that didn't exist back then.

10 posted on 08/23/2009 2:44:41 PM PDT by OldDeckHand (No Socialized Medicine, No Way, No How, No Time)
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To: OldDeckHand
I've thought all along that this wasn't something to be trifled with or mocked, in any way. It's certainly deadly serious business, and possible very deadly serious business.

It certainly is. There is a common and false belief floating around that past performance is a guarantee of future results. 1970s Swine flu turned out to be nothing, H5N1 didn't hit, SARS was contained so we are safe.

Absurd. The threat is always there. Infuenza A is a mutation machine. The genetic tumblers stop in the right position and we are right where we were in 1918.

PLoS has another contribution today:

First estimation of direct H1N1pdm virulence

From reported non consolidated data from Mauritius and New Caledonia

We provide rough estimates of direct lethality from ARDS due to H1N1pdm from two independent sources of data, one from New Caledonia where 30,000 infections are assumed to have occured and 3 deaths reported to be attributable directly to the pandemic virus.

Another source is Mauritius where 70,000 infections are estimated to have occured, and 7 reported death from ARDS (5 of them are currently confirmed).

These surveillance data allows for first estimation of direct lethality due to H1N1pdm to be 1 per 10,000 infections, about 100 times more than regular seasonal influenza.


11 posted on 08/23/2009 2:46:55 PM PDT by Brugmansian
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To: Brugmansian
These surveillance data allows for first estimation of direct lethality due to H1N1pdm to be 1 per 10,000 infections, about 100 times more than regular seasonal influenza.

That would mean roughly 3-4 million deaths in the United States.

12 posted on 08/23/2009 2:52:16 PM PDT by buccaneer81 (Bob Taft has soiled the family name for the next century. I AM JIM THOMPSON!)
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To: Brugmansian
Quick search found this, I thought this sounded familiar.

March 24, 1976: Ford Orders Swine-Flu Shots for All

President Gerald Ford orders a nationwide vaccination program to prevent a swine-flu epidemic. Ford was acting on the advice of medical experts, who believed they were dealing with a virus potentially as deadly as the one that caused the 1918 Spanish influenza pandemic

13 posted on 08/23/2009 3:04:35 PM PDT by MrPiper
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To: Brugmansian

In a discussion I read a couple of years ago concerning bird flu, it was stated that any pandemic flu with a high incidence of pneumonia could fairly quickly tie up all the respirator equipment in the US. I believe it said at the time that the US had about 80,000 respirators. - Whatever the number is, all such specialized equipment could be put use, and none be available for later victims with serious respiratory involvement.


14 posted on 08/23/2009 3:04:41 PM PDT by Will88
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To: buccaneer81
I believe the French study is only looking at those who develop ARDS. That is only a fraction of those who will get the disease. Among that group, the fatality rate is 100 times normal.

The OP estimates 200,000 deaths

15 posted on 08/23/2009 3:10:02 PM PDT by Brugmansian
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To: buccaneer81
"That would mean roughly 3-4 million deaths in the United States. "

Yeah, somebody's math isn't quite right - probably the doctor's given they went to medical school and aren't accountants.

1 in 10,000 dead would be significanly less lethal than the average seasonal flu, which kills anywhere from 35K to 50K each year, in the US alone. Of course, the difference is virtually all the deaths from seasonal flu come from much older and ailing people that have already compromised immune systems.

If this new strains starts to kill people who are actively engaged in the workforce, and it's distributed across the country, that's where some complexions will come from.

16 posted on 08/23/2009 3:20:09 PM PDT by OldDeckHand (No Socialized Medicine, No Way, No How, No Time)
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To: calex59
BS, it is another phony crisis. Believe it if you want, I don’t and the end of the flu season this year will bear out my beliefs.

The odds are in your favor, but to dismiss the threat outright is pretty foolish. Pandemics do happen, and some day there will likely be another deadly one. But the reality is no one knows today whether this will be a severe flu season or a fairly normal one. Everyone has to decide whether to take any out of the ordinary precautions.

17 posted on 08/23/2009 3:21:31 PM PDT by Will88
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To: Brugmansian; buccaneer81
"I believe the French study is only looking at those who develop ARDS. That is only a fraction of those who will get the disease. Among that group, the fatality rate is 100 times normal."

Yes, you are right. I should have read it more closely. After reading the following paragraph from your linked article, it makes much more sense...

There are not many assessments available with regards with the incidence of death from ARDS due to seasonal influenza in the litterature. Empirical evidence suggests in France that less than 5 to 10 of such cases are identified each year, when an average of 6 million seasonal infections are estimated from the French Sentinelles system [3]. We may therefore assume, waiting for better estimates in the future, that deaths from ARDS due to seasonal influenza is an exceptional event, which occurs once every million infected patients.

1 in 10,000 is much, much worse than 5/10 in 6,000,000.

18 posted on 08/23/2009 3:24:33 PM PDT by OldDeckHand (No Socialized Medicine, No Way, No How, No Time)
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To: Will88
to dismiss the threat outright is pretty foolish.

Like those who hang around when a CAT 5 approaches because the last one didn't hit.

Have a question for you. Notice an upswing this year of those concerned over vaccinations and/or dismiss the threat?

I am not making a judgement on those who do have objections to vaccines on various grounds. Remember when Dan Burton almost punched out Dick Armey over thimerosal. It is a legitimate debate.

However....I've never seen so much anti-vax rhetoric before. Brings out the cynic in me. Remember a few years ago when a foreign supplier had to trash its vaccine and start over? Liberals and the media went wild. Bush was going to kill the elderly because they would not get their flu shot.

For months Obama's HHS has been telling us we would have over 100 million doses by early fall. We won't. Probably not half what the HHS claimed. What vaccine will be here will be rationed. The elderly won't get it.

Could it be that the left is ramping up the anti-vax rhetoric to obscure the fact the HSS and Obama have been derelict? Liberals certainly aren't out bemoaning the fact the elderly will not get it when they should. I've even seen leftists claim the elderly are immune (some many have some immunity but as a group they are not immune).

19 posted on 08/23/2009 3:40:04 PM PDT by Brugmansian
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To: Brugmansian

No vaccine for me.

Stocking up on
NAC
curcurmin/bioperine
etc.


20 posted on 08/23/2009 3:47:53 PM PDT by RummyChick
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