Dog Brothers Public Forum

Politics, Religion, Science, Culture and Humanities => Science, Culture, & Humanities => Topic started by: Crafty_Dog on January 23, 2007, 05:08:35 AM

Title: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on January 23, 2007, 05:08:35 AM
The dilemma of a deadly disease: patients may be forcibly detained
Doctors fear TB strain could cause a global pandemic if it is not controlled

Chris McGreal in Johannesburg and Sarah Boseley, health editor
Tuesday January 23, 2007


South Africa is considering forcibly detaining people who carry a deadly
strain of tuberculosis that has already claimed hundreds of lives. The
strain threatens to cause a global pandemic, but the planned move pits
public protection against human rights.
The country's health department says it has discussed with the World Health
Organisation and South Africa's leading medical organisations the
possibility of placing carriers of extreme drug resistant TB or XDR-TB under
guard in isolation wards until they die, but has yet to reach a decision.

Pressure to take action has been growing since a woman diagnosed with the
disease discharged herself from a hospital last September and probably
spread the infection before she was finally coaxed back when she was
threatened with a court order.

More than 300 cases of the highly infectious disease, which is spread by
airborne droplets and kills 98% of those infected within about two weeks,
have been identified in South Africa.

But doctors believe there have been hundreds, possibly thousands, more and
the numbers are growing among the millions of people with HIV, who are
particularly vulnerable to the disease. Their fear is that patients with
XDR-TB, told that there is little that can be done for them, will leave the
isolation wards and go home to die. But while they are still walking around
they risk spreading the infection.

Now a group of doctors has warned in a medical journal that if enforced
isolation is not introduced XDR-TB could swamp South Africa and spread far
beyond its borders. Regular TB is already the single largest killer of
people with Aids in South Africa.


Jerome Amir Singh of the Centre for Aids Programme of Research in South
Africa and two colleagues wrote in the peer-reviewed journal Public Library
of Science Medicine that the government must overcome its understandable
qualms over human rights in the interests of the majority. Without
exceptional control measures, including enforced isolation, XDR-TB "could
become a lethal global pandemic", they say.

"The containment of infectious patients with XDR-TB may arguably take
precedence over any other patients not infected with highly infectious and
deadly airborne diseases, including those with full-blown Aids. This is an
issue requiring urgent attention from the global community," they wrote.

"The South African government's initial lethargic response to the crisis and
uncertainty amongst South African health professionals concerning the
ethical, social and human rights implications of effectively tackling this
outbreak highlight the urgent need to address these issues lest doubt and
inaction spawn a full-blown XDR-TB epidemic in South Africa and beyond."

Mary Edginton of the Witwatersrand university's medical school endorses
enforced quarantining.

"You can look at it from two points of view. From the patient's point of
view, you are expected to stay in some awful place, you can't work and you
can't see your family. You will probably die there. From the community's
point of view such a person is infectious. If they go to the shops or wander
around their friends they can spread it, potentially to a large group of
people," she said.

Karin Weyer of the Medical Research Council has called for enforced
hospitalisation of high-risk TB patients on the grounds that the risks to
society outweigh individual rights. But she opposes forcible treatment
because of the dangers associated with the drugs.

Professor Edginton said that medical authorities in the US and other
countries can obtain a court order to detain a person with infectious TB or
someone who is non-infectious but has failed to adhere to treatment. "The
Americans are much better at enforcing their laws on this," she said.

South African law also permits enforced isolation but some lawyers say it
comes into conflict with the constitutional guarantees on individual rights.
However, the constitution also guarantees communal rights, including
protection from infection and the right to a safe environment.

South Africa's health department yesterday said it has discussed the
possibility of enforced isolation with the country's Medical Research
Council and the World Health Organisation but has not reached a conclusion.

Poor housing

Ronnie Green-Thompson, a special adviser to the health department, said the
issue at stake is the human rights of the individual weighed against the
rights of the wider public. "The issue of holding the patient against their
will is not ideal but may have to be considered in the interest of the
public. Legal opinion and comment as well as sourcing the opinion of human
rights groups is important," he said.

"Also of importance is preventing those factors that lead to infectious TB
and these are poverty, poor housing, overcrowding and poor nutrition and any
other factors that weakens patients' resistance to acquiring infections."

Umesh Lalloo, of Durban's Nelson Mandela School of Medicine and head of the
research team into the first XDR-TB outbreak, said he is not persuaded that
detention is necessary.

"It's a very difficult call. Given our recent past with human rights
violations we need to be careful. I'm not dismissing such a move but it's a
very radical step. What we should be pushing for is a reinforcement of the
TB control programme which would contain the spread," he said. Professor
Lalloo said one consideration is that almost all infections appear to have
spread to patients in hospital.

The doctors and co-authors said that it is essential that patients were
detained in "humane and decent living conditions" and they urged the
government to change the rules so that those in hospital with TB continue to
receive welfare payments which are cut off if they are treated at the
state's expense.

Although cases of XDR-TB were discovered in South Africa a decade ago, the
disease started claiming dozens of lives at the small Tugela Ferry hospital
in rural KwaZulu-Natal two years ago. XDR-TB's origins are uncertain but the
WHO says the misuse of anti-tuberculosis drugs is the most likely cause.

Guardian Unlimited © Guardian News and Media Limited 2007
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on January 26, 2007, 12:19:20 PM

INDONESIA: Two pigs in Bali, Indonesia, have become infected with the bird flu virus, Chinese medical expert Zhong Nanshan said. The virus' detection in pigs raises concerns that the virus could be transmitted to people.
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on January 28, 2007, 05:52:34 AM
Today's NY Times:

Virulent TB in South Africa May Imperil Millions
Published: January 28, 2007
JOHANNESBURG, Jan. 27 — More than a year after a virulent strain of tuberculosis killed 52 of 53 infected patients in a rural South African hospital, experts here and abroad say the disease has most likely spread to neighboring countries, and some say urgent action is essential to halt its advance.

Several expressed concern at what they called South Africa’s sluggish response to a health emergency that, left unchecked, could prove hugely expensive to contain and could threaten millions across sub-Saharan Africa.

The director of the government’s tuberculosis programs called those concerns unfounded and said officials were doing everything reasonable to combat the outbreak.

The form of TB, known as XDR for extensively drug-resistant, cannot be effectively treated with most first- and second-line tuberculosis drugs, and some doctors consider it incurable.

Since it was first detected last year in KwaZulu-Natal Province, bordering the Indian Ocean, additional cases have been found at 39 hospitals in South Africa’s other eight provinces. In interviews on Friday, several epidemiologists and TB experts said the disease had probably moved into Lesotho, Swaziland and Mozambique — countries that share borders and migrant work forces with South Africa — and perhaps to Zimbabwe, which sends hundreds of thousands of destitute refugees to and from South Africa each year.

But no one can say with certainty, because none of those countries have the laboratories and clinical experts necessary to diagnose and track the disease. Ominously, none have the money and skills that would be needed to contain it should it begin to spread.

Even in South Africa, where nearly 330 cases have been officially documented, evidence of the disease’s spread is mostly anecdotal, and epidemiological work needed to trace its progress is only now beginning.

“We don’t understand the extent of it, and whether it’s more widespread than anyone thinks,” Mario C. Raviglione, the director of the Stop TB Department of the World Health Organization in Geneva, said in a telephone interview. “And if we don’t know what has caused it, then we don’t know how to stop it.”

Cases of XDR TB exist elsewhere, in countries like Russia and China where inadequate treatment programs have allowed drug-resistant strains of the disease to emerge. The South African outbreak is considered far more alarming than those elsewhere, however, because it is not only far larger, but has surfaced at the center of the world’s H.I.V. pandemic.

Although one third of the world’s people, by W.H.O. estimates, are infected with dormant tuberculosis germs, the disease thrives when immune systems are weakened by H.I.V. At least two in three South African TB sufferers are H.I.V. positive. Should XDR TB gain a foothold in the H.I.V.-positive population, it could wreak havoc not only among the five million South Africans who carry the virus, but the tens of millions more throughout sub-Saharan Africa.

People without H.I.V. have a far smaller chance of contracting tuberculosis, even if they are infected with the bacillus that causes TB. But because tuberculosis is spread through the air, anyone in close contact with an active TB sufferer is at some risk of falling ill.

Most if not all of the 52 people who died in the initial outbreak of XDR TB, at the Church of Scotland Hospital in a KwaZulu-Natal hamlet called Tugela Ferry in 2005 and early 2006, had AIDS. Most died within weeks of being tested for drug-resistant tuberculosis, a mortality rate scientists called unprecedented.

Since then, South African health officials say, they have confirmed a total of 328 cases of XDR TB, all but 43 in KwaZulu-Natal. Slightly more than half the patients have died.

Those numbers are deceptive, however. The Tugela Ferry outbreak was reported in part because the hospital there was part of a Yale University research project involving H.I.V.-positive patients with tuberculosis. Because South Africa’s treatment and reporting programs for tuberculosis are notoriously poor — barely half of TB patients are cured — virtually all experts contend the true rate of infection is greater.

“We’re really concerned that there may be similar outbreaks to the one in Tugela Ferry that are currently going undetected because the patients die very quickly,” said Dr. Karin Weyer, who directs tuberculosis programs for South Africa’s Medical Research Council, a semiofficial research arm of the government.

Some other researchers and experts say they share Dr. Weyer’s concern. They say South African health officials have lagged badly in assembling the epidemiological studies, treatment programs and skilled clinicians needed to combat the outbreak, and say the government has responded slowly to international offers of help.
Virulent TB in South Africa May Imperil Millions

Published: January 28, 2007
(Page 2 of 2)

Dr. Weyer said the council “shares the concern that not enough is being done, quickly enough, to get on top of the problem.” In particular, she said, officials have yet to carry out epidemiological studies or address a “shocking” lack of infection controls in hospitals that could allow TB and other infections to spread freely among H.I.V.-positive patients

“It’s an emergency, and we’re not reacting as if it were an emergency,” said Dr. Nesri Padayatchi, an epidemiologist and expert on drug-resistant TB for Caprisa, a Durban-based consortium of South African and American AIDS researchers. “I think we have the financial resources to address the issue, and we’ve been told the Department of Health has allocated these resources.”

Although the government was first told of the outbreak 20 months ago, in May 2005, “to date, on the ground in clinics and hospitals, we are not seeing the effect,” she said.

In KwaZulu-Natal’s major city, Durban, the sole hospital capable of treating XDR TB patients has a waiting list of 70 such cases, she said.

Dr. Weyer said the waiting list indicates that “capacity is becoming a problem” in KwaZulu-Natal, the outbreak’s center. “I’m quite sure we may find a similar situation in other provinces,” she added.

A spokesman at the hospital said it could not easily determine how many patients were awaiting treatment.

But the manager of South Africa’s national tuberculosis program, Dr. Lindiwe Mvusi, said such complaints were misplaced. The Durban hospital in question, she said, is under renovation, and officials are “looking for accommodations in other hospitals” while construction proceeds.

Hospitals in other provinces have enough beds now for XDR TB patients, and some are expanding isolation wards to handle any spread of the disease, she said.

She said other responses to the outbreak were under way, including a rough assessment of TB cases in hospitals nationwide. A more comprehensive national survey of TB cases may be conducted late this year, she added, and health officials in KwaZulu-Natal have begun surveillance programs to detect new cases of drug-resistant TB in the province.

Dr. Mvusi also rejected the notion that the tuberculosis had moved beyond South Africa’s borders. But in interviews, a number of TB experts and epidemiologists raised that concern, including Mr. Raviglione at the world health organization, Dr. Padayatchi, Dr. Weyer and Dr. Gerald Friedland, director of the AIDS program at the Yale University School of Medicine.

Dr. Raviglione of W.H.O. said that South African health officials were cooperating on responses to the outbreak, and that an official of his organization would arrive in Pretoria within days to discuss placing a team of global TB experts in the country.

“W.H.O. is ready to come to South Africa and to help in any place, for anything, whether surveillance, or detection, or infection control,” he said. However, those arrangements have not been completed.

Dr. Mvusi, the government’s TB program head, said global health experts were welcome, but “in an advisory role, because we want the capacity locally.”
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on February 02, 2007, 06:02:55 AM
Closings and Cancellations Top Advice on Flu Outbreak

Published: February 2, 2007
ATLANTA, Feb. 1 — In the event of a severe flu outbreak, schools should close for up to three months, ballgames and movies should be canceled, and working hours should be staggered so subways and buses are less crowded, the federal government said Thursday in issuing new pandemic flu guidelines to states and cities.

This Is Only a Drill Health officials acknowledged that such measures would greatly disrupt public life, but argued that they would provide the time needed to produce vaccines and would save lives because flu viruses attack in waves lasting about two months.

“We have to be prepared for a Category 5 pandemic,” said Dr. Martin S. Cetron, director of global migration and quarantine for the federal Centers for Disease Control and Prevention, in releasing the guidelines. “It’s not easy. The only thing that’s harder is facing the consequences. That will be intolerable.”

Officials are, for the first time, modeling the new guidelines on the five levels of hurricanes.

Category 1 assumes that 90,000 Americans would die, Glen J. Nowak, a spokesman for the disease centers, said. (About 36,000 Americans die of flu in an average year.) Category 5, which assumes 1.8 million dead, is the equivalent of the 1918 Spanish flu pandemic. That flu killed about 2 percent of those infected; the H5N1 flu now circulating in Asia has killed more than 50 percent of those infected but is not easily transmitted.

The new guidelines advocate having sick people and their families — even apparently healthy members — stay home for 7 to 10 days. They advise against closing state borders or airports because crucial deliveries, including food, would stop.

The report urges communities to think about ways to continue services like transportation and meal service to particularly vulnerable groups like the elderly and those who live alone.

The guidelines are only advisory, since the authority for measures like school closings rests with state and city officials, but many local officials have asked for guidance, Dr. Cetron said. The federal government has taken primary responsibility for developing and stockpiling vaccines and antiviral drugs, as well as masks and some other supplies.

The new guidelines are partly based on a recent study of how 44 cities fared in the 1918 epidemic conducted jointly by the disease centers and the University of Michigan’s medical school. Historians and epidemiologists pored over hospital records and newspaper clippings, trying to determine what factors contributed to the varying impact.

A few small towns escaped the epidemic entirely by cutting off all contact with the outside, but most cities took less drastic measures. Those included isolating the sick and quarantining homes and rooming houses; closing schools, churches, bars and other gathering places; canceling parades, ballgames and other public events; staggering factory hours; discouraging use of public transport; and encouraging use of face masks.

The most effective approach seemed to be moving early and quickly. “No matter how you set up the model,” Dr. Howard Markel, a leader of the study, said, “the cities that acted earlier and with more layered protective measures fared better.”

Any pandemic is expected to move faster than a new vaccine can be produced; current experimental H5N1 vaccines are in short supply and are based on strains isolated in 2004 or 2005. Although the government is creating a $4 billion stockpile of the vaccine Tamiflu, it is useful only when taken within the first 48 hours, and Tamiflu-resistant strains of the flu have already been found in Vietnam and in Egypt.

“No one’s arguing that by closing all the schools you’re going to prevent the spread,” Dr. Markel added. “But if you can cut cases by 10 or 20 or 30 percent and it’s your family that’s spared, that’s a big deal.”

School closings can be controversial, and picking the right moment is hard because it must be done before cases soar.

Several public health experts praised the guidelines, though there were objections to some aspects.

Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said he saw no point in worrying about exactly when to close schools, because his experience in meningitis outbreaks convinced him that anxious parents would keep children at home anyway.

“I don’t think we’ll have to pull that trigger,” Dr. Osterholm said. “The hard part is going to be unpulling it. How do the principals know when schools should open again?”

Other experts said that children out of school often behaved in ways that still put them at risk. Youngsters are sent to day care centers, and teenagers gather in malls or at one another’s houses.

“We’ll be facing the same problem, but without the teaching,” said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at the Mailman School of Public Health at Columbia University. “They might as well be in class.”

Dr. Cetron said that caring for children in groups of six or fewer would cut the risks of transmission. He also said that parents would keep many children from gathering.

“My kids aren’t going to be going to the mall,” he said.

The historian John M. Barry, author of “The Great Influenza” (Viking Adult, 2004), questioned an idea underpinning the study’s conclusions. There is evidence, Mr. Barry said, that some cities with low rates of sickness and death in 1918, including St. Louis and Cincinnati, were first hit by a milder spring wave of the virus. That would have, in effect, inoculated their citizens against the more severe fall wave, and might have been more important than their public health measures.

Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on February 07, 2007, 06:57:02 PM
From Bird to Person
February 7, 2007; Page A15

LONDON -- The "deadly" H5N1 avian flu is back on the front pages of newspapers and TV news shows. The British environment minister has pledged quick action to "eradicate" the disease from the U.K., and over 150,000 turkeys on one farm have been culled. "This is," someone said on the BBC's "Breakfast" show Monday, "a disease of birds, not humans." And so it is.

The H5N1 virus has still not made the critical interspecies leap which would make it easy for an infected person to give the disease to another person. That may happen, or it may not; and nobody can predict the outcome or its timing with any degree of confidence. Meanwhile, as of the World Health Organization's compilation on Feb. 3, there had been a total of 271 laboratory-confirmed cases of the virus in humans, and of that number a staggering 165, or 61%, died, making it one of the most lethal pathogens in history, even if not one of the most infectious.

Still, just 18 months ago many experts were predicting a global pandemic in a matter of months, perhaps one that would kill millions. There is historical precedent: The 1918-1919 "Spanish Flu" swept around the world in a matter of weeks, and before the disease burned out, more than 50 million people had died. Today H5N1 is reminiscent only of the Asian "Swine flu," which threatened the U.S. in 1976 but never turned into a serious threat to human life (although the media hype surrounding it helped undermine Gerald Ford's presidency). In 2004, worried people rapidly bought up much of the world's supply of Tamiflu and Relenza, the only two drugs that seemed to have a chance of beating H5N1. Now most of us have forgotten the names of these drugs.

Influenza viruses have eight genes and these mutate rapidly. Two sites on the viral genome, called H and N, are well catalogued, and each of those genes can come in many forms. Those are the markers that trigger the human immune system. If your body has seen a whiff of a particular virus, it will produce large numbers of antibodies if you later become infected with a strain having the same markers. If you have never been exposed to a particular strain, there are no antibodies in your bloodstream, and your body will fight an uphill battle for survival. The more virulent the virus, the less chance you have.

So far as is known, no H5N1 virus has ever circulated on the planet. That means nobody has any natural immunity. Our good fortune last flu season was that the bird flu virus had not yet learned the trick of passing easily from human to human. The few confirmed victims were almost all people who'd worked very closely with infected fowl in extremely unsanitary conditions. One can suppose that they were massively exposed, allowing this "disease of birds, not humans" to develop in their bodies.

Almost all influenza viruses originate in migrating water fowl in South-East Asia, and by and large the birds don't get sick. However, those birds can pass their viruses to domesticated birds. In the great viral mixing pot of China, where people live in close contact with both their birds and their pigs, influenza viruses can readily pass from one species to another, and sometimes to an animal or person already infected with another flu bug.

In this environment, mutations are guaranteed to occur, and from time to time a new pathogen with the ability to pass between people develops. If it carries the same marker combination as one or another previous flu virus, much of the world's population will have a basic immunity. If it does not have familiar markers, much of humanity is at risk once that virus learns to jump from person to person. Each year a panel of experts tries to guess which strains of flu will pose the highest risk in the coming influenza season, and orders up vaccines to give the vulnerable some protection. H5N1 has not been selected, because it still hasn't become contagious in our species. But it could make the jump at any time.

The last year has brought the world a major advantage, should H5N1 become a "disease of humans." The pharmaceutical industry has learned the difficult trick of making and producing a vaccine against a hitherto unknown disease. GlaxoSmithKline recently claimed that it had succeeded in developing a "second generation" bird flu vaccine that could be given in advance, even before knowing the detailed gene structure that would allow this bird flu to infect people. The vaccine could be given before the bug even learns that deadly trick. Other companies have also developed vaccines which appear to produce broad-spectrum antibodies against many strains of the virus, and many governments have ordered large stocks from various producers.

It is probably worth stockpiling many millions of doses before H5N1 escapes into the human population. Because none of us has any useful immunity, the virus could migrate around the world with the speed of commercial air travel, not the steamships that powered the Spanish Flu. If H5N1 escapes, and if it becomes as virulent as the Spanish Flu (which killed 1% of those who developed the disease), the pessimistic predictions of millions of people dead within months could come true. Only if vaccine bottles were already on the shelf, ready for instant use, could the virus be contained.

However, deadly as it could be, and as harmless as it has so far been, the H5N1 avian flu will not be the last new influenza virus to develop. The process that produced H5N1 is at work every year, and the more intense the agribusiness of raising chickens in China becomes, the more rapidly new viruses can spread and mutate. Even if we may have dodged the H5N1 bullet, another pandemic like the Spanish Flu is inevitable and could break out into the human population so quickly that vaccines cannot be produced in time.

New types of influenza virus must be detected and combated while they are still diseases of birds, not humans. Detection of new viruses will happen where they originate. A global pathogen surveillance system -- as Sen. Joseph Biden suggested almost five years ago -- is necessary because the global first line of defense against influenza is not the U.S. Centers for Disease Control and Prevention, but the public health agencies of China, Vietnam and other nations in that region. Those agencies need multilateral support and encouragement, and the United States must take the lead. And countries where flu viruses originate need the courage to recognize that reporting a new disease does not reveal weakness, but rather demonstrates the strength of their health systems.

Mr. Zimmerman is professor of science and security at King's College London. He was chief scientist of the U.S. Senate Foreign Relations Committee staff and science adviser for arms control at the U.S. State Department.
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on February 19, 2007, 09:02:49 AM
1241 GMT -- RUSSIA -- A bird flu outbreak near Moscow involves the dangerous H5N1 strain that can infect humans, Russian health officials confirmed Feb. 19. Nikolai Vlasov, a senior official at Russia's health watchdog Rosselkhoznadzor, said the strain is probably related to the Asian type of the virus and might have been carried by wild birds migrating from the Caucasus, Balkans or Asian regions. The outbreak, Russia's second of 2007, is the first to be recorded near the capital.
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: SB_Mig on February 21, 2007, 09:27:00 AM
The Survivalist Returns
What's wrong with the CDC's new pandemic planning guide.
By David Shenk
Posted Tuesday, Feb. 6, 2007, at 1:25 PM ET

"Cascading consequences" is one of those elegant phrases that disaster planners use to refer to very bad stuff happening later on—hypothetical events that only occur as a result of other events and are therefore very difficult to predict and even more difficult to plan for. It's not the initial head-on collision, but the divorce resulting from the affair precipitated by the sense of worthlessness fueled by the lost job clinched by the rude insubordination fed by the frustration from the lateness from the traffic jam caused by the head-on collision.

If you're Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, and you're trying to figure out precisely how to react to a hypothetical human-transmissible form of the H5N1 "bird flu" virus, cascading consequences are what you live and breathe. Should you quarantine cities? Close schools? Restrict public transportation? What happens to a complex urban civilization when people, supplies, and services get arbitrarily derailed?

Last week, the CDC issued a comprehensive new "pre-pandemic planning" guide (PDF here) for communities that includes contingencies for five category levels of pandemic. In the mildest scenario, Category 1, communities would not be urged to do much beyond voluntary isolation of ill patients in their homes. In Category 5, the most severe, schools might be cancelled for months at a time, work schedules could be staggered, and public events banned.

The CDC guide is well-intentioned and clear, but it suffers from three profound problems. The first is a hindsight/foresight problem. Pandemics can't be tracked in advance with satellites and don't give off measurable wind speeds. In practical terms, as Gerberding has already acknowledged, we're going to have to assume the worst right away and make category distinctions months later. Sending the message now that we can nuance a pandemic—that we're going to be able to respond with anything less than a massive and coordinated effort—could end up spawning dangerous confusion.

The second, and larger, problem is that we simply do not know at this point which social measures will make things better and which will make them worse. School closures sound like a good idea, but they didn't protect any community during the last pandemic in 1918, and they don't work for seasonal flu. Furthermore, there are cascading consequences: What about the millions of kids who depend on schools for meals? What about the economic and infrastructure disruption from adults having to stay home from work? And if the virus seems to be hitting cities in waves and rolling around the country several times, when—exactly—do you re-open the schools?

The third and most important problem is what's missing from this CDC document: a vaccine endgame. The report is candid about vaccine being the best "countermeasure" and explicitly states that its strategy is to delay the epidemic "in order to 'buy time' for production and distribution of a well-matched pandemic strain vaccine." What it doesn't explain is why the federal government can't accelerate a vaccine program given the very real prospect that this could become the worst public-health crisis in nearly a century. "The government is moving way too slowly on the vaccine," says one pandemic expert involved in U.S. policy discussions. "We're on a five-year timeline and we need to be much more ambitious and aggressive. That's the one thing that could change this whole equation."

Where does this leave citizens? The Survivalist sees three separate courses of action.

1. Be a constituent.
We all need to pressure policy-makers to start a crash vaccine program.

2. Be a community citizen.
The CDC plan is a decent start and a vast improvement on past government efforts. But effective pandemic response will require extensive what-if conversations at every level of society—in the workplace, at the PTA, at the water-filtration plant. Do your part by imagining what your practical role would be and discussing it with colleagues and neighbors.

3. Be a survivalist.
If you're as worried about a pandemic as I am (and as Julie Gerberding is), take nothing for granted. Carefully game out your own family response: Could you manage to telecommute for several months? To the extent possible, every family should be prepared for some level of isolation, with necessary food, health, and entertainment supplies. In a pandemic scenario, social distance can slow down the spread of the disease and buy valuable time for a vaccine.
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: SB_Mig on February 21, 2007, 09:36:04 AM
From: David Shenk
Subject: How To Survive the Avian Flu, Smallpox, or Plague

In a matter of months, bird flu will probably show up somewhere the United States. A few wild geese will test positive for the H5N1 strain, along with a farm cat or two. Grave precautions will be issued, followed by a flurry of safety assurances from the White House and Tyson farms. CNN and Leno will make a great day of it. Poultry sales will fall off for a few months. It won't mean much.
The real disaster, if it happens, will unfold more quietly at first. A sick farmer in China's Guangdong province will sneeze at dinner. He'll turn out to have been simultaneously infected with the new strain and the more conventional flu bug. Out of his nose a nasty new viral hybrid will hurtle through the air and get unluckily sucked into the lungs of his niece, who will breed it for a day or two and hand it off to the postman, who will hand it off to a truck driver, who will deliver it to a big city saloon. From there, a small army of sneezable new H5N1 bugs will hitch on a few plane passengers to Europe and the United States, and the nightmare will begin.

This is the great fear of world health officials, stoked by the fact that H5N1 is an entirely new strain of flu; no one has any immunity against it, and no traditional vaccine can be prepared in advance. Further, this flu is already eerily reminiscent of the devastating "Spanish Flu" pandemic of 1918 in that most of its human fatalities are, surprisingly, adolescents and young adults. Both viruses seem to trick the healthiest immune systems into a response so strong that it kills the patient. A disease that kills the strongest among us. An estimated 20 million to 50 million people died in the 1918 pandemic (compared with the 9 million soldiers who died around the same time in World War I), and there is every expectation that an H5N1 pandemic could be just as devastating—if it mutates to a more transmissible form.

If that key mutation takes place, public-health officials will have a one-in-a-million shot of spotting and containing the initial human cluster at its source. If they can't pull off that minor miracle, there'll be no way to prevent its worldwide spread. Once it's out, it's out, and we will just have to brace ourselves for it. Big cities won't have to wait long—chances are that the bug will already be in New York, London, and elsewhere before it is even noticed. Within weeks, it would be virtually everywhere.

Of course, it may not happen at all. No one can predict whether or when a pandemic flu will actually occur. We can't even put reliable odds on it. All health officials can say with certainty is that, historically, pandemics do happen, and that conditions are now in place for another one to unfold. The gun is loaded and cocked. It might not fire this year or next, or even in the next 25 years, but everything we know says it is bound to happen sooner or later. "The general consensus among scientists who are studying this is that it is not a matter of if a pandemic will happen, but when," Stanford immunology professor Lucy Tompkins has said, echoing many other similar comments. Considering the horrific potential—tens, or even hundreds, of millions dead before effective vaccines can be manufactured and distributed—we'd have to be nuts not to get ready now.

According to Michael Osterholm, director of the Center of Infectious Disease Research and Policy:

We can predict now 12 to 18 months of stress, of watching loved ones die, of potentially not going to work, of wondering if you're going to have food on the table the next day. Those are all things that are going to mean that we're going to have to plan unlike any other kind of crisis that we've had literally in the last 80-some years in this country.

Avian flu is not, of course, the only looming biological threat. There is also the very real possibility of terrorist attack with agents that cause smallpox, plague, tularemia, or viral hemorrhagic fever. Once introduced, any of these agents could spread widely and cause mass casualties and social disruption. What can we as individuals do to prepare? First, take a minute to imagine the potentially drastic change in the human landscape: Hospitals everywhere are filled beyond capacity. Streets, subways, schools, theaters, and cafes are more or less deserted. The only way to protect yourself and your family is to avoid contact with people, so that's just what you do. You work from home if you can, and you and your family do not socialize at all—no play dates, no dinner parties, no movies or restaurants. You eat at home, play at home, teach your kids at home, even administer medical care at home. (A hospital visit is a surefire way to pick up an infectious agent.) If you don't have an expansive yard, maybe you occasionally take your kids to a big park—but they stick close as a rule and do not bound off with other kids. When you go food shopping, you wear a mask and don't stop to talk to anyone. Every day, you wipe the newspaper and the mail down with bleach. Or better yet, you cancel both. For a large segment of the population, all contact becomes electronic, all interaction virtual. In the case of avian flu, this would go on week after week, month after month, until the vaccine comes. (Due to drugs already available, smallpox and other agents might be contained sooner.)

It sounds absurd, and it is, but this kind of surreal shift is what happens when something comes along that fundamentally changes the social paradigm. Avian flu and bioweapons could be that powerful.

Now that you've swallowed that idea, consider the next, even weirder, level. In the most severe pandemic, social isolation could be the least of our problems. If the infection and death rate get high enough, services and supplies could become dangerously interrupted. With key people absent from filtration plants, city water systems might go in and out of reliability. Same with fire, police, and of course emergency rooms. Electrical grids could fail without sufficient expertise at key moments. Food shortages are a serious possibility if production or transportation stop. The stock market, needless to say, won't enjoy the supply shortages and dearth of shopping. It's not hard to imagine a grave pandemic sparking a worldwide depression, and even an environment of desperation and lawlessness.

Or maybe not. It's also possible that H5N1 will mutate into a much milder human-to-human virus, and that the subsequent pandemic will feel like a nasty but conventional flu season. It's possible that bioweapons will never emerge as anything more than a public-health exercise. The point is, no one knows, and so it pays to prepare for the worst.

Here's how to survive a severe pandemic: Prepare to become self-sufficient for several months; stockpile nonperishable food, water, disinfectants, prescription medication, office supplies, batteries and generators, air-filter masks, cash (small bills), portable gas cookware, entertainment for the kids, and so on. If you happen to be shopping for an air purifier anyway, make sure it has a UV component like these—that's the only type that will actually kill a virus. Consider having to take care of a sick family member if a hospital is out of the question; this would require the antivirals Tamiflu or Relenza (Relenza is likely to be more effective, since Tamiflu more quickly provokes resistance), as well as drugs for nausea, fever, pain, and muscle aches; basic medical supplies like gloves, masks, and a blood pressure monitor would also be prudent. There are a number of extremely thorough preparedness guides here. More generally, you can learn everything you need to know about the causes and consequences of a pandemic here.

If you have a rural retreat, consider using it. Also, consider that in a worst-case scenario, you might have to defend the security of your well-supplied home from desperate outsiders. Finally, consider that everyone has to die sometime, and unless you have no survivors at all, it is reckless not to have your affairs in order.

Aside from whatever personal planning you're comfortable with, be sure to follow this issue closely. There's a reasonable chance that attentive readers will have a few weeks' warning before people start emptying grocery-store shelves. Look for phrases like:

" … a quarantine has been placed around the village of ____"

" … emergency doses of Tamiflu have been rushed to the scene . . ."

" …'this could be what we've been fearing,' said one WHO official."

A little citizen activism wouldn't hurt either. Make sure your state is stockpiling antivirals to the greatest extent possible. USA Today recently reported that many states are not taking advantage of a federal program to acquire large reserves. In addition, contact your local health department and inquire about the particular plans of your city and state. A coherent government plan in advance of any pandemic is vital. If it ever does hit, there will be no time to create one, and laissez-faire health commissioners will have a lot of blood on their hands.

Emergency planning list:
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on June 02, 2007, 06:54:44 AM
Published: June 2, 2007
San Francisco
NY Times

IF it turns out that none of his fellow passengers were actually infected with the dangerous form of tuberculosis he carries, then Andrew Speaker, the young honeymooner who recently eluded government efforts to keep him off commercial flights, may actually have done a favor to public health. His case has brought to light the neglected but growing problem of super drug-resistant tuberculosis, and the ease with which this deadly airborne disease can travel around the world.

Federal health officials have recently warned state and city TB treatment programs to expect budget cuts of as much as 25 percent over the next five years. But Mr. Speaker is not the first world traveler to carry the most drug-resistant TB, and he will surely not be the last. Instead of cutting back on TB research and treatment, we should be intensifying our efforts to fight the disease.

We urgently need tests capable of diagnosing drug resistance overnight, so that we can know which patients present the most danger to the public. We need new drugs to outwit the disease. And we need to support a worldwide effort to prevent TB bacteria from developing further drug-resistance.

Tuberculosis is an illness that was once thought to be under control. A century ago, it was responsible for one in five deaths in the United States. But then antibiotics came along, and a national effort to develop new drugs and diagnostic tools and to institute TB-control public health programs drove down the rates of tuberculosis in the United States to the point where people assumed it was eradicated.

Twenty years ago, complacency about TB control combined with the H.I.V. epidemic and a growing immigrant population to bring about a resurgence. As a result, in the early 1990s, TB programs in the United States were rebuilt to provide better patient care and case investigation and to improve adherence to treatment.

These programs have become models for TB treatment around the world. But unfortunately, in many countries, public health standards still fall short. Patients infected with tuberculosis are given inadequate courses of antibiotics, or they fail to adhere to the course of treatment they are given. In such cases, the most drug-resistant strains of the bacteria are allowed to multiply.

It’s easy to see how drug resistance in any one country grows into a global problem. One-third of the world’s population carries the TB bacillus in their bodies, and in the stream of people traveling around the world the bacteria are constantly on the move.

The World Health Organization estimates that each person with TB infects 10 to 15 other people, usually by coughing the germs into the air. And once the bacteria reach a new host, they can either progress to disease, keeping the cycle going, or be carried around for years or decades, only to cause illness later on in a chosen few. A robust immune system is needed to contain the infection, but even in healthy people, 5 percent to 10 percent of those exposed go on to develop TB.

The most extremely resistant form of the illness — the kind that Mr. Speaker has, known as XDR-TB, which is impervious to even our most powerful antibiotics — is now found all over the world. It is thought to be rare, though the exact numbers are unknown. But we know that the numbers are rising, because strains of TB that are resistant to multiple drugs — the precursors to XDR-TB — are proliferating. In 2004, almost half a million of the more than 8 million cases of tuberculosis worldwide were resistant to the most potent TB drugs. And drug resistance feeds further drug resistance.

Adding to the problem is the long time, often a period of months, that it takes to detect drug resistance. Doctors are forced to treat in the dark, not knowing whether their drugs are actually working.

What is needed are tests capable of diagnosing drug resistance within 24 hours — tests that do not require letting the bacteria grow in culture for days but rather identify gene mutations that confer drug resistance.

Such genetic tests to detect resistance to first-line TB drugs already exist, though they are in limited use, mainly in New York and California. We need to put in the effort to develop them for the second-line antibiotics, and make the investment to ensure that the quick tests are put into widespread use.

Perhaps if Mr. Speaker’s doctors had known before he left for Paris that his tuberculosis was the drug-resistant kind, they might have taken even stronger action to keep him from flying to Europe in the first place. State and federal laws give public health officials the authority they need to keep contagious patients away from the public, but in exercising that authority, it helps to know the danger that a patient poses.

In addition, we need more drugs to treat TB. No new drug class has been approved for TB since the antibiotic rifampin, 35 years ago. Without effective drugs to treat the new superbugs, patients often suffer longer periods of contagion, and that makes their treatment extremely costly (from about $90,000 to more than $700,000 per patient).

Last fall, the World Health Organization proclaimed XDR-TB to be a public health emergency and called on governments to provide $95 million in 2007 to deal with the problem. Three bills now before Congress would increase domestic and international spending for TB treatment and research.

As global travel continues to increase and the rate of drug-resistant TB rises, the number of cases of drug-resistant tuberculosis inevitably will grow. It is essential that we redouble our efforts to halt the epidemic of drug resistance and the global spread of all forms of TB.

L. Masae Kawamura is the director of the tuberculosis control section of the San Francisco Department of Public Health.

Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on October 05, 2007, 01:19:04 PM

NEW YORK (Reuters) - The H5N1 bird flu virus has mutated to infect people more easily, although it still has not transformed into a pandemic strain, researchers said on Thursday.

The changes are worrying, said Dr. Yoshihiro Kawaoka of the University of Wisconsin-Madison.

"We have identified a specific change that could make bird flu grow in the upper respiratory tract of humans," said Kawaoka, who led the study.

"The viruses that are circulating in Africa and Europe are the ones closest to becoming a human virus," Kawaoka said.

Recent samples of virus taken from birds in Africa and Europe all carry the mutation, Kawaoka and colleagues report in the Public Library of Science journal PLoS Pathogens.

"I don't like to scare the public, because they cannot do very much. But at the same time it is important to the scientific community to understand what is happening," Kawaoka said in a telephone interview.

The H5N1 avian flu virus, which mostly infects birds, has since 2003 infected 329 people in 12 countries, killing 201 of them. It very rarely passes from one person to another, but if it acquires the ability to do so easily, it likely will cause a global epidemic.

All flu viruses evolve constantly and scientists have some ideas about what mutations are needed to change a virus from one that infects birds easily to one more comfortable in humans.

Birds usually have a body temperature of 106 degrees F, and humans are 98.6 degrees F usually. The human nose and throat, where flu viruses usually enter, is usually around 91.4 degrees F.

"So usually the bird flu doesn't grow well in the nose or throat of humans," Kawaoka said. This particular mutation allows H5N1 to live well in the cooler temperatures of the human upper respiratory tract.

H5N1 caused its first mass die-off among wild waterfowl in 2005 at Qinghai Lake in central China, where hundreds of thousands of migratory birds congregate.
That strain of the virus was carried across Asia to Africa and Europe by migrating birds. Its descendants carry the mutation, Kawaoka said.

"So the viruses circulating in Europe and Africa, they all have this mutation. So they are the ones that are closer to human-like flu," Kawaoka said.
Luckily, they do not carry other mutations, he said.

"Clearly there are more mutations that are needed. We don't know how many mutations are needed for them to become pandemic strains."
Title: Superbug
Post by: Crafty_Dog on October 17, 2007, 10:37:11 AM
Antibiotic-resistant bacterium that causes severe infections has migrated from hospitals and now kills more Americans than AIDS.
By Thomas H. Maugh II, Los Angeles Times Staff Writer
October 17, 2007
The number of severe infections by a "superbug," known as methicillin-resistant Staphylococcus aureus, isat least twice as high as researchers previously believed, and the bacterium now kills more Americans than AIDS, researchers reported today.

The antibiotic-resistant infections, commonly called MRSA, were once confined to a few hospitals, but a new study by the national Centers for Disease Control and Prevention found that in 2005 they made an estimated 94,000 Americans seriously ill and killed almost 19,000, compared with 17,000 who died of AIDS.

"Certainly, MRSA now has to be viewed as a very important target for prevention and control," said Dr. David A. Talan, an infectious diseases specialist at Olive View-UCLA Medical Center in Sylmar who was not involved in the study.

The infections have been a growing concern, particularly over the last decade, as they have spread outside hospitals, popping up in prisons, athletic fields and locker rooms.

The study reported that nearly 14% of new antibiotic-resistant staph infections are not linked to hospitals or other medical facilities, indicating that the disease has become ingrained in parts of the wider community.

The finding, reported in the Journal of the American Medical Assn., is the latest evidence of a widespread pattern of increasing drug resistance among a variety of infectious agents, including multi-drug resistant tuberculosis, antibiotic-resistant Clostridium difficile and other once-innocuous organisms.

Some hospitals, gyms and other public facilities have begun to implement more stringent infection controls to prevent the spread of the bacterium, such as more thorough scrubbing of equipment, using hotter water for laundry, banning towel sharing and increasing the use of disinfectants.

The bacterium also remains susceptible to some powerful and expensive antibiotics, such as vancomycin. But experts fear that the ability of the bacterium to mutate will outpace the ability of scientists to create new drugs.

The spread of resistant organisms is "astounding," Dr. Elizabeth A. Bancroft, an epidemiologist with the Los Angeles County Department of Public Health, wrote in an editorial accompanying the report.

Bancroft said the reported incidence of resistant staph infections is just "the tip of the iceberg" because the CDC researchers studied only blood-borne infections that find their way into internal organisms.

Several studies have found that such infections represent only 6% to 9% of all MRSA infections, which can also thrive on the skin in a more innocuous form, waiting for the opportunity to enter the body.

"It appears that the total burden of MRSA is much greater than what was estimated in this study," she said.

Most forms of the staph bacterium are easily killed with common antibiotics, such as amoxicillin. But beginning in 1968, researchers began to see variants that required treatment with stronger antibiotics.

Experts attribute the emergence of the superbugs to indiscriminate use of antibiotics, the failure of patients to complete their antibiotic regimens and the use of antibiotics in animal feed. In each case, incomplete eradication of the bacteria leads to mutations that have increased resistance to the drugs.

Confined to the surface of the skin, the bacteria do minimal damage. But in hospitals, nursing homes and dialysis centers, they can hitch a ride inside the body on needles and other invasive devices, spreading through the bloodstream and causing severe illness.

In the same fashion, they can be spread by tattooing and drug use in prisons and by cuts and abrasions on the athletic field. In 2003, four members of the USC football team were hospitalized and three more infected by MRSA.

Doctors have been aware of the growing staph problem, but there were no hard data to document it.

The new results were obtained by Dr. R. Monina Klevens of the CDC and her colleagues as part of the agency's ongoing Active Bacterial Core surveillance program, which monitors infections in nine regions of the U.S., including San Francisco, Baltimore, Atlanta and Denver. All infections were laboratory confirmed.

The group observed 8,987 cases of blood-borne MRSA infections in the survey area, which was extrapolated to come up with a nationwide estimate of 94,360 cases. There were 1,598 deaths in the area, corresponding to 18,650 deaths nationwide.

Only 26.6% of the cases were infections that occurred in hospitals. An additional 58.4% were infections that occurred in the community but were linked to hospitalization or medical procedures. Infections unrelated to medical procedures accounted for 13.7% of cases.

Infection rates were highest among those older than 65, and African Americans were twice as likely as whites to suffer an infection. In both groups, Klevens said, the higher rates were most likely due to a higher incidence of chronic diseases, which both weaken patients and send them more often to the hospital, where they come in contact with the bacterium.

For infants younger than 1, the rate was four times as high in blacks as in whites.

Healthcare advocates argue that hospitals need to improve hygiene. Some studies, for example, show that hospital workers wash their hands only about half as often as guidelines recommend.

Other critics say hospitals should screen all newly admitted patients for MRSAs and isolate those found to be positive. Hospitals, however, say such isolated patients are likely to receive less care because of the inconvenience associated with entering their rooms.

Despite the best efforts of scientists, the rapid evolution of bacteria gives them a major advantage, as illustrated by another report in the journal detailing the appearance of an ear infection resistant to all antibiotics approved for use in children.

Dr. Michael E. Pichichero and Dr. Janet R. Casey of the University of Rochester reported on nine ear infections caused by a multi-drug resistant strain of Streptococcus pneumoniae that succumbed only to a powerful antibiotic known as Levaquin, whose label carries a warning against using it in children.

The first four children were successfully treated by inserting tubes in their ears, which allowed the infections to resolve naturally. The last five were given a ground-up Levaquin pill, which ended the infection with no adverse effects.

Physicians agreed that Levaquin should be used in children only as a last resort, and only if the bacterium in question has been grown in culture and shown to be susceptible.
Title: Dangerous new MRSA
Post by: Crafty_Dog on January 16, 2008, 06:36:54 AM
S.F. General researchers follow strain of drug-resistant bacteria

Sabin Russell, Chronicle Medical Writer

Tuesday, January 15, 2008

San Francisco General Hospital researchers have been chasing the rogue strain of drug-resistant staph called USA300 since they first isolated it from a patient specimen seven years ago.

With every turn, the aggressive and persistent bug keeps getting worse.

Now, a new variant of that strain, resistant to six major kinds of antibiotics, is spreading among gay men in San Francisco, Boston, New York and Los Angeles.

City doctors first spotted the original USA300 during tests for patients treated at a walk-in clinic for skin infections in 2001. Since then, they have watched it morph from laboratory curiosity into the dominant form of staph infection in much of the United States.

"It stormed into town and just took over, displacing everything else," said Dr. Chip Chambers, infectious disease chief for the renowned hospital.

At first, USA300 hit the down-and-out: injection-drug users, jail inmates, homeless men and women. Today it is also infecting suburban moms, executives, doctors, athletes and children. It has turned up in tattoo parlors and newborn nurseries. People with HIV infection seem especially prone to it, but it also strikes patients, gay and straight, who have no previous health problems.
Staph infections are usually treatable but can be lethal. USA300 is as dangerous as they come - it can attack organs throughout the body, forcing doctors to amputate fingers, toes and limbs. Its most disturbing trait, however, is just how easily it gets around.

"USA300 has a tremendous ability to spread," said Francoise Perdreau-Remington, director of the molecular epidemiology lab at San Francisco General, where the strain was first identified. "It has been described in at least 44 states and is now spreading in European countries."

USA300 is one of a dozen distinct varieties of MRSA, or methicillin-resistant Staphylococcus aureus, now circulating. The first MRSA strain, resistant to the penicillin substitute methicillin, was discovered in 1961. It continues to evolve. More than 200 families of the strain have come and gone since. USA300 is shaping up as the worst of the lot.

The various MRSA families have been gaining strength as a public health menace for years.

MRSA infections used to be confined to hospitalized patients. But in the late 1990s, people began contracting them in community settings - in gyms, jails, schools and even at home. The federal Centers for Disease Control and Prevention calculated last fall that drug-resistant staph was killing 19,000 Americans a year - more than are dying of AIDS.

Tracking down new disease threats is Perdreau-Remington's specialty. The French-born microbiologist was recruited to San Francisco General in 1995 to create the lab because of her expertise in disease detective work at the University of Cologne in Germany. A key to her microbe hunting is the ability to compare new strains to old ones. Her lab at the San Francisco hospital stores a frozen cache of 16,000 germs taken from patients in the hospital and health clinics.

In 2000, San Francisco General had set up a special walk-in clinic catering to drug users and street people to handle the growing volume of skin and soft-tissue infections that were driving up costs in its emergency room.

Perdreau-Remington began running tests to find out what was causing so many infections. Her lab analyzed bacterial specimens to produce genetic fingerprints that look like strips of bar code. It was during that screening program, using samples from the clinic, that she found the genetic fingerprint of what would be called USA300.

The unique signature showed up on March 1, 2001. At first, it represented just one of 15 specimens on a standard computer readout, known as a "gel." When the same new fingerprint showed up in three of 15 specimens three months later, Perdreau-Remington remembers thinking: "Uh-oh, we have a problem."

She labeled the new strain the "S-clone."

By February 2002, six of 15 samples displayed the S-clone's signature. Among patients at the clinic, the new bug shortly thereafter outnumbered all others by a 2-to-1 ratio.

Perdreau-Remington soon learned that the bug had been lurking elsewhere. She began collaborating with her counterparts in Los Angeles County, where inmates of the largest jail system in the United States had been complaining of "spider bites." Samples of the skin sores yielded the same S-clone fingerprints.

Throughout the United States, other researchers were independently finding the same bug.

Fred Tenover, director of laboratory science at the CDC, remembers running a test that pooled drug-resistant staph samples from 12 states, including ones from prisons in Georgia, Texas and California and from a football team in Pennsylvania. "The patterns were indistinguishable," he said. "I looked at the gel and said, 'This can't be.' So we went back and retested them. It was amazing."
The fingerprints were identical to those of Perdreau-Remington's S-clone.

Tenover, who was developing for the CDC a uniform system for describing a dozen distinctive types of drug-resistant staph, named the emerging bug USA300.

Perdreau-Remington's early isolation of USA300 has made her lab at San Francisco General a world leader for the study of it. Once it became clear that a new strain of drug-resistant staph was loose, she set out to discover where it came from. She went back to her freezers and screened hundreds of samples of staph taken since 1996.

Her survey unearthed the earliest known sample of USA300. Its fingerprints were spotted in a frozen specimen taken from a man who visited the newly opened walk-in clinic at San Francisco General on Sept. 25, 2000.

Ominously, the strain that first appeared outside the hospital began to infect vulnerable patients inside as well. By 2002, USA300 accounted for 14 percent of staph infections acquired at San Francisco General, and the numbers keep rising.

"Now, more than 80 percent of MRSA infections in this hospital are caused by USA300," Perdreau-Remington said.

Under a powerful microscope, USA300 resembles a cluster of faintly yellow BBs - indistinguishable from other strains of drug-resistant staph. Like a fancier brand of automobile, however, this one is packed with options that make it potentially more deadly and easier to spread.

Toxic proteins carried by USA300 have been implicated in infections that destroy fingers and toes or cause the rare but frighteningly fast skin- and muscle-tissue destruction attributed popularly to "flesh-eating bacteria" - a condition known as necrotizing fasciitis.

Until recently, flesh-eating infections were thought to be caused by other bugs, such as Streptococcus. A study published in the New England Journal of Medicine in 2005 changed all that. Doctors at UCLA-Harbor Medical Center reviewed 14 cases of the frightening skin disease. All 14 had drug-resistant staph cultured from their wounds. Five samples were tested at Perdreau-Remington's San Francisco lab for strain type. They all turned up USA300.

When drug-resistant staph invades the lungs, it can cause a pneumonia that destroys lung tissue and kills a patient within hours. Last winter, the CDC implicated USA300 in outbreaks of severe pneumonia such as the one that killed six of 10 flu patients in Louisiana and Georgia last winter. Four of the dead were children.

Concern over USA300 is so great that Perdreau-Remington won funding to map the complete genome of the germ, identifying the entire coded sequence of genetic instructions that tell this particular strain of staph bacteria how to make copies of itself.

She chose a sample taken in 2003 from a wrist abscess on a 36-year-old patient who was also being treated for AIDS at San Francisco General. She picked that specimen because it seemed unusually resistant to treatment. It was labeled USA300 FPR3757 - using Perdreau-Remington's initials.

The gene map, published in the British medical journal the Lancet in February 2006, has yielded clues to why this strain spreads so quickly. The bug appears to have swapped genes from Staphylococcus epidermidis, a usually harmless staph species that is commonly found on human skin. Researchers theorize that, by stealing a trick from the milder staph bug, the malevolent USA300 may colonize on human skin more easily than other varieties of MRSA.

Further along the gene map are sections that produce resistance to the antibiotics tetracycline, erythromycin, clindamycin, Cipro and mupirocin, a topical ointment often used to kill MRSA colonies living in people's noses.

Perdreau-Remington did not know it at the time, but the sample she took - FPR3757 - was among the very first isolates found of the highly drug-resistant USA300 variant now spreading readily through San Francisco's gay community. The new bug virtually has her name on it.

USA300 - even the new variant - is treatable with some antibiotics. Perhaps the most important of these is vancomycin, an antibiotic reserved for the most serious staph infections. But FPR3757 is just a short step away from acquiring resistance to that drug as well.

Dangerous intestinal bacteria have already evolved resistance to vancomycin. Known as vancomycin-resistant enterococcus, or VRE, the bugs carry a "cassette" of genes containing all the instructions needed for bacteria to sidestep the antibiotic.

Perdreau-Remington's team has spotted on the USA300 genome a region that is primed to accept this vancomycin-resistance cassette. It could snap into place like a Lego block.

Drug-resistant bacterial strains have been labeled "superbugs," but most infectious disease specialists recognize that these bacteria are not doing anything remarkable. They are performing as they have for millions of years, using their enormous capacity to mutate and multiply to outmaneuver whatever biological or environmental threats they face.

Because both VRE and USA300 are circulating in hospital environments, some patients are probably battling both bugs at the same time. Given the propensity of staph germs to swap genes, these patients provide fertile ground for the evolution of an even more dangerous bug.

If USA300 were to acquire vancomycin resistance from VRE, the result would be a virulent new form of staph, which would spread readily outside the medical setting and be nearly impossible to treat.

Perdreau-Remington believes there's an urgent need for new drugs to combat such a monster.

"This is the horror scenario," she said. "We have very little time left."

E-mail Sabin Russell at

This article appeared on page A - 1 of the San Francisco Chronicle
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on January 17, 2008, 04:58:01 AM
Here is one interpretation of the meaning underlying the preceding article.  Comments?


( - A drug-resistant strain of a deadly staph infection found in some U.S. hospitals is now spreading among homosexual men, researchers said. A conservative group has characterized the problem as the result of "unnatural behaviors."

Methicillin-resistant Staphylococcus aureus, or MRSA, killed about 19,000 Americans in 2005 -- most of them in hospitals, according a report published in October in the Journal of the American Medical Association. But now the infection is popping up outside hospitals in San Francisco, Boston, New York and Los Angeles, according to Reuters.

"The medical community has known for years that homosexual conduct, especially among males, creates a breeding ground for often deadly disease. In recent years we have seen a profound resurgence in cases of HIV/AIDS, syphilis, rectal gonorrhea and many other STDs among those who call themselves 'gay,' said Matt Barber, policy director for cultural issues with Concerned Women for America (CWA).

Active homosexual men in San Francisco are considered 13 times more likely to be infected with MRSA than heterosexuals, researchers reported in the Annals of Internal Medicine.

"Once this reaches the general population, it will be truly unstoppable," Reuters quoted Binh Diep, a researcher at the University of California, San Francisco who led the study, as saying. "That's why we're trying to spread the message of prevention," he added.

"The human body is quite callous in how it handles mistreatment and the perversion of its natural functions," said Barber. "When two men mimic the act of heterosexual intercourse with one another, they create an environment, a biological counterfeit, wherein disease can thrive. Unnatural behaviors beget natural consequences."

He blamed television shows like "Will and Grace," which "glorify the homosexual lifestyle," and homosexual indoctrination in schools for the "laissez-faire attitude toward sexual deviancy."

"'Stay out of our bedrooms!' we're often commanded by militant 'gay' activists," Barber said. "Well, now the dangerous and possibly deadly consequence of what occurs in those bedrooms is spilling over into the general population. It's not only frightening, it's infuriating."

Barber called for parents to speak out against "politically correct cultural elites" who "endanger our children and larger communities through propagandist promotion of this demonstrably deadly lifestyle."

"Why does it take a potentially deadly staph epidemic for people to acknowledge reality? Will that even do it? Enough is enough!" Barber added.
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on January 22, 2008, 06:26:32 AM
KOLKATA, India : India's worst ever outbreak of bird flu could turn into a disaster, an official warned Tuesday, as five people were reportedly quarantined with symptoms of the virus.

Eight districts in the eastern state of West Bengal have been hit by the virus, and dead birds are being sold and locals said to be "feasting" on cheap chicken.

The state's animal resources minister, Anisur Rahaman, said authorities were "determined to cull all poultry in the districts in three or four days, otherwise the state will face a disaster."

More than 100,000 bird deaths have been reported, and teams are racing to cull two million chickens and ducks.

The Times of India reported five people in West Bengal have been quarantined with "clinical symptoms" of avian flu -- including fever, coughing, sore throat and muscle ache -- after handling affected poultry.

If the tests are positive, this will be the first case of human infection in India, home to 1.1 billion people and hit by bird flu among poultry three times since 2006.

Health officials in New Delhi said they were currently analysing blood samples from close to 150 people who have complained of fever.

On the ground, culling teams have been facing an uphill battle with villagers smuggling birds out of flu affected areas and selling them in open markets.

Thirty-year-old Sheikh Ali, a vendor in Birbhum's Gharisa market, 340 kilometres (192 miles) from the state capital Kolkata, said the sale of poultry had doubled in the past week.

"The prices of chicken have come down from 60 rupees to 20 rupees (1.5 dollars to 50 cents) per kilogramme (2.2 pounds).

"Poor villagers are feasting on chicken. At normal times, they cannot afford to buy as prices are so high. Now they are enjoying the meat," Ali said.

People typically catch the disease by coming into direct contact with infected poultry, but experts fear a flu pandemic if the H5N1 mutates into a form easily transmissible between humans.

Migratory birds have been largely blamed for the global spread of the disease, which has killed more than 200 people worldwide since 2003.

In Birbhum, police seized two trucks of smuggled poultry early Tuesday but culling teams were yet to arrive at the spot, an AFP correspondent said.

"Poultry owners are smuggling their birds out at night and transporting it to different places for fear of culling," said Shubhendu Mahato, a security guard at Arambagh Hatchery, one of the biggest in West Bengal.

Chicken shops had also sprung up along the main highways overnight with people crowding them, the AFP correspondent said.

Neighbouring Nepal, which has banned poultry imports from India since 2006, said its border posts were on high alert.

Bangladesh, which also borders West Bengal, was meanwhile battling its own serious outbreak -- with experts warning the situation was far worse than the government was letting on.

"Bird flu is now everywhere. Every day we have reports of birds dying in farms," said leading poultry expert and the treasurer of Bangladesh Poultry Association M.M Khan.

"Things are now very, very serious and public health is under danger. The government is trying to suppress the whole scenario," Khan said, adding that farmers were also holding back from reporting cases.


In a closely related vein

Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on February 25, 2008, 12:23:15 PM
Will the first casualty of a pandemic be "the plan"?

Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on March 06, 2008, 07:28:07 PM
(NaturalNews) The avian flu has undergone a critical mutation making it easier for the virus to infect humans, according to a study conducted by researchers at the University of Wisconsin at Madison and published in the journal PLoS Pathogens.

"We have identified a specific change that could make bird flu grow in the upper respiratory tract of humans," lead researcher Yoshihiro Kawaoka said.

The H5N1 strain of influenza, also known as "bird flu," has decimated wild and domestic bird populations across the world since it emerged between 1999 and 2002. This highly virulent variety of the flu has been identified as a public health concern because in the past, varieties of influenza have mutated and crossed the species barrier to humans.

Since 2003, 329 humans have been confirmed infected with H5N1, with 201 fatalities. The vast majority of these worked closely with infected birds, such as in the poultry industry.

One of the primary things that keeps bird flu from infecting humans is that the virus has evolved to reproduce most effectively in the bodies of birds, which have an average body temperature of 106 degrees Fahrenheit. Humans, in contrast, have an average body temperature of 98.6 degrees, with temperatures in the nose and throat even lower (91.4 degrees). This vast temperature difference makes it very difficult for the bird flu virus to survive and grow in the human body.

In the current study, researchers found that a strain of H5N1 has developed a mutation that allows it to thrive in these lower temperatures.

"The viruses that are circulating in Africa and Europe are the ones closest to becoming a human virus," Kawaoka said. But he pointed out that one mutation is not sufficient to turn H5N1 into a major threat to humans.

"Clearly there are more mutations that are needed. We don't know how many mutations are needed for them to become pandemic strains."

"We are rolling the dice with modern poultry farming practices," warned consumer health advocate Mike Adams, author of the book How to Beat the Bird Flu. "By raising chickens in enclosed spaces, treating them with antibiotics, and denying them access to fresh air, clean water and natural sunlight, we are creating optimal conditions for the breeding of highly infectious diseases that can quickly mutate into human pandemics," Adams said. "Given current poultry farming practices, it is only a matter of time before a highly virulent strain crosses the species barrier."
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on March 09, 2008, 07:23:13 AM
The subject of masks came up on WT forum.  I haven't checked these for myself, but post them here to have the URLs for reference:


Most of the information I've read suggests than N95 masks are adequate for bird flu.

There's a lot of information on the subject available here;

I'd suggest spending some time studying the available information to determine what level of protection you're comfortable with.


There is a single study that has cast some doubt on the efficacy of N-95 masks in a pandemic influenza situation.

This link is from the IAFF, whose leadership I personally feel are no-talent @ssclowns, but worth reading:

Having masks are a valid tactic for pandemic influenza, but betting your life on them is foolhardy at best. During the SARS outbreak, there is strong circumstantial evidence that universal precautions failed in more than one case of direct transmission to healthcare workers.

A surgical mask will beat nothing, a N-95 is better than a surgical mask and not being exposed to airborne particulate is the best solution.

With N-95's, be aware that moisture will likely degrade their effectiveness, so sweating, heavy breathing and high humidity will burn through.
Title: Superbugs
Post by: Crafty_Dog on March 13, 2008, 03:11:01 PM

The War on Superbugs
Lots of bad news—so little good news
By G.W. (Bill) Riedel, Ph.D.
Special to the Epoch Times Mar 13, 2008

Bacteriophages are one answer to the superbug crisis. (Ada Fitzgerald-Cherry/The Epoch Times)
A report entitled: "The Epidemic of Antibiotic-Resistant Infections" published in Clinical Infectious Diseases, 2008:46, Jan. 15, page 155 starts as follows: "We are in the midst of an emerging crisis of antibiotic resistance for microbial pathogens in the United States and throughout the world."

As of the year 2000 an estimated 70,000 deaths due to nosocomially acquired [hospital acquired], drug-resistant infections occurred per year in hospitals throughout the United States. Methicillin-resistant Staphylococcus aureus seriously sickened more than 94,000 Americans in 2005 and almost 19,000 died, more than the 17,000 Americans who died of AIDS-related causes. As more bacteria become resistant to the old antibiotics there are few new antibiotics being developed because most pharmaceutical companies have withdrawn from research for new antibiotics, in part because developing new antibiotics is a slow and costly process.

In Canada the official body counters tell us that "an estimated 220,000 patients who walk through the doors of hospitals each year suffer the unintended and often devastating consequences of an infection," and they estimate that 8,000 to 12,000 Canadian patients die annually from such infections. That would mean that from January 1, 2000 to April 30, 2008 there will have been 100,000 Canadian victims of superbug infections.

Against so much bad news it would be logical that the news media would jump on any opportunity to publish any good news. So when the Bacteriophage 2008 meeting in Herefordshire was chosen for the release of initial Phase II clinical trail data of the first fully-regulated clinical trail to test whether phage therapy really works as a treatment option for superbug infections, one would have expected a media flurry, especially since the trail reported positive results.

To date only two such reports can be found when using Google-News with the string "phage therapy." The first report, which this author found was entitled: "Technology to defeat bacterial infections shows positive results" and was published by Disease/Infection News, 25-Feb-2008 at

In this trail the U.K. company Biocontrol Ltd. used bacteriophages against Pseudomonas aeruginosa bacteria, which are often resistant to traditional antibiotics. Over a 17-month period a double-blind Phase II trail took place at a specialist London hospital involving 24 patients with chronic ear infections that were not responding to antibiotic treatments. Significant improvements amounting to a mean 50 percent reduction in symptoms were noted as compared to a mean of only 20 percent in the control group who did not receive phages. The company now plans to perform Phase III trails for the ear treatment as soon as possible and is looking at the future possibility of treating patients with cystic fibrosis where lung infections with Pseudomonas aeruginosa are common and dangerous.

Dr. Riedel,, has a Ph.D. in Microbiology/Food Science. He has held various positions in research, industrial food science, and consumer product regulatory affairs in Canada.
Title: Bird Flu: Human to Human in Pakistan?
Post by: Crafty_Dog on April 06, 2008, 11:36:48 PM
First case of human-to-human transmission of bird flu confirmed in Pakistan

April 6 : A report by BBC News has confirmed the first case of human-to-human transmission of bird flu in Pakistan.
Pakistan’s north-west and southern regions were hit by bird flu last year. Thousands of birds were culled to control the spread of the disease.
Tests carried out by the World Health Organisation (WHO) have now shown that bird flu killed some members of a family in north-west Pakistan late last year.
This is the first confirmation of people dying from bird flu in the country, with the samples collected from the family in Peshawar testing positive.
According to Dr Mukhtiar Zaman Afridi, head of the isolation ward for avian flu patients at Khyber Teaching Hospital in Peshawar, a poultry worker in Peshawar apparently passed the disease on to members of his family.
“The worker, whose name is being withheld on the request of the WHO, was brought to the hospital with avian flu symptoms on 29 October 2007,” he said.
Though this worker has fully recovered since then, on 12 November, his elder brother was brought in with similar symptoms. He died a week later.
On 21 November, two more brothers of the same worker came down with bird flu.
“One of them died on 28 November, while the other has recovered,” said Dr Afridi.
Apart from the poultry worker, none of the others was found to have had any direct contact with sick or dead poultry.
Genetic sequencing tests performed by WHO laboratories in Egypt and the US on samples collected from three of the four brothers established human-to-human transmission.
Serum taken from all three was found to have been infected by the H5N1 avian influenza virus.
Though a WHO report said that the tests suggest “limited human-to-human transmission,” it adds, however, that this “outbreak did not extend into the community, and appropriate steps were taken to reduce future risks of human infections.” (ANI)
Title: Indonesia hoards bird flu virus samples
Post by: Crafty_Dog on April 17, 2008, 01:26:38 PM
Recipe for a Pandemic
April 18, 2008
Over nearly 60 years, the World Health Organization has developed sophisticated systems for monitoring the emergence of seasonal influenza and possible pandemics as well as arming scientists with the tools to develop vaccines. Now, one country is jeopardizing all that, putting itself and the rest of the world at risk.

The culprit: Indonesia. Its Health Ministry refuses to give the WHO avian flu virus samples taken from Indonesian victims. This matters because sample sharing allows experts around the world to track mutations of the virus and spot dangerous mutations. Even more important, sharing allows researchers to develop vaccines.

Health Minister Siti Fadilah Supari asserts that Indonesian bird flu is a form of intellectual property, from which the country should benefit. Whether that means Indonesia simply wants to ensure affordable access to any vaccine developed from its samples – or whether Jakarta will demand a share in the profits – is unclear. Ms. Supari has complained in the past of labs using Indonesian samples for "commercial" reasons, raising the question of where she thinks vaccines come from, if not from private companies with a profit motive. Of almost 60 bird flu cases in the past year, Indonesia has given WHO all of two samples – but only for surveillance, not vaccine research. They were from high-profile cases in Bali, and Jakarta worried that tourists would stay away.

The dispute may partly be due to domestic politics. Ms. Supari evidently thinks this viral nationalism plays well in public opinion. She published a book earlier this year titled "It's Time To Change: Divine Hands Behind Bird Flu," in which she speculates the U.S. uses virus samples to conduct research on biological weapons. Next year is an election, and Ms. Supari is becoming a favorite of various Islamic groups, on which President Susilo Bambang Yudhoyono could end up depending.

Whatever Jakarta's motivation, without the samples it's much harder for researchers to develop any vaccine. Viruses mutate constantly. That's especially true in Indonesia, which has the highest number of cumulative bird flu infections – 132 since 2003, compared with 106 in Vietnam. Without samples from those cases, researchers can't tackle the most up-to-date form.

The worst-case scenario would be for a virulent strain to evolve in Indonesia and catch researchers by surprise, because they have no experience working with its predecessors. Even if scientists do develop a vaccine based on samples from, say, Vietnam, they have no way of testing its efficacy against the Indonesian variety. All together, it's a recipe for a pandemic, particularly if other countries start following Jakarta's lead.

Indonesia's leaders now say they want a speedy resolution to the sample-sharing dispute. In a meeting this week with U.S. Secretary of Health and Human Services Mike Leavitt, the Coordinating Minister for the People's Welfare, Aburizal Bakrie, promised to finalize an agreement within two months.

There's no time to waste. Of the 240 human bird flu deaths reported in 12 countries since 2003, 107 have been in Indonesia – 12 already this year. The next highest cumulative death toll is 52 in Vietnam. Better to share samples now and allow scientists to develop a vaccine than scramble to do so when a pandemic hits.

But the world will have vaccines to protect against the avian flu virus only if scientists are able to carry out research. By hoarding samples and trying to tinker with the financial incentives that drive pharmaceutical innovation, Indonesia is endangering everyone.

Title: Economics of Flu Vaccines
Post by: Body-by-Guinness on August 27, 2008, 10:04:55 AM
Novavax Moves Closer to Licensing Bird Flu Vaccine
By Kendra Marr
Washington Post Staff Writer
Wednesday, August 27, 2008; D04

Novavax said yesterday that its bird flu vaccine elicited a robust immune response in humans, moving the biotech a step closer to licensing its pandemic vaccine production system.

In the trial, 160 patients received two vaccine injections, of 15 to 90 micrograms, one month apart. Of the patients who received the highest dosage, 94 percent produced antibodies to neutralize H5N1, an Indonesian strain of bird flu that emerged in 2005 and has been linked to 110 deaths.

"These results are strong and very competitive," said Rahul Singhvi, Novavax's chief executive.

Shares of Novavax fell 6 cents, or 2 percent, to $2.91.

Novavax has had a demo of the vaccine manufacturing process set up at its Rockville headquarters since May 1 but does not have a buyer.

There were 385 cases of bird flu in humans, leading to 243 deaths, from 2003 to June 19, according to the World Health Organization's most recent data. Outbreaks have mostly centered on Asia.

Many large multinational biotechs -- GlaxoSmithKline, Sanofi-Aventis, Novartis -- are working on bird flu vaccines in the United States and Western Europe under government contract, said Ken Trbovich, an analyst with RBC Capital Markets.

Novavax has partnered with GE Healthcare to reach the rest of the world by providing other countries a system to quickly mass-produce vaccines.

"If you truly believe a pandemic outbreak is likely, there is reason to believe foreign governments and the U.S. will clamp down and control the supply," Trbovich said. He added, "Other places in the world may have a lot of money, but no amount of money will get you vaccines in the case of a pandemic."

Traditionally, to create flu vaccines, drugmakers grow live virus strains in chicken eggs, which act as incubators. The virus is later killed and bottled into a vaccine. But eggs are a volatile medium, and a scarce supply essentially stops production.

Novavax's bird flu vaccine uses particles that mimic the size and shape of the virus, which trigger an immune response but lack the genetic material to replicate.

Because the particles are produced in more stable insect-cell cultures, yields are seven to 10 times higher than egg-based manufacturing, Novavax said. The vaccine can also be created within 10 to 12 weeks of identifying a pandemic strain -- half the time it takes to make egg-based vaccines.

GE is developing the production equipment, which is cheap to set up and run in case of a pandemic.

In December, Novavax studied low doses of its bird flu vaccine in a much smaller patient population. After tweaking the production process, the biotech was able to elicit a stronger immune response in this recent trial.

Novavax is seeking a governmental or pharmaceutical partner to finance the next set of human trials.

"We see no reason to invest additional money of our own into the pandemic vaccine when we can wait for a foreign government that needs this vaccine to put money in," Singhvi said.

Meanwhile, Novavax will be begin human tests of its seasonal influenza vaccine, using virus-like particles, in the fall. Currently all U.S. flu vaccines are egg-based.

"The pandemic area is difficult to monetize even if you successfully generate a contract," Trbovich said. "There are no reoccurring revenues. Moving a seasonal flu vaccine into clinical trials is their first real commercial opportunity."
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on August 29, 2008, 05:04:21 AM
Amazing that the stock actually fell a bit on this news , , , :?
Title: Bird Flu breakout in China?
Post by: Crafty_Dog on February 04, 2009, 05:13:45 AM
A friend forwarded the following to me.  The site's reliability is unknown to me
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on February 04, 2009, 05:50:34 PM

Title: Adult Stem Cell HIV Cure?
Post by: Body-by-Guinness on February 12, 2009, 04:06:55 AM
Published online 11 February 2009 | Nature | doi:10.1038/news.2009.93
News: Briefing
Stem-cell transplant wipes out HIV
But the treatment is too risky to help most who are infected with the virus.

Heidi Ledford

Bone marrow stem-cells may have cured one man of HIV.Getty
A man may have been cured of both HIV and leukaemia after receiving a stem-cell transplant from a donor who is genetically resistant to HIV.

About two years after the procedure, there is still no sign of the virus, even though the patient no longer takes antiretroviral drugs. Nature News takes a look at the promises and limitations of the experimental treatment.

Haven't we heard about this before?

The German physicians announced their finding in November 2008. Since then, the results have been peer reviewed and are now published in the New England Journal of Medicine1.

What did the physicians actually do?

They essentially did what they would do for any leukaemia patient who was not responding adequately to chemotherapy: they searched donor registries for bone-marrow donors who were a match for their patient, and prepared to perform a transplant.

But haematologist Gero Hütter of the Charité Universitätsmedizin in Berlin took the search for a donor one step further. Hütter does not specialize in HIV cases but when he realized that his patient would need a transplant, he remembered a paper he had read more than a decade earlier about HIV resistance in people who carry a specific genetic mutation.

The mutation is a short deletion in the CCR5 gene. The gene encodes a receptor that HIV uses to enter immune cells called CD4+ T cells. About 1% of the European population carries the CCR5 mutation in both copies of the CCR5 gene, making such people much less likely to contract the virus. If Hütter could replace his patient's immune cells with cells that lacked the CCR5 receptor, his patient might be less susceptible to HIV infection.

The patient had 80 matches in the bone-marrow registries of the German Bone Marrow Donor Center, and Hütter reasoned that one of those matches might also carry CCR5 mutations. Donor number 61 turned out to be the one, and in February 2007, the transplant was performed.

Can we really learn anything from an experiment performed in only one patient?

Even though the technique has only been applied in one patient, the results are valuable, says James Riley, an HIV researcher at the University of Pennsylvania in Philadelphia. "Of all the 'n=1' experiments out there, this is a good one," he says. "It's a tremendous proof of principle that if you can make the majority of your cells resistant to infection, you can really stop the virus."

Meanwhile, Hütter says that a different team of physicians intends to perform the same procedure in another HIV-positive patient with leukaemia. So in a few years, the experiment may reach n=2.

Was the patient cured?

That remains unclear. Although the patient has gone about two years without a relapse, it is still possible that the virus will make a comeback. The virus could be lurking in cells that doctors have not been able to test — such as cells in the brain or heart.

In addition, there is another strain of HIV that does not use CCR5 receptors to invade cells. This strain does not typically show up in patients with functioning immune systems, but it is still possible that this form of HIV could eventually proliferate in this patient.

What is clear is that this is not a treatment most HIV-positive people would want to receive. The risks involved with a bone-marrow transplant far outweigh those that come with years of antiretroviral drug therapy, even considering the troublesome side effects of these drugs. Before receiving the transplant, recipients are "conditioned" with drugs and radiation to destroy their own blood-producing stem cells. The procedure leaves them vulnerable to infection, and there is also the possibility that their bodies will eventually reject the transplant.

Instead of risking a transplant, couldn't you just use a drug to block CCR5?

You could. One CCR5 inhibitor, called maraviroc, is made by the pharmaceutical company Pfizer and is approved for use in the United States and Europe. Other companies are busy developing additional CCR5-targeting drugs.

Unfortunately, maraviroc does not completely prevent the virus from binding to CCR5, and it can only be used in combination with other antiretrovirals. "Basically HIV can find its way around the drug and still use CCR5," says Riley, who adds that the virus might outcompete the inhibitor, or may be able to bind to a different region of CCR5 than the drug.

Others are trying gene-therapy approaches to prevent CCR5 from being made at all. For example, Riley has been collaborating with Sangamo BioSciences, a biotechnology company based in Richmond, California, to determine whether the company's technique for snipping out targeted genes could be used to delete the CCR5 gene. Sangamo announced last week that it has launched a Phase I clinical trial that will involve removing a sample of the participant's T cells, deleting the CCR5 gene, and then infusing the cells back into the patient. The trial is a first step towards ascertaining the safety of the technique — not its efficacy — and participants will not be conditioned to destroy their unmodified T cells.

Hütter, G. et al. N. Engl. J. Med. 360, 692–698 (2009).
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on February 12, 2009, 09:42:32 AM
That is fascinating!

I wonder if this sort of thing will meet the approval of the O-bot bureaucrats?  :-P
Title: A worrying new blend in swine flu
Post by: Crafty_Dog on April 23, 2009, 03:17:49 PM

Seven people in U.S. hit by strange new swine flu 23 Apr 2009 20:54:48 GMT
Source: Reuters
 *Five new cases found in addition to two people on Tuesday

*CDC says no reason for concern yet

*Flu is unusual mixture but no deaths seen

(Updates throughout with quotes, details)

By Maggie Fox, Health and Science Editor

WASHINGTON, April 23 (Reuters) - Seven people have been diagnosed with a strange and unusual new kind of swine flu in California and Texas, the U.S. Centers for Disease Control and Prevention reported on Thursday.

All seven people have recovered but the virus itself is a never-before-seen mixture of viruses typical among pigs, birds and humans, the CDC said.

"We are likely to find more cases," the CDC's Dr. Anne Schuchat told a telephone briefing. "We don't think this is time for major concern around the country."

The CDC reported the new strain of swine flu on Tuesday in two boys from California's two southernmost counties.

Now, five more cases have been seen -- all found via normal surveillance for seasonal influenza. None of the patients, whose symptoms closely resembled seasonal flu, had any direct contact with pigs.

"We believe at this point that human-to-human spread is occurring," Schuchat said. "That's unusual. We don't know yet how widely it is spreading ... We are also working with international partners to understand what is occurring in other parts of the world."

Two of the new cases were among 16-year-olds at the same school in San Antonio "and there's a father-daughter pair in California," Schuchat said. One of the boys whose cases was reported on Tuesday had flown to Dallas but the CDC has found no links to the other Texas cases.


Unusually, said the CDC's Nancy Cox, the viruses all appear to carry genes from swine flu, avian flu and human flu viruses from North America, Europe and Asia.

"We haven't seen this strain before, but we hadn't been looking as intensively as we have," Schuchat said. "It's very possible that this is something new that hasn't been happening before."

Surveillance for and scrutiny of influenza has been stepped up since 2003, when highly pathogenic H5N1 avian influenza reappeared in Asia. Experts fear this strain, or another strain, could spark a pandemic that could kill millions.

H5N1 currently only rarely infects people but has killed 257 out of 421 infected in 15 countries since 2003, according to the World Health Organization.

The influenza strain is an H1N1, the same family as one of the seasonal flu viruses now circulating. Now that the normal influenza season is waning, it may be easier to spot cases of the new swine flu, Schuchat said.

Only one of the seven cases was sick enough to be hospitalized and all have recovered, Schuchat said.

"This isn't something that a person could detect at home," she said. The new cases appear to have somewhat more vomiting and diarrhea than is usually seen in flu, which mostly causes coughing, fever, sore throat and muscle aches.

The CDC is asking doctors to think about the possibility of swine flu when patients appear with these symptoms, to take a sample and send it to state health officials or the CDC for testing.

Cox said the CDC is already preparing a vaccine against the new strain, just in case. "This is standard operating procedure," Cox said. The agency will issue daily updates at

Seasonal flu kills between 250,000 and 500,000 people globally in an average year. And every few decades, a completely new strain pops up and it can cause a pandemic, a global epidemic that kills many more than usual. (Editing by Eric Walsh)
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on April 24, 2009, 08:46:06 PM the mexican counts are
 different than what we are seeing in the news but it has other good info.
Title: More on Swine Flu
Post by: Crafty_Dog on April 24, 2009, 10:50:57 PM
Title: Tamiflu
Post by: Crafty_Dog on April 25, 2009, 06:41:14 AM
Pasting this from the Health thread here too:

WHO ready with antivirals to combat swine flu
Fri Apr 24, 2009 5:11pm EDT  Email | Print | Share| Reprints | Single Page[-] Text

By Stephanie Nebehay

GENEVA (Reuters) - The World Health Organization (WHO) said on Friday that it was prepared with rapid containment measures including antivirals if needed to combat the swine flu outbreaks in Mexico and the United States.

The Geneva-based agency has been stockpiling doses of Roche Holding's Tamiflu, known generically as oseltamivir, a pill that can both treat flu and prevent infection.

The new virus, not previously detected in pigs or humans, has proved sensitive to the drug, the WHO said in a statement.

The WHO and its regional office in Washington, D.C., are also sending experts to Mexico to help health authorities with disease surveillance, laboratory diagnosis and clinical management of cases.

Mexican health officials have reported more than 850 cases of pneumonia in the capital, Mexico City, including 59 who died. In San Luis Potosi, in central Mexico, 24 cases including 3 deaths have been detected.

They have also informed the WHO about a third suspected outbreak of swine flu in Mexicali, near the U.S. border, with four suspect cases and no deaths so far.

The U.S. Centers for Disease Control have said there were 8 cases of swine influenza in California and Texas and no deaths.

Health authorities in the two North American countries have the resources required already in place, including Tamiflu, and are "well equipped," according to the WHO.

"WHO is prepared with rapid containment measures should it be necessary to be deployed," WHO spokeswoman Aphaluck Bhatiasevi told Reuters.

The United Nations agency saw no need at this point to issue travel advisories warning travelers not to go to parts of Mexico or the United States. "However, the situation may change depending on what the situation in the field is," she said.

The WHO will convene a meeting of its Emergency Committee on international health regulations, probably on Saturday afternoon, she added.

WHO director-general Margaret Chan was flying back to Geneva overnight from Washington, D.C., for the emergency discussions which would link public health authorities and experts in various parts of world in a virtual meeting, she said.

The emergency committee could make recommendations including whether to change the pandemic alert level, she added.

"Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high concern," the WHO said in a statement.
Title: Today's NYT
Post by: Crafty_Dog on April 26, 2009, 06:37:24 AM
XICO CITY — This sprawling capital was on edge Saturday as jittery residents ventured out wearing surgical masks and President Felipe Calderón published an order that would give his government emergency powers to address a deadly flu outbreak, including isolating those who have contracted the virus, inspecting the homes of affected people and ordering the cancellation of public events.

Skip to next paragraph
Students Fall Ill in New York, and Swine Flu Is Likely Cause (April 26, 2009)
Worrying About Every Cough at a Queens School (April 26, 2009)
Dot Earth: Contagion on a Small Planet (April 26, 2009) White-coated health care workers fanned out across the international airport here to look for ailing passengers, and thousands of callers fearful they might have contracted the rare swine flu flooded government health hot lines. Health officials also began notifying restaurants, bars and nightclubs throughout the city that they should close.

Of those Mexicans who did go out in public, many took the advice of the authorities and donned the masks, which are known here as tapabocas, or cover-your-mouths, and were being handed out by soldiers and health workers at subway stops and on street corners.

“My government will not delay one minute to take all the necessary measures to deal with this epidemic,” Mr. Calderón said in Oaxaca State during the opening of a new hospital, which he said would set aside an area for anyone who might be affected by the new swine flu strain that has already killed as many as 81 people in Mexico and sickened more than 1,300 others.

Mr. Calderón pointed out that he and the other officials who attended the ceremony intentionally did not greet each other with handshakes or kisses on the cheek, which health officials have urged Mexicans to avoid.

At a news conference Saturday night to address the crisis, Mexico’s health minister, José Ángel Córdova, said 20 of the 81 reported deaths were confirmed to have been caused by swine flu, while the rest are being studied. Most of the cases of illness were reported in the center of the country, but there were other cases in pockets to the north and south.

The government also announced at the news conference that schools in and around the capital that serve millions of students would remain closed until May 6.

With 20 million people packed together tight, Mexico City typically bursts forth on the weekends into parks, playgrounds, cultural centers and sidewalk cafes. But things were quieter than usual on Saturday.

The government encouraged people to stay home by canceling concerts, closing museums and banning spectators from two big soccer matches on Sunday that will be played in front of television cameras, but no live crowd.

At street corners on Saturday, even many of the jugglers, dancers and musicians who eke out a living collecting spare change when the traffic lights turn red were wearing bright blue surgical masks.

The newspaper Reforma reported that President Obama, who recently visited Mexico, was escorted around Mexico City’s national anthropology museum on April 16 by Felipe Solis, an archaeologist who died the next day from flu-like symptoms. But Dr. Córdova said that it does not appear that Mr. Solis died of influenza.

White House officials said Saturday that they were aware of the news reports in Mexico but that there was no reason to be concerned about Mr. Obama’s health, that he had no symptoms and that his medical staff had recommended he not be tested.

The Centers for Disease Control and Prevention in Atlanta said Saturday that it had sent a team of experts to Mexico to assist with the investigation of the outbreak, which has already been reported in Texas and California and possibly in New York, raising fears that it could spread into a global pandemic.

The possible New York cases were reported at a Queens high school, where eight students tested positive for a type of influenza that health officials suspect could be the new swine flu. Some of the school’s students had traveled to Mexico recently.

Still, the World Health Organization, which held a meeting on Saturday to discuss the outbreak, chose not to raise the level of global pandemic flu alert, which has been at a Level 3 because of the avian flu.

Epidemiologists want to know exactly when the first cases occurred in Mexico. Mexican health officials said they first noticed a huge spike in flu cases in late March. In mid-April, they began noticing that otherwise healthy people were dying from the virus. But it was only on Thursday night that officials first sounded an alarm to the population by closing schools, after United States health officials announced a possible swine flu outbreak.

By issuing the emergency decree Saturday, Mr. Calderón may have been trying to head off criticism that his government had been too slow to act. He had earlier called in the army to distribute four million masks throughout the capital and its suburbs.

Lt. Raymundo Morales Merla, who stood outside a military transport truck parked outside a downtown subway station on Saturday, led a group of 27 soldiers who had arrived at 7 a.m. to hand out as many masks as they could.

The scene at the airport was alarming, with doctors stationed at the entrances to answer questions and to keep an eye out for obviously sick people. Regular public address announcements in English and Spanish warned travelers that anyone exhibiting any symptoms should cancel their flight and immediately seek medical attention.

Even Sunday Mass will probably be affected. The Roman Catholic Church gave worshipers the option to listen to Masses on the radio and told priests who decided to hold services to be brief and put Communion wafers in worshipers’ hands instead of their mouths.

Axel de la Macorra, 46, a physics professor at National Autonomous University of Mexico, said he became worried when he learned recently that a 31-year-man who played at a tennis club he once belonged to had suddenly died. “He got sick at the beginning of April and two weeks later, he was dead,” said Mr. de la Macorra, who was weighing whether to attend a First Communion with 200 guests on Saturday.

“My mother told me to wear it so I did,” said Noel Ledezma, 29, who had his mask pulled down so he could sip a coffee and eat a muffin as he walked to work. “Who knows who will be next.”

Sarahe Gomez, who was selling jewelry at a mall in the upscale Polanco neighborhood, spoke through a mask to the few customers who visited her kiosk. “I’m in the middle of all these people and one of them could have it,” she said. “The virus could be anywhere. It could be right here.”

She then took a half step back.

“This is no joke,” said Servando Peneda, 42, a lawyer who ventured out to pay a bill, but left his two sons home. “There’s 20 million of us in this city and I’d say half of us have these masks on today. I know all of us will die one day, but I want to last out the week.”

Antonio Betancourt contributed reporting from Mexico City, and Sheryl Gay Stolberg from Washington.
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on April 26, 2009, 07:36:49 AM

Title: Stratfor on Pig Flu
Post by: Crafty_Dog on April 27, 2009, 09:06:55 AM
Intelligence Guidance (Special Edition): April 27, 2009 - Swine Flu Outbreak
April 27, 2009 | 1500 GMT

A member of the Mexican Navy stands guard at Pantitlan subway station in Mexico City on April 26Editor’s Note: The following is an internal STRATFOR document produced to provide high-level guidance to our analysts. This document is not a forecast, but rather a series of guidelines for understanding and evaluating events, as well as suggestions on areas for focus.

Related Special Topic Page
Weekly Updates
We need to ramp up on a number of issues related to the H1N1 swine flu outbreaks. So far there are 1,663 suspected infections and 103 reported deaths. Nearly all of the infections and all of the deaths are in Mexico (98 percent of both have been in Mexico City itself). The high population density of Mexico City has allowed the new strain to spread very quickly and provided ample opportunities for it to be carried abroad. There are now suspected cases in Canada, New Zealand, Spain, France, Israel, Brazil and the United States.

But before we delve deeper into this topic, we must clarify what this is not. It is obvious that we’re not dealing with a 1918 style pandemic. The current H1N1 strain � “H1” and “N1” indicate certain proteins on the surface of the flu virus � was first detected in March. While there obviously have been deaths, we are not seeing numbers that indicate this is particularly horrible disease. Something like the 1918 avian virus would already be killing people in significant numbers in places as scattered as Singapore, Buenos Aires and Moscow. It appears that this H1N1 strain is simply a new strain of the common flu that is somewhat more virulent. All evidence thus far indicates that a simple paper mask is effective at limiting transmission, and that common anti-viral medications such as Tamiflu and Relenza work well against the new strain.

That does not mean there will not be disruptions. Several governments already are banning the import of North American pork products. Considering that the human-communicable strain has already traveled to every continent, this is a touch silly, but governments must appear to do something — and there is nothing seriously that can be done to quarantine a continent from something as communicable as a flu bug. We expect limited travel restrictions to pop up sooner rather than later. EU Health Commissioner Andorra Vassiliou has already recommended that Europeans rethink any plans to travel to North America. This is not yet a ban or even a travel warning, but those are logical next steps for spooked governments. Several states have been using thermal scanners at airports to check passengers for fevers, and so isolate potential carriers (this measure is of limited use — once a carrier is in the airport, he has probably already spread the virus).

The busy folks at the Centers for Disease Control and Prevention (CDC) need to become our new best friends. The CDC is not like the Federal Emergency Management Agency (FEMA) — it is not tasked to provide any hands-on, local support. Instead, they are a sort of brain trust of researchers that decode the virus, and based on their findings, produce recommendations as to how to limit the virus’ spread and mitigate the virus’ effects. At present the CDC has not yet decoded the virus.

We also need to touch base with various national health authorities the world over who were stressed about a possible H5N1 outbreak in 2007. Many of the procedures that were put into place to deal with a potential H5N1 catastrophe (information dissemination, vaccine dissemination, antiviral stockpiles, etc) remain applicable for combating this new H1N1 strain. We need to familiarize ourselves with what the thresholds are for the major health authorities. Some question to ask: At what point would you consider quarantines? At what point would you release antiviral stockpiles? How big are those stockpiles? What steps are you taking to detect new cases? Are there any travel or trade restrictions that you are considering or implementing?

Are there any places in the world where H1 flu strains are not prevalent? Once you have the flu, you develop a natural resistance to not just that specific strain, but any strain that is somewhat similar. H1 has been present in the United States for years and H1 strains regularly make it into American flu vaccines. Since it is believed that it is the H1 portion of this new virus that has been tweaked, in theory this will provide Americans with some limited protection. Are there any national populations that lack this protection?

We need to look at trade as well. Already Russia, China and the Philippines have barred pork imports of North American origin. (Incidentally, you are never at risk of contracting flu viruses from meat products unless you fail to cook it thoroughly.) We need to look at the trade question from two points of view. First, what trade flows (primarily pork) could be directly affected. Second, the global economy really does not need a major confidence hit right now. We need to be extremely vigilant of any indirect impacts this will have on capital availability, travel and consumer spending in the current fragile economic climate. Asian and European stock markets had a bad day today, but not inordinately so (Japan’s Nikkei — one of the world’s largest exchanges by value — actually rose a bit).

But the biggest question is why have there been deaths in Mexico City and not anywhere else? The idea that the Mexican health system is subpar does not hold: most people do not seek medical treatment for flu symptoms, so medical quality does not yet seriously enter into the picture. The explanation could be nothing more complicated than the fact that the strain first broke out in Mexico City and has not yet advanced far enough elsewhere to produce deaths (and if that is the case we should be seeing some terminal cases in the United States in the next few days).

So far the CDC does not have an opinion on this topic, but we need to discover if there is something fundamentally different about the situation — or the virus — in Mexico vis-a-vis the rest of the world.
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: ccp on April 27, 2009, 01:36:19 PM
I would not yet jump to the conclusion this article suggests that this virus is not as dangerous as say the one in 1918 - at least not yet.

It is true the one then was an avian virus and this one from pigs.   Yet I read the people who are dying are not the typical young and old as in most influenza seasons but the young and healthy which is eerily like the one in 1918.  H1 or H5 this applies:

The scientists suspect that with the 1918 flu, changes in just 25 to 30 out of about 4,400 amino acids in the viral proteins turned the virus into a killer. The new work also reveals that 1918 virus acts much differently from ordinary human flu viruses. It infects cells deep in the lungs of mice and infects lung cells, like the cells lining air sacs, that would normally be impervious to flu. And while other human flu viruses do not kill mice, this one, like today's bird flus, does.
Title: Pig Flu gathering momentum here in US
Post by: Crafty_Dog on April 27, 2009, 01:48:40 PM

"Swine flu fears prompt global quarantine plans"
By LAURAN NEERGAARD, AP Medical Writer Lauran Neergaard, Ap Medical Writer –

WASHINGTON – President Barack Obama said Monday the threat of spreading swine flu infections was a concern but "not a cause for alarm," while customs agents began checking people coming into the United States by land and air. The World Health Organization said there were 40 confirmed cases in the U.S. but no deaths.

Countries across the globe increased their vigilance amid increasing worries about a worldwide pandemic, Obama told a gathering of scientists that his administration's Department of Health and Human Services "has declared a public health emergency as a precautionary tool to ensure that we have the resources we need at our disposal to respond quickly and effectively."

The acting head of the Centers for Disease Control and Prevention, Dr. Richard Besser, said that Americans should be prepared for the problem to become more severe, and that it could involve "possibly deaths."

The quickening pace of developments in the United States in response to some 1,600 swine flu infections in neighboring Mexico — and reports of over 100 deaths — was accompanied by a host of varying responses around the world. The European Union advised against nonessential travel to the U.S. and Mexico, while China, Taiwan and Russia considered quarantines and several Asian countries scrutinized visitors arriving at their airports.

U.S. customs officials began checking people entering U.S. territory. Officers at airports, seaports and border crossings were watching for signs of illness, said Customs and Border Protection spokesman Lloyd Easterling.

If a traveler says something about not feeling well, the person will be questioned about symptoms and, if necessary, referred to a CDC official for additional screening, Easterling said. The customs officials were wearing personal protective gear, such as gloves and masks, he said.

Multiple airlines, including American, United, Continental, US Airways, Mexicana and Air Canada, said they were waiving usual penalties for changing reservations for anyone traveling to, from, or through Mexico, but had not canceled flights.

The CDC's Besser said that while the U.S. hasn't advised against travel to Mexico, it has urged people to take precautions, such as frequent hand-washing while there.

A private school in South Carolina was closed Monday because of fears that young people who recently returned from Mexico might have been infected.

"We are closely monitoring the emerging cases of swine flu in the United States," Obama said. "I'm getting regular updates on the situation from the responsible agencies, and the Department of Health and Human Services as well as the Centers for Disease Control will be offering regular updates to the American people so that they know what steps are being taken and what steps they may need to take."

"But one thing is clear: Our capacity to deal with a public health challenge of this sort rests heavily on the work of our scientific and medical community," the president said. "And this is one more example of why we cannot allow our nation to fall behind."

Besser, the CDC official, described the new U.S. border initiative as "passive screening." He said authorities were "asking people about fever and illness, looking for people who are ill."

The U.S. declared a national health emergency in the midst of uncertainty about whether the mounting sick count meant new infections were increasing or health officials had simply missed something that had been simmering for weeks or months. The declaration allowed Washington to ship roughly 12 million doses of flu-fighting medications from a federal stockpile to states in case they are needed.

Besser traveled the morning news-show circuit Monday, telling interviewers the U.S. government was being "extremely aggressive" and saying he wouldn't personally recommend traveling to parts of Mexico where the new virus had taken hold.

Besser said he was not reassured by the fact that so far in the U.S., no one had died from the disease.

"From what we understand in Mexico, I think people need to be ready for the idea that we could see more severe cases in this country and possibly deaths," he said. "That's something people have to be ready for and we're looking for that. So far, thankfully, we haven't seen that. But we're very concerned and that's why we're taking very aggressive measures."

Meanwhile, officials of Newberry Academy in South Carolina said Monday that seniors from the school were in Mexico earlier this month and some had flu-like symptoms when they returned.

State Department of Health and Environmental Control spokesman Jim Beasley said test results on the students could come back as early as Monday afternoon. The agency has stepped up efforts to investigate all flu cases in South Carolina. There have been no confirmed swine flu cases in the state.

A New York City school where eight cases were confirmed will be closed Monday and Tuesday, and 14 schools in Texas, including a high school where two cases were confirmed, will be closed for at least the next week. Some schools in California and Ohio also were closing after students were found or suspected to have the flu.

In Mexico, the outbreak's center, soldiers handed out 6 million face masks to help stop the spread of the virus that is suspected in up to 103 deaths. Most other countries are reporting only mild cases so far, with most of the sick already recovering.

Spain reported its first confirmed swine flu case on Monday and said another 17 people were suspected of having the disease. The European Union health commissioner advised Europeans to avoid nonessential travel to Mexico and the United States. Also, three New Zealanders recently returned from Mexico are suspected of having it.

"These are the early days," said World Health Organization spokesman Peter Cordingley. "It's quite clear that there is a potential for this virus to become a pandemic and threaten globally." He said it was spreading rapidly in Mexico and the southern United States.

Worldwide, attention focused on travelers.

"It was acquired in Mexico, brought home and spread," Nova Scotia's chief public health officer, Dr. Robert Strang, said of Canada's first confirmed cases.


Associated Press writers Mark Stevenson and Olga R. Rodriguez in Mexico City; Frank Jordans in Geneva; Mike Stobbe in Atlanta; Maria Cheng in London and Eileen Sullivan in Washington contributed to this report.
Title: "phase four' says the WHO
Post by: ccp on April 27, 2009, 03:04:29 PM
TORONTO, April 27 -- The World Health Organization has raised its pandemic alert system to level four -- sustained human-to-human transmission -- in response to the swine flu outbreak in the U.S., Mexico, and at least two other countries.

The Geneva-based WHO made the change from level three -- some human-to-human transmission -- on the advice of an expert panel meeting today.

Earlier today, acting CDC director Richard Besser, M.D., said the change won't affect the U.S. response to the outbreak.

"It really doesn't matter from our perspective what you call this," he said in a press conference. "Our actions are based on what's happening in our country and our communities."

Stepping up one phase, Dr. Besser said, "would not change anything that we are currently doing."

The pandemic threat level has six major levels. Phases one through three increase from strictly animal-to-animal transmission to some human-to-human transmission, sufficient to create small clusters of disease.

Level four requires sustained human-to-human transmission able to cause what the WHO calls "community-level outbreaks."

Levels five and six are the pandemic levels.

Phase five is characterized by human-to-human spread of the virus into at least two countries in a region, although most countries are not affected.

In phase six, there are community-level outbreaks in at least one other country in a different region. This level is regarded as a signal that a global pandemic is truly under way.

Title: WSJ: Understanding Swine Flu
Post by: Crafty_Dog on April 28, 2009, 05:19:39 AM

The extent and impact of the swine flu epidemic, which appears to have originated in Mexico and spread rapidly to a dozen countries and parts of the U.S., is still unknown. The epidemiology of such disease outbreaks is rather like a jigsaw puzzle, and we are now at the stage where the picture is intriguing even if we're not sure what we're seeing.

Chad Crowe
 We do know the number of cases in Mexico exceeds 1,995, there have been at least 149 deaths, and there have been 20 cases in five U.S. states (with no fatalities as yet). And that the outbreak causes us to confront complex issues that encompass medicine, epidemiology, virology and even politics and ethics.

These events demonstrate that good surveillance is needed in order to detect early on that a new infectious agent, transmissible between humans, has emerged. Unfortunately, conditions in many countries are conducive to the emergence of such new infectious agents, especially flu viruses, which mutate rapidly and inventively. Intensive animal husbandry procedures that place poultry and swine in close proximity to humans, combined with unsanitary conditions, poverty and grossly inadequate public-health infrastructure of all kinds -- all of which exist in Mexico, as well as much of Asia and Africa -- make it unlikely that a pandemic can be prevented or contained at the source.

In theory, a flu pandemic might be contained in its early stages by performing "ring prophylaxis" -- aggressively using antiflu drugs, vaccines and quarantines to isolate relatively small outbreaks of the new infectious agent. Addressing H5N1 avian flu in 2005, Johns Hopkins University virologist Donald S. Burke said, "it may be possible to identify a human outbreak at the earliest stage, while there are fewer than 100 cases, and deploy international resources -- such as a WHO [World Health Organization] stockpile of antiviral drugs -- to rapidly quench it. This 'tipping point' strategy is highly cost-effective."

But a strategy can be "cost-effective" only if it is feasible. Early ring prophylaxis might work in Minneapolis, Toronto, Singapore or Zurich. In places such as Indonesia, China and Mexico, however, the expertise, coordination, discipline and infrastructure are lacking. Moreover, there is no vaccine available to prevent infection of humans by the new H1N1 swine flu (or by H5N1 avian flu, for that matter).

The rapid and constant movement of goods and people around the world makes early containment virtually impossible. We saw this with the SARS (Severe Acute Respiratory Syndrome) epidemic in 2003: Within a matter of weeks, the disease spread rapidly from southern China to infect individuals in some 37 countries, killing about 800.

In the current swine flu outbreak, New York City high-school students apparently brought the virus back from Mexico and infected their classmates. All six cases so far reported in Canada were connected directly or indirectly with travel to Mexico.

Flu viruses can be directly transmitted (via droplets from sneezing or coughing) from pigs to people, and vice versa. These cross-species infections occur most commonly when people are in close proximity to large numbers of pigs, such as in barns, livestock exhibits at fairs, and slaughterhouses. And, of course, flu is transmissible from human to human, either directly or via contaminated surfaces.

Pigs are uniquely susceptible to infection with flu viruses of mammalian and avian origin. This is of concern for a couple of reasons. First, pigs can serve as intermediaries in the transmission of flu viruses from birds to people. And when avian viruses infect pigs, they adapt and become more efficient at infecting mammals -- which makes them more easily transmitted and dangerous to humans.

Second, pigs can serve as hosts in which two (or more) influenza viruses infecting an animal simultaneously can undergo "genetic reassortment," a process in which pieces of viral RNA (the virus's genetic material, similar to DNA) are shuffled and exchanged, creating a new organism. The influenza viruses responsible for the world-wide 1957 and 1968 flu pandemics -- which killed about 70,000 and 34,000, respectively, in the U.S. -- were such viruses, containing genes from both human and avian viruses.

Experience shows that attempts to stem the spread of an outbreak may actually exacerbate it. In 2006, China's chaotic effort to vaccinate 14 billion chickens to control avian flu was compromised by counterfeit vaccines and the absence of protective gear for vaccination teams. This likely spread contagion by vaccinators who carried infected fecal material on their shoes from one farm to another.

The situation in Mexico resembles the scenario we might expect for an outbreak of a major human-to-human pandemic in its earliest stages: a large number of illnesses among social and family contacts of victims; infection of health-care workers and patients in hospitals where the victims are treated; and the rapid spread of confirmed cases from an initial region to other countries as people infected by the virus travel while it is incubating, but before they become seriously ill.

Because they have been stockpiled for use in the event of an avian flu pandemic, large amounts of the antiflu drugs Tamiflu and Relenza are available. However, they must be administered during the first couple of days after symptoms begin to be an effective treatment. They can also prevent the onset of the disease if administered in adequate doses prior to exposure. The danger of using antiflu drugs in poor countries with inadequate public-health facilities such as Mexico is that they may be administered improperly and in suboptimal doses, which would promote viral resistance and intensify an outbreak.

If the swine flu outbreak becomes a pandemic with a high rate of severe complications (such as pneumonia) and death, we will need to be smart, nimble and flexible. That will involve triage on many levels -- including decisions about which patients are likely to benefit from scarce commodities such as drugs and ventilators -- as well as "social engineering" determinations about issues such as mandatory quarantine, the canceling of public events, shutting airports and closing our southern border. Let's hope it doesn't come to that.

Dr. Miller, a physician and molecular biologist, is a fellow at Stanford University's Hoover Institution. He is a former flu researcher and was an official at the National Institutes of Health and the Food and Drug Administration from 1977 to 1994.
Title: NYT: What's in the pipeline?
Post by: Crafty_Dog on April 28, 2009, 06:21:05 AM
Where Will the Swine Flu Go Next?

AS the swine flu threatens to become the next pandemic, the biggest questions are whether its transmission from human to human will be sustained and, if so, how virulent it might become. But even if this virus were to peter out soon, there is a strong possibility it would only go underground, quietly continuing to infect some people while becoming better adapted to humans, and then explode around the world.

What happens next is chiefly up to the virus. But it is up to us to create a vaccine as quickly as possible.

Influenza viruses are unpredictable because they are able to mutate so rapidly. That capacity enables them to jump easily from species to species, infecting not only pigs and people but also horses, seals, cats, dogs, tigers and so on. An avian virus responsible for the 1918 pandemic jumped first from birds to humans, then from humans to swine (as well as other animals). Now, and not for the first time, pigs have given a virus back to humans.

Mutability makes even existing, well-known flu viruses unpredictable. A new virus, formed by a combination of several existing ones as this virus is, is even less predictable. After jumping to a new host, influenza can become more or less virulent — in fact, different offshoots could go in opposite directions — before a relatively stable new virus emerges.

Influenza pandemics have occurred as far back in history as we can look, but the four we know about in detail happened in 1889, 1918, 1957 and 1968. The mildest of these, the so-called Hong Kong flu in 1968, killed about 35,000 people in the United States and 700,000 worldwide. Ordinary seasonal influenza, in comparison, now kills 36,000 Americans a year, because the population has a higher proportion of elderly people and others with weak immune systems. (If a virus like the Hong Kong flu hit today, it would probably kill more people for the same reason.)

The worst influenza pandemic, in 1918, killed 675,000 in the United States. And although no one has a reliable worldwide death toll, the lowest reasonable number is about 35 million, and some scientists believe it killed as many as 100 million — at a time when the world’s population was only a quarter of what it is today. The dead included not only the elderly and infants but also robust young adults.

What’s important to keep in mind in assessing the threat of the current outbreak is that all four of the well-known pandemics seem to have come in waves. The 1918 virus surfaced by March and set in motion a spring and summer wave that hit some communities and skipped others. This first wave was extremely mild, more so even than ordinary influenza: of the 10,313 sailors in the British Grand Fleet who became ill, for example, only four died. But autumn brought a second, more lethal wave, which was followed by a less severe third wave in early 1919.

The first wave in 1918 was relatively mild, many experts speculate, because the virus had not fully adapted to humans. And as it did adapt, it also became more lethal. However, there is very good evidence that people who were exposed during the first wave developed immunity — much as people get protection from a modern vaccine.

A similar kind of immune-building process is the most likely explanation for why, in 1918, only 2 percent of those who contracted the flu died. Having been exposed to other influenza viruses, most people had built up some protection. People in isolated regions, including American Indian reservations and Alaskan Inuit villages, had much higher case mortality — presumably because they had less exposure to influenza viruses.

The 1889 pandemic also had a well-defined first wave that was milder than succeeding waves. The 1957 and 1968 pandemics had waves, too, though they were less well defined.

In all four instances, the gap between the time the virus was first recognized and a second, more dangerous wave swelled was about six months. It will take a minimum of four months to produce vaccine in any volume, possibly longer, and much longer than that to produce enough vaccine to protect most Americans. The race has begun.

John M. Barry, a visiting scholar at the Tulane/Xavier Center for Bioenvironmental Research, is the author of “The Great Influenza.”
Title: And I Bet He Flies Coach, Too
Post by: Body-by-Guinness on April 30, 2009, 06:53:27 AM
Guess Joe didn't get the memo that we are supposed to keep going about our business where the swine flu is concerned. Instead, people shouldn't be riding the subway or flying in aircraft:
Title: Some truths about flu
Post by: ccp on April 30, 2009, 11:51:56 AM
This is an excellent book on the 1918-19 pandemic:

I wrote an article for a local newspaper on the 1918 pandemic when it was the 75th anniversary of it in 1993.

One thing I have not heard mentioned has to do with the fact that most people who died back then did not die of viral neumonia but of secondary bacterial pneumonia.

Indeed the reason it was even named the influenza epidemic was because pathologists early into it identified on smears the heamophilus influenza BACTERIA.  So influenza got it's name by mistake.  Of course in those days they could not see or had no way to even know what a virus was.

So most of those people similarly sick today would not have died because we now have antibiotics to cure them.

So the threat with that kind of virus is much less serious for those of us in the US then it was.  Maybe in the thousands but definitely not in the hundreds of thousands or millions in the US.

That said for other countries, in sub Sahara Africa, remote places in Asia, S. America where access to care is less robust the death rate for such a virus could be very high.

Additionally, the virus could mutate into something nver seen before with death rates much higher than say the estimated 5% in 1918 more akin to Ebola or Hanta viruses.

So I don't take the potential threat lightly.

Should we quarentine those coming from Mexico or prevent those from going?

Of course I am not a world expert but my feeling is that even trying to prevent the spread of influenza is just a fantasy.

It can't be done.

Even in 1918-19 before the advent of mass travel and migration the virus made its way to EVERY single corner of the world where there was humanity.

All the South sea Islands, Eskimos etc.  There was no place to hide.  There was no palce that was not hit.  None!

This is not trying to prevent a few cased of drug resistent TB.  You put armed military on the border with Mexico.  Forget it.
Influenza will get here if it is destined to.

Of course the politicians will always try to put blame on the other side.

Title: Re: Epidemics: Bird Flu, TB, etc
Post by: ccp on May 02, 2009, 07:29:59 AM
Just a thought.  I wonder if I should believe the new and reduced number of flu deaths in Mexico.
It seems reasonable to question the motives and thus the validity of the *new* estimates of the the death toll from flu.
Mexico's economy is being hurt by this whole thing.  We hear corruption is rampant.  So now I hear that oh, its not nearly as bad as we thought.  Well is it or not?  I don't know what to believe.

****Lower Mexico flu death toll heartens nervous world 02 May 2009 12:46:21 GMT
Source: Reuters
 (For full coverage of the flu outbreak, click [nFLU])

* Mexico cuts suspected flu death toll to up to 101

* WHO says flu spans 15 countries, 615 people infected

* U.S. responding aggressively to flu outbreak-Obama

* China cancels Mexico flights, Hong Kong seals off hotel

(Adds Obama comments)

By Catherine Bremer

MEXICO CITY, May 2 (Reuters) - New laboratory data showed fewer people have died in Mexico than first thought from a new influenza strain, a glint of good news for a world rattled by the threat of a flu pandemic.

Mexico cut its suspected death toll from the H1N1 flu to up to 101 from as many as 176, as dozens of test samples came back negative. Fewer patients with severe flu symptoms were also checking into hospitals, suggesting the infection rate of a flu that has spread to Europe and Asia was declining.

The World Health Organisation said on Saturday 15 countries have reported 615 infections with the new flu virus A-H1N1, widely known as swine flu [nL2430119].

Italy later confirmed its first case, a man in the Tuscany region who returned from Mexico on April 24. He has recovered.

Almost all infections outside Mexico have been mild. The only death in another country has been a Mexican toddler who was taken to the United States before he fell sick.

The U.S. Centers for Disease Control and Prevention agreed the outbreak may not be as severe as it looked a few days ago, citing many mild cases that were not immediately noticed. [ID:nN01346626]

President Barack Obama said the United States was responding aggressively to the new flu strain [nN01348184].

He outlined steps his administration was taking to address the virus, including school closures, and said antivirals were being distributed to states where they may be needed and new stockpiles had been ordered.

For Mexicans -- spending a second weekend stuck indoors with stores and businesses shuttered across the country and the capital, Mexico City, devoid of its lively restaurants, bars, cinemas and museums -- the data is cheering.

Health Minister Jose Angel Cordova acknowledged the numbers were encouraging but cautioned it was too early to say Mexico had control of the flu.

"For now it's unpredictable," Cordova said late on Friday. "We need more days to see how it behaves and whether there is really a sustained decline."

The new virus is only the third infectious disease experts regard as having pandemic potential in the past 10 years.

It has world health experts racing to find a vaccine and is wreaking havoc with a travel industry that flies hundreds of thousands of people to and from Mexico each week. [ID:nNN0129623]

China suspended flights to Mexico after Hong Kong authorities on Friday confirmed a Mexican man who flew via the Chinese mainland was infected with the flu strain.


Police in surgical masks quarantined 200 guests and 100 staff inside a Hong Kong hotel where the Mexican, 25, had been staying, saying they would be confined for a week. [ID:nT31820]

"They said everybody needed to go back to their rooms. I don't want to go to my room because I want to be out," an Australian man at the hotel told a TV reporter by telephone.

Hong Kong was badly hit by the SARS virus in 2003 and has had many episodes of H5N1 bird flu for more than a decade.

The Asian Development Bank said it was prepared to provide assistance to countries in the region to cope with the possible spread of flu, as it did during the SARS outbreak. [nJAK469756]

Several European countries have confirmed cases of the virus. The United States has been hit with 145 cases in 22 states. [ID:nN01348184]

Mexico has released a confusing batch of flu data in recent days but public hospitals have noted a steady drop in patients turning up with fevers, suggesting the infection rate may be declining as the nation dons face masks and hand gel.

"There are very few deaths worldwide," said Marcelo Musi, a salesman shopping for vegetables in Mexico City, where residents weary of masks, hand sanitizers and frightening headlines clutched at signs of an end to the crisis. "If there are no more cases, they say things will get better."

President Felipe Calderon ordered non-essential businesses to close for five days from Friday, extending a three-day holiday weekend over Monday and Tuesday. [ID:nN01340553]

Analysts say the move will further dent negative economic growth this year.

Countless families were devastated at having their long weekend ruined as restaurants, bars, playgrounds and parks that hold outdoor "cumbia" dances all stayed closed.

Cordova said of 159 files on suspected flu deaths, tests showed 58 died of other causes. He said 16 deaths are confirmed as caused by the H1N1 flu and 85 are being tested. (Additional reporting by Louise Egan and Anahi Rama and Tan Ee Lyn in Hong Kong, Laura MacInnis in Geneva, Silvia Aloisi in Rome; Editing by Janet Lawrence)****
Title: stratfor
Post by: Crafty_Dog on May 05, 2009, 09:51:13 AM
May 4, 2009

By George Friedman

Related Special Topic Page
Swine Flu Outbreak 2009

Word began to flow out of Mexico the weekend before last of well over 150 deaths suspected to have been caused by a new strain of influenza commonly referred to as swine flu. Scientists who examined the flu announced that this was a new strain of Influenza A (H1N1) derived partly from swine flu, partly from human flu and partly from avian flu strains (although there is some question as to whether this remains true). The two bits of information released in succession created a global panic.

This panic had three elements. The first related to the global nature of this disease, given that flus spread easily and modern transportation flows mean containment is impossible. Second, there were concerns (including our own) that this flu would have a high mortality rate. And third, the panic centered on the mere fact that this disease was the flu.

News of this new strain triggered memories of the 1918-1919 flu pandemic, sparking fears that the “Spanish flu” that struck at the end of World War I would be repeated. In addition, the scare over avian flu created a sense of foreboding about influenza — a sense that a catastrophic outbreak was imminent.

By midweek, the disease was being reported around the world. It became clear that the disease was spreading, and the World Health Organization (WHO) declared a Phase 5 pandemic alert. A Phase 5 alert (the last step before a pandemic is actually, officially declared, a step that may be taken within the next couple of days) means that a global pandemic is imminent, and that the virus has proved capable of sustained human-to-human transmission and infecting geographically disparate populations. But this is not a measure of lethality, only communicability, and pandemics are not limited to the deadliest diseases.

‘Pandemic,’ not ‘Duck and Cover’

To the medical mind, the word “pandemic” denotes a disease occurring over a wide geographic area and affecting an exceptionally high proportion of the population. The term in no way addresses the underlying seriousness of the disease in the sense of its wider impact on society. The problem is that most people are not physicians. When the WHO convenes a press conference carried by every network in the world, the declaration of a level 5 pandemic connotes global calamity, even as statements from experts — and governments around the world — attempt to walk the line between calming public fears and preparing for the worst.

The reason to prepare for the worst was because this was a pandemic with an extremely unclear prognosis, and about which reliable information was in short supply. Indeed, the new strain could mutate into a more lethal form and re-emerge in the fall for the 2009-2010 flu season. There are also concerns about how its victims disproportionately are healthy young adults under 45 years of age — which was reported in the initial information out of Mexico, and has been reported as an observed factor in the cases that have popped up in the United States. This was part of the 1918 flu pandemic pattern as well. (In contrast, seasonal influenza is most deadly among the elderly and young children with weaker immune systems.)

But as the days wore on last week, the swine flu began to look like little more than ordinary flu. Toward the end of the week, a startling fact began to emerge: While there were more than a hundred deaths in Mexico suspected of being caused by the new strain, only about 20 (a number that has increased slightly after being revised downward earlier last week) have been confirmed as being linked to the new virus. And there has not been a single death from the disease reported anywhere else in the world, save that of a Mexican child transported to the United States for better care. Indeed, even in Mexico, the country’s health minister declared the disease to be past its peak May 3. STRATFOR sources involved in examining the strain have also suggested that the initial analysis of the swine flu was in fact in error, and that the swine flu may have originated during a 1998 outbreak in a pig farm in North Carolina. This information reopens the question of what killed the individuals whose deaths were attributed to swine flu.

While little is understood about the specifics of this new strain, influenza in general has a definitive pattern. It is a virus that affects the respiratory system, and particularly the lungs. At its deadliest it can cause secondary infections — typically bacterial rather than viral — leading to pneumonia. In the most virulent forms of influenza, it is the speed with which complications strike that drives death rates higher. Additionally, substantively new strains (as swine flu is suspected of being) can be distinct enough from other strains of flu that pre-existing immunity gained from flus of years past does not help fend off the latest variation.

Influenza is not a disease that lingers and then kills people — save the sick, old and very young, whose immune systems are more easily compromised. Roughly half a million people (largely from these groups) die annually worldwide from more common strains of influenza, with the Centers for Disease Control and Prevention (CDC) pegging average American deaths at roughly 36,000 per year.

Swine flu deaths have not risen as would be expected at this point for a highly contagious and lethal new strain of influenza. In most cases, victims have experienced little more than a bad cold, from which they are recovering. And infections outside Mexico so far have not been severe. This distinction of clear cases of death in Mexico and none elsewhere (again, save the one U.S. case) is stark.

Much of what has occurred in the last week regarding the new virus reminds us of the bird flu scare of 2005. Then as now, the commonly held belief was that a deadly strain was about to be let loose on humanity. Then as now, many governments were heightening concerns rather than quelling them. Then as now, STRATFOR saw only a very small chance of the situation becoming problematic.

Ultimately, by the end of last week it had become clear to the global public that “pandemic” could refer to bad colds as well as to plagues wiping out millions.

A Real Crisis
The recent swine flu experience raises the question of how one would attempt to grapple with a genuine high-mortality pandemic with major consequences. The answer divides into two parts: how to control the spread, and how to deploy treatments.

The flu virus is widely present in two species other than humans, namely, birds and pigs. The history of the disease is the history of its transmission within and across these three species. It is comparatively easy for the disease to transmit from swine to birds and from swine to humans; the bird-to-human barrier is the most difficult to cross.

Cross-species influenza is of particular concern. In the simplest terms, viruses are able to recombine (e.g., human flu and avian flu can merge into a hybrid flu strain). What comes out can be a flu transmissible to humans, but with a physical form that is distinctly avian — meaning it fails to alert human immune systems to the intrusion. This can rob the human immune system of the ability to quickly recognize the disease and put up a fight.

New humanly transmissible influenza strains often have been found to originate in places where humans, pigs and/or fowl live in close proximity to each other — particularly in agricultural areas where animal and human habitation is shared or in which constant, close physical contact takes place.

Agricultural areas of Asia with dense populations, relatively small farms and therefore frequent and prolonged contact between species traditionally have been the areas in which influenza strains have transferred from animals to humans and then mutated into diseases transmissible by casual human contact. Indeed, these areas have been the focus of concern over a potential outbreak of bird flu. This time around, the outbreak began in Mexico (though it is not yet clear where the virus itself originated).

And this is key to understanding this flu. Because it appears relatively mild, it might well have been around for quite awhile — giving people mild influenza, but not standing out as a new variety until it hit Mexico. The simultaneous discovery of the strain amid a series of deaths (and what may now be in hindsight inflated concerns about its lethality) led to the recent crisis footing.

Any time such threats are recognized, they already are beyond containment. Given travel patterns in the world today, viruses move easily to new locations well before they are identified in the first place they strike. The current virus is a case in point. It appears, although it is far from certain, that it originated in the Veracruz area of Mexico. Within two days of the Mexican government having issued a health alert, it already had spread as far afield as New Zealand. One week on, cases completely unrelated to Mexico have already been confirmed on five continents.

In all probability, this “spread” was less the discovery of new areas of infection than the random discovery of areas that might have been infected for weeks or even months (though the obvious first people to test were those who had recently returned from Mexico with flu symptoms). Given the apparent mildness of the infection, most people would not go to the doctor. And if they did, the doctor would call it generic flu and not even concern himself with its type. What happened last week appears to have been less the spread of a new influenza virus than the “discovery” of places to which it had spread awhile ago.

The problem with the new variety was not that it was so deadly; had it actually been as uniquely deadly as it first appeared to be, there would have been no mistaking its arrival, because hospitals would be overflowing. It was precisely its mildness that sparked the search. But because of expectations established in the wake of the Mexico deaths, the discovery of new cases was disassociated from its impact. Its presence alone caused panic, with schools closing and border closings discussed.

The virus traveled faster than news of the virus. When the news of the virus finally caught up with the virus, the global perception was shaped by a series of deaths suddenly recognized in Mexico (as mentioned, deaths so far not seen elsewhere). But even as the Mexican Health Ministry begins to consider the virus beyond its peak, the potential for mutation and a more virulent strain in the next flu season looms.

As mentioned, viruses that spread through casual human contact can be globally established before anyone knows of it. The first sign of a really significant influenza pandemic will not come from the medical community or the WHO; it will come from the fact that people are catching influenza and dying, and are doing so all over the world at the same time. The system established for detecting spreading diseases is hardwired to be behind the curve. This is not because it is inefficient, but because no matter how efficient, it cannot block casual contact — which, given modern air transportation, spreads diseases globally in a matter of days or even hours.

Therefore, the problem is not the detection of deadly pandemics, simply because they cannot be missed. Rather, the problem is reacting medically to deadly pandemics. One danger is overreacting to every pandemic and thereby breaking the system. (As of this writing, the CDC remained deeply concerned about swine flu, though calm seems to be returning.)

The other danger is not reacting rapidly enough. In the case of influenza, medical steps can be taken. First, there are anti-viral medicines found to be effective against the new strain, and if sufficient stockpiles exist — which is hardly universally the case, especially in the developing world — and those stockpiles can be administered early enough, the course of the disease can be mitigated. Second, since most people die from secondary infection in the lungs, antibiotics can be administered. Unlike with the 1918 pandemic, the mortality rate can be dramatically reduced.

The problem here is logistical: The distribution and effective administration of medications is a challenge. Producing enough of the medication is one problem; it takes months to craft, grow and produce a new vaccine, and the flu vaccine is tailored every year to deal with the three most dangerous strains of flu. Another problem is moving the medication to areas where it is needed in an environment that maintains its effectiveness. Equally important is the existence of infrastructure and medical staff capable of diagnosing, administering and supporting patients — and doing so on a scale never before attempted.

These things will not be done effectively on a global basis. That is inevitable. But influenza, even at the highest death rates ever recorded for the disease, does not threaten human existence as we know it. At its worst, flu will kill a lot of people, but the human race and the international order will survive.

The true threat to humanity, if it ever comes, will not come from influenza. Rather, it will come from a disease spread through casual human contact, but with a higher mortality rate than flu and no clear treatment. While HIV/AIDS boasts an extraordinarily high mortality rate and no cure exists, it at least does not spread through casual contact as influenza does, and so the pace at which it can spread is limited.

Humanity will survive the worst that influenza can throw at it even without intervention. With modern intervention, its effect declines dramatically. But the key problem of pandemics was revealed in this case: The virus spread well before information on it spread. Detection and communication lagged. That did not matter in this case, and it did not matter in the case of HIV/AIDS, because the latter was a disease that did not spread through casual contact. However, should a disease arise that is as deadly as HIV, that spreads through casual contact, about which there is little knowledge and for which there is no cure, the medical capabilities of humanity would be virtually useless.

There are problems to which there are no solutions. Fortunately, these problems may not arise. But if they do, no amount of helpful public service announcements from the CDC and the WHO will make the slightest bit of difference.

Title: Swine Flu
Post by: Crafty_Dog on August 29, 2009, 04:18:34 AM
WHO warns of severe form of swine flu
By Maggie Fox, Health and Science Editor Maggie Fox, Health And Science Editor – Fri Aug 28, 1:36 pm ET

WASHINGTON (Reuters) – Doctors are reporting a severe form of swine flu that goes straight to the lungs, causing severe illness in otherwise healthy young people and requiring expensive hospital treatment, the World Health Organization said on Friday.  Some countries are reporting that as many as 15 percent of patients infected with the new H1N1 pandemic virus need hospital care, further straining already overburdened healthcare systems, WHO said in an update on the pandemic.

"During the winter season in the southern hemisphere, several countries have viewed the need for intensive care as the greatest burden on health services.  Preparedness measures need to anticipate this increased demand on intensive care units, which could be overwhelmed by a sudden surge in the number of severe cases."

Earlier, WHO reported that H1N1 had reached epidemic levels in Japan, signaling an early start to what may be a long influenza season this year, and that it was also worsening in tropical regions.

"Perhaps most significantly, clinicians from around the world are reporting a very severe form of disease, also in young and otherwise healthy people, which is rarely seen during seasonal influenza infections.  In these patients, the virus directly infects the lung, causing severe respiratory failure. Saving these lives depends on highly specialized and demanding care in intensive care units, usually with long and costly stays."


Minority groups and indigenous populations may also have a higher risk of being severely ill with H1N1.

"In some studies, the risk in these groups is four to five times higher than in the general population.   Although the reasons are not fully understood, possible explanations include lower standards of living and poor overall health status, including a high prevalence of conditions such as asthma, diabetes and hypertension."

WHO said it was advising countries in the Northern Hemisphere to prepare for a second wave of pandemic spread. "Countries with tropical climates, where the pandemic virus arrived later than elsewhere, also need to prepare for an increasing number of cases," it said.

Every year, seasonal flu infects between 5 percent and 20 percent of a given population and kills between 250,000 and 500,000 people globally. Because hardly anyone has immunity to the new H1N1 virus, experts believe it will infect far more people than usual, as much as a third of the population.  It also disproportionately affects younger people, unlike seasonal flu which mainly burdens the elderly, and thus may cause more severe illness and deaths among young adults and children than seasonal flu does.

"Data continue to show that certain medical conditions increase the risk of severe and fatal illness. These include respiratory disease, notably asthma, cardiovascular disease, diabetes and immunosuppression.  When anticipating the impact of the pandemic as more people become infected, health officials need to be aware that many of these predisposing conditions have become much more widespread in recent decades, thus increasing the pool of vulnerable people."

WHO estimates that more than 230 million people globally have asthma, and more than 220 million have diabetes. Obesity may also worsen the risk of severe infection, WHO said.

The good news -- people infected with AIDS virus do not seem to be at special risk from H1N1, WHO said.

(Editing by Mohammad Zargham)
Title: Overblowing H1N1
Post by: Body-by-Guinness on September 17, 2009, 11:41:40 AM
‘Behind the Headlines’? Despite the Headlines!

Posted by Jim Harper

STRATFOR—a group I hadn’t heard of before—provides, in their words, “geopolitical intelligence – independent, non-ideological and non-partisan analysis and perspective that is unavailable anywhere else in the world.” They also say they provide the “intelligence behind the headlines.”

Well, I was struck—delighted, really—to see them outright contradict the headlines in a report of theirs that mercilessly skewers H1N1 (swine) flu fears:

It has been five months since the A(H1N1) influenza virus — aka the swine flu — climbed to the top of the global media heap, and with the start of the Northern Hemisphere’s annual flu season just around the corner, the topic is worth revisiting.

If you take only one fact away from this analysis, take this: The U.S. Centers for Disease Control and Prevention (CDC) believes that hospitalization rates and mortality rates for A(H1N1) are similar to or lower than they are for more traditional influenza strains. And if you take two facts away, consider this as well: Influenza data are incomplete at best and rarely cross-comparable, so any assertions of the likelihood of mass deaths are little more than scaremongering bereft of any real analysis or, more important, any actual evidence.

One would expect “intelligence” reporting firms to have the same incentives as politicians and other media: drum up fear to drum up business. But there is value in providing actual facts and sound strategies for responding to world events. As a non-expert, I’m not able to evaluate the substance of the STRATFOR report or its conclusions, but I give it credibility as a statement against interest.

After the early ineptitude shown by the Obama Administration, I was beginning to think that the steady drumbeat of news about preparation for flu season was appropriate societal girding for what could be a notable disease outbreak. I am more inclined now to believe that we are flushing more money down the drain because of fears the administration generated.

Overreaction harms the country, and it is the responsibility of governments—if they take a role—to quell impulses toward overreaction when incidents of national significance occur.
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on September 17, 2009, 06:24:59 PM
Never heard of Stratfor before?  Hah!  He needs to spend more time around here  :lol:
Title: Do Flu Immunizations Work? I
Post by: Body-by-Guinness on October 14, 2009, 11:38:18 AM
Whether this season’s swine flu turns out to be deadly or mild, most experts agree that it’s only a matter of time before we’re hit by a truly devastating flu pandemic—one that might kill more people worldwide than have died of the plague and AIDS combined. In the U.S., the main lines of defense are pharmaceutical—vaccines and antiviral drugs to limit the spread of flu and prevent people from dying from it. Yet now some flu experts are challenging the medical orthodoxy and arguing that for those most in need of protection, flu shots and antiviral drugs may provide little to none. So where does that leave us if a bad pandemic strikes?
by Shannon Brownlee and Jeanne Lenzer
Does the Vaccine Matter?


DRIVE TOO FAST along Red Lion Road, beside Philadelphia’s Northeast Airport, and you will miss the low-rise cement building where the biotech company MedImmune has been quietly pumping out swine flu vaccine at about a million doses a week. Through the summer and fall, workers wearing protective gear that covered them from head to toe brewed up batches of live, genetically modified flu virus. Robots then injected tiny doses of virus-laden fluid into glass vials, which were mounted into nasal spritzers, labeled, and readied for shipment at the direction of the Centers for Disease Control and Prevention, in Atlanta, which is helping to coordinate the nation’s pandemic-preparedness plan. In the most ambitious vaccination program the nation has mounted since the anti-polio campaign in the 1950s, the federal government has commissioned MedImmune and four other companies to produce enough vaccine to cover the entire U.S. population.

Vaccination is central to the government’s plan for preventing deaths from swine flu. The CDC has recommended that some 159 million adults and children receive either a swine flu shot or a dose of MedImmune’s nasal vaccine this year. Shots are offered in doctors’ offices, hospitals, airports, pharmacies, schools, polling places, shopping malls, and big-box stores like Wal-Mart. In August, New York state required all health-care workers to get both seasonal and swine flu shots. To further protect the populace, the federal government has spent upwards of $3billion stockpiling millions of doses of antiviral drugs like Tamiflu—which are being used both to prevent swine flu and to treat those who fall ill.

But what if everything we think we know about fighting influenza is wrong? What if flu vaccines do not protect people from dying—particularly the elderly, who account for 90 percent of deaths from seasonal flu? And what if the expensive antiviral drugs that the government has stockpiled over the past few years also have little, if any, power to reduce the number of people who die or are hospitalized? The U.S. government—with the support of leaders in the public-health and medical communities—has put its faith in the power of vaccines and antiviral drugs to limit the spread and lethality of swine flu. Other plans to contain the pandemic seem anemic by comparison. Yet some top flu researchers are deeply skeptical of both flu vaccines and antivirals. Like the engineers who warned for years about the levees of New Orleans, these experts caution that our defenses may be flawed, and quite possibly useless against a truly lethal flu. And that unless we are willing to ask fundamental questions about the science behind flu vaccines and antiviral drugs, we could find ourselves, in a bad epidemic, as helpless as the citizens of New Orleans during Hurricane Katrina.

THE TERM INFLUENZA, which dates back to the Middle Ages, is taken from the Italian word for occult or astral influence. Then as now, flu seemed to appear out of nowhere each winter, debilitating or killing large numbers of people, only to vanish in the spring. Today, seasonal flu is estimated to kill about 36,000 people in the United States each year, and half a million worldwide.

Yet the flu, in many important respects, remains mysterious. Determining how many deaths it really causes, or even who has it, is no simple matter. We think we have the flu anytime we fall ill with an ailment that brings on headache, malaise, fever, coughing, sneezing, and that achy feeling as if we’ve been sleeping on a bed of rocks, but researchers have found that at most half, and perhaps as few as 7 or 8 percent, of such cases are actually caused by an influenza virus in any given year. More than 200 known viruses and other pathogens can cause the suite of symptoms known as “influenza-like illness”; respiratory syncytial virus, bocavirus, coronavirus, and rhinovirus are just a few of the bugs that can make a person feel rotten. And depending on the season, in up to two-thirds of the cases of flu-like illness, no cause at all can be found.

Nobody knows precisely why we are much more likely to catch the flu in the winter months than at other times of the year. Perhaps it’s because flu viruses flourish in cool temperatures and are killed by exposure to sunlight. Or maybe it’s because in winter, people spend more time indoors, where a sneeze or a cough can more easily spread a virus to others. What is certain is that influenza viruses mutate with amazing speed, so each flu season sees slightly different genetic versions of the viruses that infected people the year before. Every year, the World Health Organization and the Centers for Disease Control and Prevention collect data from 94 nations on the flu viruses that circulated the previous year, and then make an educated guess about which viruses are likely to circulate in the coming fall. Based on that information, the U.S. Food and Drug Administration issues orders to manufacturers in February for a vaccine that includes the three most likely strains.

Every once in a while, however, a very different bug pops up and infects far more people than the normal seasonal flu variants do. It is these novel viruses that are responsible for pandemics, defined by the World Health Organization as events that occur when “a new influenza virus appears against which the human population has no immunity” and which can sweep around the world in a very short time. The worst flu pandemic in recorded history was the “Spanish flu” of 1918–19, at the end of World WarI. A third of the world’s population was infected, with at least 40million and perhaps as many as 100million people dying—more than were killed in World Wars I and II combined. (Some scholars suggest that one reason World WarI ended was that so many soldiers were sick or dying from flu.) Since then, two other flu pandemics have occurred, in 1957 and 1968, neither of which was particularly lethal.

In August, the President’s Council of Advisors on Science and Technology projected that this fall and winter, the swine flu, H1N1, could infect anywhere between one-third and one-half of the U.S. population and could kill as many as 90,000 Americans, two and a half times the number killed in a typical flu season. But precisely how deadly, or even how infectious, this year’s H1N1 pandemic will turn out to be won’t be known until it’s over. Most reports coming from the Southern Hemisphere in late August (the end of winter there) suggested that the swine flu is highly infectious, but not particularly lethal. For example, Australian officials estimated they would finish winter with under 1,000 swine flu deaths—fewer than the usual 1,500 to 3,000 from seasonal flu. Among those who have died in the U.S., about 70 percent were already suffering from congenital conditions like cerebral palsy or underlying illnesses such as cancer, asthma, or AIDS, which make people more vulnerable.

Public-health officials consider vaccine their most formidable defense against the pandemic—indeed, against any flu—and on the surface, their faith seems justified. Vaccines developed over the course of the 20th century slashed the death rates of nearly a dozen infectious diseases, such as smallpox and polio, and vaccination became one of medicine’s most potent weapons. Influenza virus was first identified in the 1930s, and by the mid-1940s, researchers had produced a vaccine that was given to soldiers in World WarII. The U.S. government got serious about promoting flu vaccine after the 1957 flu pandemic brought home influenza’s continuing potential to cause widespread illness and death. Today, flu vaccine is a staple of public-health policy; in a normal year, some 100 million Americans get vaccinated.

But while vaccines for, say, whooping cough and polio clearly and dramatically reduced death rates from those diseases, the impact of flu vaccine has been harder to determine. Flu comes and goes with the seasons, and often it does not kill people directly, but rather contributes to death by making the body more susceptible to secondary infections like pneumonia or bronchitis. For this reason, researchers studying the impact of flu vaccination typically look at deaths from all causes during flu season, and compare the vaccinated and unvaccinated populations.

Such comparisons have shown a dramatic difference in mortality between these two groups: study after study has found that people who get a flu shot in the fall are about half as likely to die that winter—from any cause—as people who do not. Get your flu shot each year, the literature suggests, and you will dramatically reduce your chance of dying during flu season.

Yet in the view of several vaccine skeptics, this claim is suspicious on its face. Influenza causes only a small minority of all deaths in the U.S., even among senior citizens, and even after adding in the deaths to which flu might have contributed indirectly. When researchers from the National Institute of Allergy and Infectious Diseases included all deaths from illnesses that flu aggravates, like lung disease or chronic heart failure, they found that flu accounts for, at most, 10 percent of winter deaths among the elderly. So how could flu vaccine possibly reduce total deaths by half? Tom Jefferson, a physician based in Rome and the head of the Vaccines Field at the Cochrane Collaboration, a highly respected international network of researchers who appraise medical evidence, says: “For a vaccine to reduce mortality by 50 percent and up to 90 percent in some studies means it has to prevent deaths not just from influenza, but also from falls, fires, heart disease, strokes, and car accidents. That’s not a vaccine, that’s a miracle.”

The estimate of 50 percent mortality reduction is based on “cohort studies,” which compare death rates in large groups, or cohorts, of people who choose to be vaccinated, against death rates in groups who don’t. But people who choose to be vaccinated may differ in many important respects from people who go unvaccinated—and those differences can influence the chance of death during flu season. Education, lifestyle, income, and many other “confounding” factors can come into play, and as a result, cohort studies are notoriously prone to bias. When researchers crunch the numbers, they typically try to factor out variables that could bias the results, but, as Jefferson remarks, “you can adjust for the confounders you know about, not for the ones you don’t,” and researchers can’t always anticipate what factors are likely to be important to whether a patient dies from flu. There is always the chance that they might miss some critical confounder that renders their results entirely wrong.

When Lisa Jackson, a physician and senior investigator with the Group Health Research Center, in Seattle, began wondering aloud to colleagues if maybe something was amiss with the estimate of 50 percent mortality reduction for people who get flu vaccine, the response she got sounded more like doctrine than science. “People told me, ‘No good can come of [asking] this,’” she says. “‘Potentially a lot of bad could happen’ for me professionally by raising any criticism that might dissuade people from getting vaccinated, because of course, ‘We know that vaccine works.’ This was the prevailing wisdom.”

Nonetheless, in 2004, Jackson and three colleagues set out to determine whether the mortality difference between the vaccinated and the unvaccinated might be caused by a phenomenon known as the “healthy user effect.” They hypothesized that on average, people who get vaccinated are simply healthier than those who don’t, and thus less liable to die over the short term. People who don’t get vaccinated may be bedridden or otherwise too sick to go get a shot. They may also be more likely to succumb to flu or any other illness, because they are generally older and sicker. To test their thesis, Jackson and her colleagues combed through eight years of medical data on more than 72,000 people 65 and older. They looked at who got flu shots and who didn’t. Then they examined which group’s members were more likely to die of any cause when it was not flu season.

Jackson’s findings showed that outside of flu season, the baseline risk of death among people who did not get vaccinated was approximately 60 percent higher than among those who did, lending support to the hypothesis that on average, healthy people chose to get the vaccine, while the “frail elderly” didn’t or couldn’t. In fact, the healthy-user effect explained the entire benefit that other researchers were attributing to flu vaccine, suggesting that the vaccine itself might not reduce mortality at all. Jackson’s papers “are beautiful,” says Lone Simonsen, who is a professor of global health at George Washington University, in Washington, D.C., and an internationally recognized expert in influenza and vaccine epidemiology. “They are classic studies in epidemiology, they are so carefully done.”

The results were also so unexpected that many experts simply refused to believe them. Jackson’s papers were turned down for publication in the top-ranked medical journals. One flu expert who reviewed her studies for the Journal of the American Medical Association wrote, “To accept these results would be to say that the earth is flat!” When the papers were finally published in 2006, in the less prominent International Journal of Epidemiology, they were largely ignored by doctors and public-health officials. “The answer I got,” says Jackson, “was not the right answer.”

THE HISTORY OF FLU VACCINATION suggests other reasons to doubt claims that it dramatically reduces mortality. In 2004, for example, vaccine production fell behind, causing a 40 percent drop in immunization rates. Yet mortality did not rise. In addition, vaccine “mismatches” occurred in 1968 and 1997: in both years, the vaccine that had been produced in the summer protected against one set of viruses, but come winter, a different set was circulating. In effect, nobody was vaccinated. Yet death rates from all causes, including flu and the various illnesses it can exacerbate, did not budge. Sumit Majumdar, a physician and researcher at the University of Alberta, in Canada, offers another historical observation: rising rates of vaccination of the elderly over the past two decades have not coincided with a lower overall mortality rate. In 1989, only 15 percent of people over age 65 in the U.S. and Canada were vaccinated against flu. Today, more than 65 percent are immunized. Yet death rates among the elderly during flu season have increased rather than decreased.

Vaccine proponents call Majumdar’s last observation an “ecological fallacy,” because he fails, in their view, to consider changes in the larger environment that could have boosted death rates over the years—even as rising vaccination rates were doing their part to keep mortality in check. The proponents suggest, for instance, that influenza viruses may have become more contagious over time, and thus are infecting greater numbers of elderly people, including some who have been vaccinated. Or maybe the viruses are becoming more lethal. Or maybe the elderly have less immunity to flu than they once did because, say, their diets have changed.

Or maybe vaccine just doesn’t prevent deaths in the elderly. Of course, that’s the one possibility that vaccine adherents won’t consider. Nancy Cox, the CDC’s influenza division chief, says flatly, “The flu vaccine is the best way to protect against flu.” Anthony Fauci, a physician and the director of the National Institute of Allergy and Infectious Diseases at the NIH, where much of the basic science of flu vaccine has been worked out, says, “I have no doubt that it is effective in conferring some degree of protection. To say otherwise is a minority view.”

Majumdar says, “We keep coming up against the belief that we’ve reduced mortality by 50 percent,” and when researchers poke holes in the evidence, “people pound the pulpit.”

THE MOST vocal—and undoubtedly most vexing—critic of the gospel of flu vaccine is the Cochrane Collaboration’s Jefferson, who’s also an epidemiologist trained at the famed London School of Tropical Hygiene, and who, in Lisa Jackson’s view, makes other skeptics seem “moderate by comparison.” Among his fellow flu researchers, Jefferson’s outspokenness has made him something of a pariah. At a 2007 meeting on pandemic preparedness at a hotel in Bethesda, Maryland, Jefferson, who’d been invited to speak at the conference, was not greeted by any of the colleagues milling about the lobby. He ate his meals in the hotel restaurant alone, surrounded by scientists chatting amiably at other tables. He shrugs off such treatment. As a medical officer working for the United Nations in 1992, during the siege of Sarajevo, he and other peacekeepers were captured and held for more than a month by militiamen brandishing AK-47s and reeking of alcohol. Professional shunning seems trivial by comparison, he says.

“Tom Jefferson has taken a lot of heat just for saying, ‘Here’s the evidence: it’s not very good,’” says Majumdar. “The reaction has been so dogmatic and even hysterical that you’d think he was advocating stealing babies.” Yet while other flu researchers may not like what Jefferson has to say, they cannot ignore the fact that he knows the flu-vaccine literature better than anyone else on the planet. He leads an international team of researchers who have combed through hundreds of flu-vaccine studies. The vast majority of the studies were deeply flawed, says Jefferson. “Rubbish is not a scientific term, but I think it’s the term that applies.” Only four studies were properly designed to pin down the effectiveness of flu vaccine, he says, and two of those showed that it might be effective in certain groups of patients, such as school-age children with no underlying health issues like asthma. The other two showed equivocal results or no benefit.

Flu researchers have been fooled into thinking vaccine is more effective than the data suggest, in part, says Jefferson, by the imprecision of the statistics. The only way to know if someone has the flu—as opposed to influenza-like illness—is by putting a Q-tip into the patient’s throat or nose and running a test, which simply isn’t done that often. Likewise, nobody really has a handle on how many of the deaths that are blamed on flu were actually caused by a flu virus, because few are confirmed by a laboratory. “I used to be a family physician,” says Jefferson. “I’ve never seen a patient come to my office with H1N1 written on his forehead. When an old person dies of respiratory failure after an influenza-like illness, they nearly always get coded as influenza.”

Title: Do Flu Immunizations Work? II
Post by: Body-by-Guinness on October 14, 2009, 11:38:37 AM
There’s one other way flu researchers may be fooled into thinking flu vaccine is effective, Jefferson says. All vaccines work by delivering a dose of killed or weakened virus or bacteria, which provokes the immune system into producing antibodies. When the person is subsequently exposed to the real thing, the body is already prepared to repel the bug completely or to get rid of it after a mild illness. Flu researchers often use antibody response as a way of gauging the effectiveness of vaccine, on the assumption that levels of antibodies in the blood of people who have been vaccinated are a good predictor—although an imperfect one—of how well they can ward off the infection.

There’s some merit to this reasoning. Unfortunately, the very people who most need protection from the flu also have immune systems that are least likely to respond to vaccine. Studies show that young, healthy people mount a glorious immune response to seasonal flu vaccine, and their response reduces their chances of getting the flu and may lessen the severity of symptoms if they do get it. But they aren’t the people who die from seasonal flu. By contrast, the elderly, particularly those over age70, don’t have a good immune response to vaccine—and they’re the ones who account for most flu deaths. (Infants with severe disabilities, such as leukemia and congenital lung disease, and people who are immune-compromised—from AIDS, or diabetes, or cancer treatment—make up the rest. As of August8, only 36 deaths from swine flu had been confirmed among children in the U.S., and the overwhelming majority of those children had multiple, severe health disorders.)

In Jefferson’s view, this raises a troubling conundrum: Is vaccine necessary for those in whom it is effective, namely the young and healthy? Conversely, is it effective in those for whom it seems to be necessary, namely the old, the very young, and the infirm? These questions have led to the most controversial aspect of Jefferson’s work: his call for placebo-controlled trials, studies that would randomly give half the test subjects vaccine and the other half a dummy shot, or placebo. Only such large, well-constructed, randomized trials can show with any precision how effective vaccine really is, and for whom.

In the flu-vaccine world, Jefferson’s call for placebo-controlled studies is considered so radical that even some of his fellow skeptics oppose it. Majumdar, the Ottawa researcher, says he believes that evidence of a benefit among children is established and that public-health officials should try to protect seniors by immunizing children, health-care workers, and other people around them, and thus reduce the spread of the flu. Lone Simonsen explains the prevailing view: “It is considered unethical to do trials in populations that are recommended to have vaccine,” a stance that is shared by everybody from the CDC’s Nancy Cox to Anthony Fauci at the NIH. They feel strongly that vaccine has been shown to be effective and that a sham vaccine would put test subjects at unnecessary risk of getting a serious case of the flu. In a phone interview, Fauci at first voiced the opinion that a placebo trial in the elderly might be acceptable, but he called back later to retract his comment, saying that such a trial “would be unethical.” Jefferson finds this view almost exactly backward: “What do you do when you have uncertainty? You test,” he says. “We have built huge, population-based policies on the flimsiest of scientific evidence. The most unethical thing to do is to carry on business as usual.”

JUST AFTER 6 P.M. on a warm Friday evening in July, Dr. David Newman is only minutes into a 10-hour shift in the emergency room of New York City’s St. Luke’s Hospital, and already he has assumed responsibility for 11 patients. The young Italian tourist sitting on the bed in front of the doctor has meningitis, and through an interpreter, Newman tells him he almost certainly has the viral form of the disease, which will do nothing more than make him feel ill for a few days. There is a tiny chance, says Newman, that the illness is caused by a bacterium, which can be deadly, but he is almost positive that’s not what the tourist has. He says to his patient, “I can’t tell you with 100 percent certainty that you don’t have it, but if you do, you’ll begin to feel worse and you’ll need to come back.” The tourist, on learning that he might be infected with a potentially lethal disease, looks down at his feet and confesses that he is much more worried about another illness: swine flu. Newman smiles patiently. “It would be nice if you had swine flu,” he says. “Compared to bacterial meningitis, swine flu is safe.”

Late last spring, as headlines and airwaves warned of a possible pandemic, patients like Newman’s began clogging emergency rooms across the country, a sneezing, coughing, infectious tide of humanity more worried than truly sick, but whose mere presence in the emergency room has endangered the lives of others. “Studies show that when there is ER crowding, mortality goes up, because patients who need immediate attention don’t get it,” says Newman, the director of clinical research in the Department of Emergency Medicine at the hospital, which is affiliated with Columbia University. In an average year the ER at St. Luke’s, a sprawling 1,076-bed hospital on 113th Street, takes in 110,000 patients, some 300 a day. At the height of the summer swine flu outbreak, that number doubled. The vast majority of panicky patients who came in the door at St. Luke’s and other emergency departments didn’t actually have the virus, and of those who did, most were not sick enough to need hospitalization. Even so, says Newman, when patients with even mild flu symptoms show up in the hospital, they vastly increase the spread of the virus, simply because they inevitably sneeze and cough in rooms that are jammed with other people.

Many of the worried sick come to St. Luke’s and other hospitals in search of antiviral drugs. The CDC recommends the use of two drugs against H1N1: oseltamivir and zanamivir, better known by their brand names, Tamiflu and Relenza, which together form the second pillar of the government’s anti-pandemic-flu strategy. Public-health officials at the state and local levels are also recommending the drugs. Guidelines issued by the New York City Department of Health, says Newman, “encourage us to give a prescription to just about every patient with the sniffles,” a practice that some experts worry will quickly lead to resistant strains of the virus.

Indeed, that’s already happening. Daniel Janies, an associate professor of biomedical informatics at Ohio State University, tracks the genetic mutations that allow flu virus to develop resistance to drugs. Flu can become resistant to Tamiflu in a matter of days, he says. Handing out the drug early in the pandemic, when H1N1 poses only a minimal threat to the vast majority of patients, strikes him as “shortsighted.” Indeed, samples of resistant H1N1 were cropping up by midsummer, increasing the likelihood that come late fall, many people will be infected with a resistant strain of swine flu. Alarmed at that prospect, the World Health Organization issued an alert on August 21, recommending that Tamiflu and Relenza be used only in severe cases and in patients who are at high risk of serious complications. By mid-August, two U.S. swine flu patients had developed Tamiflu-resistant strains.

The U.S. first began stockpiling Tamiflu and Relenza back in 2005, in the wake of concern that an outbreak in Southeast Asia of bird flu, a far more deadly form of the disease, might go global. On November 1, 2005, President George W.Bush pronounced pandemic flu a “danger to our homeland,” and he asked Congress to approve legislation that included $1billion for the production and stockpiling of antivirals. This was after Congress had already approved $1.8billion to stockpile Tamiflu for the military, a decision that was made during the tenure of Defense Secretary Donald Rumsfeld. (Before joining the Bush Cabinet, Rumsfeld was chairman for four years of Gilead Sciences, the company that holds the patent on Tamiflu, and he held millions of dollars’ worth of stock in the company. According to Roll Call, an online newspaper covering events on Capitol Hill, Rumsfeld says he recused himself from all government decisions involving Tamiflu. Gilead’s stock price rose more than 50 percent in 2005, when the government’s plan was announced.)

As with vaccines, the scientific evidence for Tamiflu and Relenza is thin at best. In its general-information section, the CDC’s Web site tells readers that antiviral drugs can “make you feel better faster.” True, but not by much. On average, Tamiflu (which accounts for 85 to 90 percent of the flu antiviral-drug market) cuts the duration of flu symptoms by 24hours in otherwise healthy people. In exchange for a slightly shorter bout of illness, as many as one in five people taking Tamiflu will experience nausea and vomiting. About one in five children will have neuropsychiatric side effects, possibly including anxiety and suicidal behavior. In Japan, where Tamiflu is liberally prescribed, the drug may have been responsible for 50 deaths from cardiopulmonary arrest, from 2001 to 2007, according to Rokuro Hama, the chair of the Japan Institute of Pharmacovigilance.

Such side effects might be worth risking if the antivirals prevented serious complications of flu, such as pneumonia, hospitalization, and death. Roche Laboratories, the company licensed to manufacture and market Tamiflu, says its drug does just that. In two September2006 press releases, the company announced, “Tamiflu significantly reduces the risk of death from influenza: New data shows treatment was associated with more than a two third reduction in deaths,” and “Children with influenza [are] 53 percent less likely to contract pneumonia when treated with Tamiflu.” Once again cohort studies (the same kind of potentially biased research that led to the conclusion that flu vaccine cuts mortality by 50 percent) are behind these claims. Tamiflu costs $10 a pill. It is possible that people who take it are more likely to be insured and affluent, or at least middle-class, than those who do not, and a large body of evidence shows that the well-off nearly always fare better than the poor when stricken with an infectious disease, including flu. In both 2003 and 2009, reviews of randomized placebo-controlled studies found that the study populations simply weren’t large enough to answer the question: Does Tamiflu prevent pneumonia?

As late as this August, the company’s own Web site contained the following statement, which was written under the direction of the FDA: “Tamiflu has not been proven to have a positive impact on the potential consequences (such as hospitalizations, mortality, or economic impact) of seasonal, avian, or pandemic influenza.” An FDA spokesperson said recently that the agency is unaware of any data submitted by Roche that would support the claims in the company’s September 2006 news release about the drug’s reducing flu deaths.

WHY, THEN, HAS the federal government stockpiled millions of doses of antivirals, at a cost of several billion dollars? And why are physicians being encouraged to hand out prescriptions to large numbers of people, without sound evidence that the drugs will help? The short answer may be that public-health officials feel they must offer something, and these drugs are the only possible remedies at hand. “I have to agree with the critics the antiviral question is not cut-and-dried,” says Fauci. “But [these drugs are] the best we have.” The CDC’s Nancy Cox also acknowledges that the science is not as sound as she might like, but the government still recommends their use. And as with vaccines, she considers additional randomized placebo-controlled trials of the antiviral drugs to be “unethical” and thus out of the question.

This is the curious state of debate about the government’s two main weapons in the fight against pandemic flu. At first, government officials declare that both vaccines and drugs are effective. When faced with contrary evidence, the adherents acknowledge that the science is not as crisp as they might wish. Then, in response to calls for placebo-controlled trials, which would provide clear results one way or the other, the proponents say such studies would deprive patients of vaccines and drugs that have already been deemed effective. “We can’t just let people die,” says Cox.

Students of U.S. medical history will find this circular logic familiar: it is a long-recurring theme in American medicine, and one that has, on occasion, had deadly consequences. In 1925, Sinclair Lewis caricatured a medical culture that allowed belief—and profits—to distort science in his Pulitzer Prize–winning book, Arrowsmith. Based on the lives of the real-life microbiologists Paul de Kruif and Jacques Loeb, Lewis tells the story of Martin Arrowsmith, a physician who invents a new vaccine during a deadly outbreak of bubonic plague. But his efforts to test the vaccine’s efficacy are frustrated by an angry community that desperately wants to believe the vaccine works, and a profit-hungry institute that rushes the vaccine into use prematurely—forever preempting the proper studies that are needed.

The annals of medicine are littered with treatments and tests that became medical doctrine on the slimmest of evidence, and were then declared sacrosanct and beyond scientific investigation. In the 1980s and ’90s, for example, cancer specialists were convinced that high-dose chemotherapy followed by a bone-marrow transplant was the best hope for women with advanced breast cancer, and many refused to enroll their patients in randomized clinical trials that were designed to test transplants against the standard—and far less toxic—therapy. The trials, they said, were unethical, because they knew transplants worked. When the studies were concluded, in 1999 and 2000, it turned out that bone-marrow transplants were killing patients. Another recent example involves drugs related to the analgesic lidocaine. In the 1970s, doctors noticed that the drugs seemed to make the heart beat rhythmically, and they began prescribing them to patients suffering from irregular heartbeats, assuming that restoring a proper rhythm would reduce the patient’s risk of dying. Prominent cardiologists for years opposed clinical trials of the drugs, saying it would be medical malpractice to withhold them from patients in a control group. The drugs were widely used for two decades, until a government-sponsored study showed in 1989 that patients who were prescribed the medicine were three and a half times as likely to die as those given a placebo.

Demonstrating the efficacy (or lack thereof) of vaccine and antivirals during flu season would not be hard to do, given the proper resources. Take a group of people who are at risk of getting the flu, and randomly assign half to get vaccine and the other half a dummy shot. Then count the people in each group who come down with flu, suffer serious illness, or die. (A similarly designed trial would suffice for the antivirals.) It might sound coldhearted, but it is the only way to know for certain whether, and for whom, current remedies actually work. It would also be useful to know whether vaccinating healthy people—who can mount an immune response on their own—protects the more vulnerable people around them. For example, immunizing nursing-home staff and healthy children is thought to reduce the spread of flu to the elderly and the immune-compromised. Pinning down the effectiveness of this strategy would be a bit more complex, but not impossible.

IN THE ABSENCE of such evidence, we are left with two possibilities. One is that flu vaccine is in fact highly beneficial, or at least helpful. Solid evidence to that effect would encourage more citizens—and particularly more health professionals—to get their shots and prevent the flu’s spread. As it stands, more than 50 percent of health-care workers say they do not intend to get vaccinated for swine flu and don’t routinely get their shots for seasonal flu, in part because many of them doubt the vaccines’ efficacy. The other possibility, of course, is that we’re relying heavily on vaccines and antivirals that simply don’t work, or don’t work as well as we believe. And as a result, we may be neglecting other, proven measures that could minimize the death rate during pandemics.

“Vaccines give us a false sense of security,” says Sumit Majumdar. “When you have a strategy that [everybody thinks] reduces death by 50 percent, it’s pretty hard to invest resources to come up with better remedies.” For instance, health departments in every state are responsible for submitting plans to the CDC for educating the public, in the event of a serious pandemic, about hand-washing and “social distancing” (voluntary quarantines, school closings, and even enforcement of mandatory quarantines to keep infected people in their homes). Putting these plans into action will require considerable coordination among government officials, the media, and health-care workers—and widespread buy-in from the public. Yet little discussion has appeared in the press to help people understand the measures they can take to best protect themselves during a flu outbreak—other than vaccination and antivirals.

“Launched early enough and continued long enough, social distancing can blunt the impact of a pandemic,” says Howard Markel, a pediatrician and historian of medicine at the University of Michigan. Washing hands diligently, avoiding public places during an outbreak, and having a supply of canned goods and water on hand are sound defenses, he says. Such steps could be highly effective in helping to slow the spread of the virus. In Mexico, for instance, where the first swine flu cases were identified in March, the government launched an aggressive program to get people to wash their hands and exhorted those who were sick to stay home and effectively quarantine themselves. In the United Kingdom, the national health department is promoting a “buddy” program, encouraging citizens to find a friend or neighbor willing to deliver food and medicine so people who fall ill can stay home.

In the U.S., by contrast, our reliance on vaccination may have the opposite effect: breeding feelings of invulnerability, and leading some people to ignore simple measures like better-than-normal hygiene, staying away from those who are sick, and staying home when they feel ill. Likewise, our encouragement of early treatment with antiviral drugs will likely lead many people to show up at the hospital at first sniffle. “There’s no worse place to go than the hospital during flu season,” says Majumdar. Those who don’t have the flu are more likely to catch it there, and those who do will spread it around, he says. “But we don’t tell people this.”

All of which leaves open the question of what people should do when faced with a decision about whether to get themselves and their families vaccinated. There is little immediate danger from getting a seasonal flu shot, aside from a sore arm and mild flu-like symptoms. The safety of the swine flu vaccine remains to be seen. In the absence of better evidence, vaccines and antivirals must be viewed as only partial and uncertain defenses against the flu. And they may be mere talismans. By being afraid to do the proper studies now, we may be condemning ourselves to using treatments based on illusion and faith rather than sound science.

 The URL for this page is
Title: BO's declaration of emergency
Post by: Crafty_Dog on October 25, 2009, 09:37:32 PM
Obama declares H1N1 national emergency


Washington (CNN) -- President Obama has declared a national emergency to deal with the "rapid increase in illness" from the H1N1 influenza virus.

"The 2009 H1N1 pandemic continues to evolve. The rates of illness continue to rise rapidly within many communities across the nation, and the potential exists for the pandemic to overburden health care resources in some localities," Obama said in a statement.

"Thus, in recognition of the continuing progression of the pandemic, and in further preparation as a nation, we are taking additional steps to facilitate our response."

The president signed the declaration late Friday and announced it Saturday.

Calling the emergency declaration "an important tool in our kit going forward," one administration official called Obama's action a "proactive measure that's not in response to any new development." Having trouble finding vaccine? Share your story

Another administration official said the move is "not tied to the current case count" and "gives the federal government more power to help states" by lifting bureaucratic requirements -- both in treating patients and moving equipment to where it's most needed.

The officials didn't want their names used because they were not authorized to speak on the record.

Obama's action allows Health and Human Services Secretary Kathleen Sebelius "to temporarily waive or modify certain requirements" to help health care facilities enact emergency plans to deal with the pandemic.

Those requirements are contained in Medicare, Medicaid and state Children's Health Insurance programs, and the Health Insurance Portability and Accountability Act privacy rule.

Since the H1N1 flu pandemic began in April, millions of people in the United States have been infected, at least 20,000 have been hospitalized and more than 1,000 have died, said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

Watch how to find out if you have H1N1

Frieden said that having 46 states reporting widespread flu transmission is traditionally the hallmark of the peak of flu season. To have the flu season peak at this time of the year is "extremely unusual."

The CDC said 16.1 million doses of H1N1, or swine flu, vaccine had been made by Friday -- 2 million more than two days earlier. About 11.3 million of those had been distributed throughout the United States, Frieden said.

"We are nowhere near where we thought we would be," Frieden said, acknowledging that manufacturing delays have contributed to less vaccine being available than expected. "As public health professionals, vaccination is our strongest tool. Not having enough is frustrating to all of us."

Frieden said that while the way vaccine is manufactured is "tried and true," it's not well-suited for ramping up production during a pandemic because it takes at least six months. The vaccine is produced by growing weakened virus in eggs.


What does this have to do with firearms politics you ask? well, many in the U.S(mostly conspiracy buffs) believe there are more sinister plans involved.

The first and biggest question being asked is what emergency?

The declaration of this national emergency seems suspicious from the start. Where’s the emergency? The number of people killed by swine flu in the United States is far smaller than the number of people killed each year from seasonal flu, according to CDC statistics. People obviously aren’t dropping dead by the millions from H1N1 influenza. Most people are just getting mild flu symptoms and a few days later they’re fine.

So what does this mean for Americans? The decleration of a national emergency means the government trumphs the bill of rights. They now, by decleration of this emergency, have the power to:

•The power to force mandatory swine flu vaccinations on the entire population.

• The power to arrest, quarantine or “involuntarily transport” anyone who refuses a swine flu vaccination.

• The power to quarantine an entire city and halt all travel in or out of that city.

• The power to enter any home or office without a search warrant and order the destruction of any belongings or structures deemed to be a threat to public health.

• The effective nullification of the Bill of Rights. Your right to due process, to being safe from government search and seizure, and to remain silent to avoid self-incrimination are all null and void under a Presidential declaration of a national emergency.

None of this means that federal agents are going to march door to door arresting people at gunpoint if they refuse the vaccine, but they could if they wanted to. Your rights are no longer recognized under this national emergency declaration.

Title: Pigs, & Birds, & Pandemics, Oh My!
Post by: Body-by-Guinness on November 03, 2009, 12:55:53 PM
The Pandemic Is Political
Michael Fumento, 10.16.09, 7:15 PM ET
As evidence continues to mount that swine flu is more of a piglet than a raging razorback, why isn't curiosity mounting as to why the World Health Organization declared it a pandemic? And definitions aside, why does the agency continue to insist we're going to get hammered? The answers have far less to do with world health than with redistribution of world wealth.

Medically, the pandemic moniker is unjustifiable. When the sacrosanct World Health Organization (WHO) made its official declaration in June, we were 11 weeks into the outbreak, and swine flu had only killed 144 people worldwide--the same number who die of seasonal flu worldwide every few hours. The mildest pandemics of the 20th century killed at least a million people worldwide. And even after six months, swine flu has killed about as many people as the seasonal flu does every six days.

So how could WHO make such an outrageous claim?

Simple. It rewrote the definition of "pandemic."

A previous official definition (and widely used unofficial one) required "simultaneous epidemics worldwide with enormous numbers of deaths and illness." Severity--that is, the number--is crucial, because seasonal flu always causes worldwide simultaneous epidemics. But one promulgated in April just days before the announcement of the swine flu outbreak simply eliminated severity as a factor.

That's also how we can have a "pandemic" when six months of epidemiological data show swine flu to be far milder than the seasonal variety. New York City statistics show it to be perhaps a 10th as lethal.

In Australia and New Zealand, flu season has ended, and almost all cases have been swine flu. Yet even without a vaccine, these countries are reporting fewer flu deaths than normal. (In New Zealand, that's just 18 confirmed deaths compared with 400 normally.) Swine flu is causing negative deaths! The best explanation is that infection with the milder strain (swine flu) is inoculating against the more severe strain (seasonal flu) it has displaced.

This all makes sense once you realize that swine flu isn't some sort of alien from outer space as we've been led to believe, but rather "the same subtype as seasonal A/H1N1 that has been circulating since 1977," as the BMJ (formerly the British Medical Journal) observes. It's "something our immune systems have seen before," echoes Peter Palese of New York's Mount Sinai School of Medicine.

The older you are, the more you've been exposed and the higher your immunity level--hence the need to give two swine flu vaccinations to those under age 10.

Nevertheless, because WHO dubbed this a "pandemic," vaccination plans, emergency response measures and frightening predictions have been based on comparisons with true pandemics that by definition were especially severe. That includes the August report from the President's Council of Advisors on Science and Technology with its "plausible scenario" of "30,000 - 90,000 deaths" peaking in "mid-October."

Check your calendar.

So, then, why did WHO do it?

In part, it was CYA for the WHO. It was losing credibility over the refusal of avian flu H5N1 to go pandemic and kill as many as 150 million people worldwide, as its "flu czar" had predicted in 2005. Around the world, nations stockpiled antiviral medicines and H5N1 vaccine.

So when pig flu conveniently appeared, the WHO essentially crossed out "avian," inserted "swine," and WHO Director-General Margaret Chan could boast: "The world can now reap the benefits of investments over the last five years in pandemic preparedness."

Yet this doesn't explain why the agency hyped avian flu in the first place, nor why it exaggerated HIV infections by more than 10 times, or why it spread hysteria over Severe Acute Respiratory Syndrome (SARS). That disease ultimately killed a day's worth of seasonal flu victims before vanishing.

But the SARS scare was enough, leading to a broad expansion of WHO powers, including a degree of direct authority over national health agencies. It's now using that to leverage more authority and a bigger budget. No shocker there.

What may be surprising is that it wants to use that power to help bring about a global economic and social revolution--and that Director-General Chan was so blunt about it in a speech in Copenhagen last month.

She said "ministers of health" should take advantage of the "devastating impact" swine flu will have on poorer nations to tell "heads of state and ministers of finance, tourism and trade" that:

--The belief that "living conditions and health status of the poor would somehow automatically improve as countries modernized, liberalized their trade and improved their economies" is false. Wealth doesn't equal health.

--"Changes in the functioning of the global economy" are needed to "distribute wealth on the basis of" values "like community, solidarity, equity and social justice."

--"The international policies and systems that govern financial markets, economies, commerce, trade and foreign affairs have not operated with fairness as an explicit policy objective."

Splendid! So let's put the WHO in charge of worldwide economic and social engineering.

Then let's form a new agency that sees disease as something to prevent and treat rather than something to exploit.

Michael Fumento is director of the nonprofit Independent Journalism Project, where he specializes in health and science issues, and author of The Myth of Heterosexual AIDS: How a Tragedy Has Been Distorted by the Media and Partisan Politics.
Title: Aid Watch
Post by: Body-by-Guinness on December 08, 2009, 10:54:07 AM
Almost started a new topic on this source, "Pathological Aid" perhaps. Be that as it may, came across an interesting source monitoring the effectiveness of various sorts of aid to poorer people/countries. Like how the folks here focus on the empiric rather than the feel good. There "about us" blurb states:


The Aid Watch blog is a project of New York University's Development Research Institute (DRI). This blog is principally written by William Easterly, author of "The Elusive Quest for Growth: Economists Adventures and Misadventures in the Tropics" and "The White Man's Burden: Why the West's Efforts to Aid the Rest Have Done So Much Ill and So Little Good," and Professor of Economics at NYU. It is co-written by Laura Freschi and by occasional guest bloggers. Our work is based on the idea that more aid will reach the poor the more people are watching aid.

“Conscience is the inner voice that warns us somebody may be looking.” - H.L. Mencken

Article follows:

The Political Economy of Aid Optimism or Pessimism
By William Easterly and Laura Freschi | Published October 27, 2009
Bill and Melinda Gates are making a big media presentation today at 7pm of their Living Proof Project, in which they document aid successes in health. They call themselves “Impatient Optimists.” We can comment more after we hear their presentation. However, they invited comment already by posting progress reports on the Living Proof website.

Actually, we have also previously argued that aid has been more successful in health than in other areas.  However, one petty and parochial concern we had about the progress reports is that Bill and Melinda Gates continue to make a case for malaria success stories based on bad or fake data that we have criticized on this blog already twice. The Gateses were aware of our blog because they responded to it at the Chronicle of Philanthropy.

Yet they continue to use the WHO 2008 World Malaria Report as their main source for data on malaria prevalence and deaths from malaria in Africa. As we pointed out in the earlier post, the report establishes such low standards for data reliability that some of the numbers hardly seem worth quoting. From the WHO report: “reliable data on malaria are scarce. In these countries estimates were developed based on local climate conditions, which correlate with malaria risk, and the average rate at which people become ill with the disease in the area.” Where convincing estimates from real reported cases of malaria could not be made, figures were extrapolated “from an empirical relationship between measures of malaria transmission risk and case incidence.”

In Rwanda, which the Gateses say showed a dramatic 45 percent reduction in the number of deaths from 2001 to 2006, a closer look at the WHO data shows that there is an estimate of 3.3 million malaria cases in 2006, with an upper bound of 4.1 million and a lower bound of 2.5 million. And, according to which method is used to estimate cases, the trend can be made to show that malaria incidence is actually on the rise. The Gateses also highlight Zambia as a “remarkable success,” claiming that “overall malaria deaths decreased by 37 percent between 2001 and 2006.” While they provide no citation for this figure it appears to come from the very same WHO report, which concedes that compared to African countries with smaller populations, “nationwide effects of malaria control, as judged from surveillance data” in Zambia are “less clear.”

The downside of all this is that it appears we are having no effect whatsoever on the Gates’ use of fake or bad numbers and thus on the highest profile analysis of malaria in the world. The Gateses ignore our recommendation (and that of others) that they invest MUCH more in better data collection to know when GENUINE progress is happening. (Would Gates have put up with a Microsoft marketing executive who reported Windows sales were somewhere between 2.5 and 4.1 million, which may be either lower or higher than previous periods’ equally unreliable numbers?)  Are we insanely pig-headed for insisting that African malaria data be something a little more reliable than if the Gateses had asked the pre-K class at the Microsoft Day Care Center to give their guess?

Well, this is the third time we are saying this on this blog, so maybe we should give up. When people like the Gateses are so tenacious in the face of well-documented errors, it’s time for us economists to shift from normative recommendations (don’t claim progress based on pseudo-data!) to positive theory (what are the incentives to use bad numbers?)

What is the political economy of “impatient optimism”? Here is a possible political economy story – there are two types of political actors: (1) those who care more about the poor and want to make more effort to help them relative to other public priorities, and (2) those who care less and want to make less effort relative to other priorities.

Empirical studies and data that show that aid programs are having very positive results are very helpful to (1) and not to (2), while of course the reverse is helpful to (2) and not to (1). So each type has an incentive to selectively choose studies and data. Knowing this and knowing the public knows this, the caring type (1) might want to signal they are indeed caring by emphasizing positive studies and data, and may have no incentive to actually evaluate whether the positive data are correct or not. So the Gateses might want to say (as they did): “The money the US spends in developing countries to prevent disease and fight poverty is effective, empowers people, and is appreciated.”

If this purely descriptive theory is true, it could explain why some political actors stubbornly stick to positive data even if some obscure academic argues it is false or unreliable.

It cuts both ways – the anti-aid political actors would also have no incentive to recheck their favorite data or studies. Then the debate over evidence will not really be an intellectual debate at all, but just a political contest between two different political types.

Of course, we HATE this political economy theory when it’s applied to US. We are VERY unhappy when people conclude that because we are skeptical about malaria data quality (and thus whether they show progress), therefore we really don’t care about how many Africans are dying from malaria and wish that all government money went to subsidize fine dining in New York. And, the Gateses would probably not be fond of this political economy explanation of their actions and beliefs either. Both of us would prefer the alternative “academic” theory of belief formation, in which it is all based on evidence and data, not political interests.

How to distinguish which theory explains the behavior of any one actor is determined by the response to evidence AGAINST one’s prior position – do you change your beliefs at all? The Gateses seem to fail this test on malaria numbers. We hope we do better when it comes our time to be tested, as we should be.
Title: NYT: superbug
Post by: Crafty_Dog on February 27, 2010, 10:34:25 AM
A minor-league pitcher in his younger days, Richard Armbruster kept playing
baseball recreationally into his 70s, until his right hip started bothering
him. Last February he went to a St. Louis hospital for what was to be a
routine hip replacement.   By late March, Mr. Armbruster, then 78, was dead.
After a series of postsurgical complications, the final blow was a
bloodstream infection that sent him into shock and resisted treatment with

“Never in my wildest dreams did I think my dad would walk in for a hip
replacement and be dead two months later,” said Amy Fix, one of his

Not until the day Mr. Armbruster died did a laboratory culture identify the
organism that had infected him: Acinetobacter baumannii. The germ is one of
a category of bacteria that by some estimates are already killing tens of
thousands of hospital patients each year. While the organisms do not receive
as much attention as the one known as MRSA — for methicillin-resistant
Staphylococcus aureus — some infectious-disease specialists say they could
emerge as a bigger threat.  That is because there are several drugs,
including some approved in the last few years, that can treat MRSA. But for
a combination of business reasons and scientific challenges, the
pharmaceuticals industry is pursuing very few drugs for Acinetobacter and
other organisms of its type, known as Gram-negative bacteria. Meanwhile, the
germs are evolving and becoming ever more immune to existing antibiotics.

“In many respects it’s far worse than MRSA,” said Dr. Louis B. Rice, an
infectious-disease specialist at the Louis Stokes Cleveland V.A. Medical
Center and at Case Western Reserve University. “There are strains out there,
and they are becoming more and more common, that are resistant to virtually
every antibiotic we have.”

The bacteria, classified as Gram-negative because of their reaction to the
so-called Gram stain test, can cause severe pneumonia and infections of the
urinary tract, bloodstream and other parts of the body. Their cell structure
makes them more difficult to attack with antibiotics than Gram-positive
organisms like MRSA.  Acinetobacter, which killed Mr. Armbruster, came to
wide attention a few years ago in infections of soldiers wounded in Iraq.
Meanwhile, New York City hospitals, perhaps because of the large numbers of
patients they treat, have become the global breeding ground for another
drug-resistant Gram-negative germ, Klebsiella pneumoniae. According to
researchers at SUNY Downstate Medical Center, more than 20 percent of the
Klebsiella infections in Brooklyn hospitals are now resistant to virtually
all modern antibiotics. And those supergerms are now spreading worldwide.

Health authorities do not have good figures on how many infections and
deaths in the United States are caused by Gram-negative bacteria. The
Centers for Disease Control and Prevention estimates that roughly 1.7
million hospital-associated infections, from all types of bacteria combined,
cause or contribute to 99,000 deaths each year.   But in Europe, where
hospital surveys have been conducted, Gram-negative infections are estimated
to account for two-thirds of the 25,000 deaths each year caused by some of
the most troublesome hospital-acquired infections, according to a report
released in September by health authorities there.   To be sure, MRSA
remains the single most common source of hospital infections. And it is
especially feared because it can also infect people outside the hospital.
There have been serious, even deadly, infections of otherwise healthy
athletes and school children. !!!! By comparison, the drug-resistant
Gram-negative germs for the most part threaten only hospitalized patients
whose immune systems are weak. The germs can survive for a long time on
surfaces in the hospital and enter the body through wounds, catheters and

What is most worrisome about the Gram-negatives is not their frequency but
their drug resistance.

“For Gram-positives we need better drugs; for Gram-negatives we need any
drugs,” said Dr. Brad Spellberg, an infectious-disease specialist at
Harbor-U.C.L.A. Medical Center in Torrance, Calif., and the author of
“Rising Plague,” a book about drug-resistant pathogens. Dr. Spellberg is a
consultant to some antibiotics companies and has co-founded two companies
working on other anti-infective approaches. Dr. Rice of Cleveland has also
been a consultant to some pharmaceutical companies.

Doctors treating resistant strains of Gram-negative bacteria are often
forced to rely on two similar antibiotics developed in the 1940s — colistin
and polymyxin B. These drugs were largely abandoned decades ago because they
can cause kidney and nerve damage, but because they have not been used much,
bacteria have not had much chance to evolve resistance to them yet.

“You don’t really have much choice,” said Dr. Azza Elemam, an
infectious-disease specialist in Louisville, Ky. “If a person has a
life-threatening infection, you have to take a risk of causing damage to the

Such a tradeoff confronted Kimberly Dozier, a CBS News correspondent who
developed an Acinetobacter infection after being injured by a car bomb in
2006 while on assignment in Iraq. After two weeks on colistin, Ms. Dozier’s
kidneys began to fail, she recounted in her book, “Breathing the Fire.”
Rejecting one doctor’s advice to go on dialysis and seek a kidney
transplant, Ms. Dozier stopped taking the antibiotic to save her kidneys.
She eventually recovered from the infection.

Even that dire tradeoff might not be available to some patients. Last year
doctors at St. Vincent’s Hospital in Manhattan published a paper describing
two cases of “pan-resistant” Klebsiella, untreatable by even the
kidney-damaging older antibiotics. One of the patients died and the other
eventually recovered on her own, after the antibiotics were stopped.

“It is a rarity for a physician in the developed world to have a patient die
of an overwhelming infection for which there are no therapeutic options,”
the authors wrote in the journal Clinical Infectious Diseases.

In some cases, antibiotic resistance is spreading to Gram-negative bacteria
that can infect people outside the hospital.  Sabiha Khan, 66, went to the
emergency room of a Chicago hospital on New Year’s Day suffering from a
urinary tract and kidney infection caused by E. coli resistant to the usual
oral antibiotics. Instead of being sent home to take pills, Ms. Khan had to
stay in the hospital 11 days to receive powerful intravenous antibiotics.
This month, the infection returned, sending her back to the hospital for an
additional two weeks.

Some patient advocacy groups say hospitals need to take better steps to
prevent such infections, like making sure that health care workers
frequently wash their hands and that surfaces and instruments are
disinfected. And antibiotics should not be overused, they say, because that
contributes to the evolution of resistance.

To encourage prevention, an Atlanta couple, Armando and Victoria Nahum,
started the Safe Care Campaign after their 27-year-old son, Joshua, died
from a hospital-acquired infection in October 2006. Joshua, a skydiving
instructor in Colorado, had fractured his skull and thigh bone on a hard
landing. During his treatment, he twice acquired MRSA and then was infected
by Enterobacter aerogenes, a Gram-negative bacterium.

“The MRSA they got rid of with antibiotics,” Mr. Nahum said. “But this one
they just couldn’t do anything about.”
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: ccp on February 27, 2010, 11:07:51 AM
Safe Care Campaign.

Yes hand hygiene could help.  And yes more is and should be done towards this end.

Also of benefit may be to NOT sky dive for a living.

Kind of reminds me of the father of that young fellow in Iraq who had his head cut off on the internet blaming of course George Bush for it all.  He failed to remember his was walking around a war zone trying to start a computer business after the Iraq invasion.

Kind of fits the concept that no one wants to take responsibility for anything they do.  It is always some one else's fault.  The victimhood mentality.
Title: Skeeter Inoculation?
Post by: Body-by-Guinness on March 20, 2010, 10:34:05 PM
Researchers Turn Mosquitoes Into Flying Vaccinators
Science Magazine ^ | 3/18/10 | Martin Enserink

Here's a study to file under "unworkable but very cool." A group of Japanese researchers has developed a mosquito that spreads vaccine instead of disease. Even the researchers admit, however, that regulatory and ethical problems will prevent the critters from ever taking wing—at least for the delivery of human vaccines.

Scientists have dreamed up various ways to tinker with insects' DNA to fight disease. One option is to create strains of mosquitoes that are resistant to infections with parasites or viruses, or that are unable to pass the pathogens on to humans. These would somehow have to replace the natural, disease-bearing mosquitoes, which is a tall order. Another strategy closer to becoming reality is to release transgenic mosquitoes that, when they mate with wild-type counterparts, don't produce viable offspring. That would shrink the population over time.

The new study relies on a very different mechanism: Use mosquitoes to become what the scientists call "flying vaccinators." Normally, when mosquitoes bite, they inject a tiny drop of saliva that prevents the host's blood from clotting. The Japanese group decided to add an antigen-a compound that triggers an immune response-to the mix of proteins in the insect's saliva.

A group by led by molecular geneticist Shigeto Yoshida of Jichi Medical University in Tochigi, Japan, identified a region in the genome of Anopheles stephensi-a malaria mosquito-called a promoter that turns on genes only in the insects' saliva. To this promoter they attached SP15, a candidate vaccine against leishmaniasis, a parasitic disease spread by sand flies that can cause skin sores and organ damage. Sure enough, the mosquitoes produced SP15 in their saliva, the team reports in the current issue of Insect Molecular Biology. And when the insects were allowed to feast on mice, the mice developed antibodies against SP15.

Antibody levels weren't very high, and the team has yet to test whether they protect the rodents against the disease. (Only very few labs have the facilities for so-called challenge studies with that disease, says Yoshida.) In the experiment, mice were bitten some 1500 times on average; that may seem very high, but studies show that in places where malaria is rampant, people get bitten more than 100 times a night, Yoshida points out. In the meantime, the group has also made mosquitoes produce a candidate malaria vaccine.

Other researchers are wowed by the achievement. "The science is really beautiful," says Jesus Valenzuela of the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland, who developed the SP15 vaccine. David O'Brochta, an insect molecular geneticist at the University of Maryland, College Park, calls it "a fascinating proof of concept."

So why won't it fly? There's a huge variation in the number of mosquito bites one person received compared with the next, so people exposed to the transgenic mosquitoes would get vastly different doses of the vaccine; it would be a bit like giving some people one measles jab and others 500 of them. No regulatory agency would sign off on that, says molecular biologist Robert Sinden of Imperial College London. Releasing the mosquitoes would also mean vaccinating people without their informed consent, an ethical no-no. Yoshida concedes that the mosquito would be "unacceptable" as a human vaccine-delivery mechanism.

However, flying vaccinators-or "flying syringes" as some have dubbed them -may have potential in fighting animal disease, says O'Brochta. Animals don't need to give their consent, and the variable dosage would be less of a concern.
Title: Organic Cotton Kills African Babies
Post by: Body-by-Guinness on June 18, 2010, 12:44:09 PM
I've posted before about how Western insecticide fetishes, particularly where DDT is concerned, leads to the deaths of millions of Africans, particularly children. This piece for the most part skirts around specifics, but brings home the scope of the situation.

Battling a Scourge
By Alex Perry / Apac
To reach the most malarial town on earth, head north from Kampala, cross the Victoria Nile and, just before you come to the refugee camps that mark the southern edge of Uganda's 20-year civil war, turn east to Lake Kwania. Africa's other Great Lakes are known for freshwater beaches and cool evenings, but Kwania is more of a giant swamp: shallow, full of crocodiles and choked with lily, papyrus and hyacinth. The malaria parasite loves it here.

Kwania's creeks, looking like a million silver fish bones from the air, are perfect for a deadly subspecies of mosquito, Anopheles funestus, which feeds almost exclusively on humans, with an appetite to shame a vampire. The nearby town of Apac is packed with a living blood bank of people. The average funestus bites human flesh 190 times a night. The average resident is bitten tens of thousands of times a year, including 1,586 bites — four a day — that carry malaria. (See TIME's photo-essay "The Most Malarial Town on Earth.")

Driving into Apac late on an August day last year, I saw a naked man lumbering toward me. Tall and thin, he was gray with dust, and his hair bristled with twigs and grass. He was talking to someone only he could see. Edging past, I was surprised by a second naked figure lurching out of a side street. He had the same cracked skin stretched over the same slender frame. Ahead, a third naked figure sat by the side of the road, his head in his hands. I felt as if I'd arrived in a town of zombies.

Apac's empty streets reinforced that impression. The town seemed to exist only for sickness and death: on one road I counted 12 medical centers, 10 drugstores and a crumbling, windowless nursing school. Soon I found a building that belonged to the Ministry of Health. I pulled in, entered and followed a dark corridor to a door marked "District Health Officer." I knocked. Behind two sets of fly screens and under a ceiling fan, Dr. Matthew Emer sat at his desk. I explained I was following a new campaign to rid the world of malaria and was in Apac to see what it was up against. Who were the naked men? I asked. "Brain damage," Dr. Matthew replied. "Severe malaria can do that to a baby. You never recover."

Dr. Matthew thought I should see some statistics. Apac is home to 515,500 people. Between July 2008 and June 2009, 124,538 of them were treated for malaria. That meant 2,000 to 3,000 patients a week for Dr. Matthew and his three fellow doctors, and the number rose to 5,000 in the rainy season. Of Apac's malaria patients, nearly half were under 5. (Read Dr. Mehmet Oz's explanation on why western diseases are spreading around the world.)

Signboards erected by the side of the road announced the presence of two foreign-assistance programs. One was a European-funded child-protection group, which had no malaria component to its program. The other was the National Wetlands Program (NWP), funded by Belgium. Partly because of NWP's influence, the draining of malarial swamps is banned — which amounts to preserving wetlands at the price of human life. Spraying houses with insecticide — which in 2008 cut malaria infections in half — is also forbidden. Why? Because of objections from Uganda's organic-cotton farmers, who supply Nike, H&M and Walmart's Baby George line. Chemical-free farming sounds like a great idea in the West, but the reality is that Baby Omara is dying so Baby George can wear organic.

The Problem with Helping
This, too often, is how aid goes: good intentions sidetracked by ignorance; a promising idea poorly executed; projects that are wasteful, self-regarding and sometimes corrupt. The people being helped often see things this way, as do the ones doing the helping, who ask why the hundreds of billions of dollars given to Africa since World War II have changed so little. It was in the face of such controversy that in 2007 the aid world unveiled one of its most ambitious goals: eradicating malaria.

The history of malaria is a long one. Originating in West Africa, it spread to half of humankind by the mid–19th century and has killed tens of millions and infected hundreds of millions more, including eight American Presidents. Malaria played a role in stopping Alexander the Great in India. It contributed to the fall of Rome, the relocation of the Vatican and the U.S. defeat in Vietnam. It still rages in the poverty-stricken world: it killed 863,000 people in 2008 — 89% of them African, and 88% of those people children under 5 — and infected 243 million more, says the World Health Organization (WHO). The lobbying group Malaria No More reckons that the disease costs Africa $12 billion a year — 1.3% of its economic growth. Fixing that would be the biggest boost to health and development in history. It would also be a stunning riposte to aid's critics.

It could happen. A previous campaign against malaria in the 1950s and '60s effectively eliminated the disease in Europe and the U.S. but made little progress in Africa and Asia, in part because health officials concluded that those places were simply too tough to fix. This time things are different. Now more than ever, it's unacceptable — indeed, immoral — to see Africa and Asia as beyond help. Today's funding is unprecedented, exceeding $10 billion. So is the leadership, from the U.S. President to the Sultan of Nigeria to soccer star David Beckham. Their goal is threefold: universal protection by the end of 2010 via the distribution of 700 million insecticide-treated bed nets; no more malaria deaths by the end of 2015; no malaria at all a decade or two after that. (See the latest on AIDS care, epidemic tracking and more.)

The logistics of such a plan are less complex than they seem, because while malaria affects half the world's countries, just seven — the Democratic Republic of Congo, Ethiopia, Kenya, Nigeria, southern Sudan, Tanzania and Uganda — account for two-thirds of all cases. So how might this malaria campaign succeed where so many others have come unstuck?

The Unlikely Leader
High above the Serengeti, Ray Chambers unclips his safety belt and beckons me to follow him to the back of the plane. At 67, Chambers, the U.N. special envoy for malaria, is graying and a little stiff, but with his square jaw, Clint Eastwood voice and the plane — his own — there is still something of the Master of the Universe about him. The son of a Newark, N.J., warehouse manager, Chambers was in his 20s when he came up with the idea of the leveraged buyout, a concept that made him fabulously rich — but not happy. In 1987 he found himself visiting a project for inner-city teenagers in Newark. He promised to pay the college tuition of 1,000 kids "if they stayed the path." That made him feel great. So in 1989 he closed his investment firm and became a philanthropist, giving away $50 million by 1993. (See TIME's photo-essay "The Most Malarial Town on Earth.")

In 2005, Chambers was looking at a photograph of sleeping Mozambican children taken by his friend the Harvard economist Jeffrey Sachs. "Cute kids," he remarked. "You don't understand," replied Sachs. "They're in malarial comas. They all died." Chambers was mortified. "So I said to Jeff, 'I'd like to kind of come up with business concepts to see if we can't save 1.3 million children a year.'" The next year, he established Malaria No More — a group that raises money, implements programs and stands as a case study of how aid can change.

The ethos of Malaria No More is that aid should be seen not as a noble act of charity but as something that's in everyone's interest. Eradicating disease boosts productivity, creates markets, stabilizes governments — even gives celebrities a point. It's a route to prosperity. Official endorsement of Chambers' approach came in 2008 when U.N. Secretary-General Ban Ki-moon appointed him special envoy. "You could see Ray was the guy to get this done," says WHO head Margaret Chan.

To be fair, he was not alone. Many companies are doing well by doing good, realizing that, say, an HIV program at a South African mine cuts absenteeism. A nuanced vision of a successful company is taking hold, one that elevates social responsibility to a core mission — and was backed with $14.5 billion in the U.S. in 2007, according to the Chronicle of Philanthropy.

Partly as a result of Chambers' prodding, that new way of giving aid has encouraged Western governments to open their wallets too. Funding for malaria has exploded from $50 million in 1997 to $6.6 billion for the Global Fund to Fight AIDS, TB and Malaria and $5.5 billion for the President's Malaria Initiative, a U.S. program launched in 2005. A good example of how aid is creeping into our lives in subtler ways is Unitaid. Founded in 2006 to raise money for AIDS, TB and malaria through small taxes on air tickets and check boxes on e-tickets, it has so far raised $870 million. (See the latest on AIDS care, epidemic tracking and more.)

Religion has caught the bug too — as it were. Rick Warren's Saddleback Church in Lake Forest, Calif., is training health workers in western Rwanda. The heads of the Muslim and Christian faiths in Nigeria are training hundreds of thousands of imams and priests in malaria care and net and drug distribution. Help also comes from retired politicians like Bill Clinton and Tony Blair, who have both set up aid foundations. Blair, whose Faith Foundation is assisting the Muslim-Christian collaboration in Nigeria, told Time, "The nature of help is changing. The malaria campaign is about as good an example as you get of rebalancing the respectability of the aid case."

Real Results
The payoff can be spectacular. malaria has been at least halved in nine African countries since 2000. Ethiopia and southern Sudan should reach universal protection this year; Chambers predicts global bed-net coverage in the first quarter of 2011, just months past his target. A visit last August by Chambers and Chan to the children's ward of a Zanzibar hospital produced whoops of joy from Chan. It was empty.

That success is hardly universal — or permanent. Zanzibar has eradicated malaria twice before but each time reimported it from mainland Tanzania. Kenya, an early success story, has slipped. Congo has only just got going. What do these failures have in common? Bad government. When Chambers visited Tanzania in August 2009, he found an approved $111 million Global Fund grant lying unclaimed for want of a single signature. In Uganda, Global Fund grants totaling $367 million were suspended over allegations — now before the courts — of corruption involving three health ministers and several aid groups. "The house is on fire," Chambers told a meeting of ministers and aid groups in Kampala last August. Chan was blunter: "We will hold you to account on behalf of the 350 women and children who die every day here." That, too, is a face of aid. (Read Dr. Mehmet Oz's explanation on why western diseases are spreading around the world.)

In Apac I visited the town hospital the morning after I arrived to find 30 newly admitted babies. When I returned that night, there were another 10. Martin, 27, was the only nurse on duty, and he was equipped only with quinine — long ago phased out in the West when malaria became resistant to it — headache pills and sugar solution. I watched him try to stick an IV needle into a 4-month-old girl, Doris Amang. He tried the backs of both her hands, then both sides of her head. Doris screamed and kicked. After pricking her 12 times, he gave up. Her veins had collapsed from dehydration. The windows were wide open. I watched a mosquito settle on Doris' cheek.

The next day, I returned. There were 50 babies now but no sign of Martin or any other staff member. The mothers were looking to me, but I had nothing to offer. I left the ward, walked quickly to my car and headed for the gates. Nearby was a naked street walker, feeling his way along the fence. As I roared past, I caught a glimpse of his startled expression, his emaciated face. I drove out of town and didn't stop until I reached Kampala.

Click to Print
Find this article at:,28804,1995199_1995197_1995176,00.html
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Rarick on June 19, 2010, 05:14:34 AM
I remember reading a book way back in 6th grade that talked about "macroEngineering"  while the region mentioned in the previous post wasn't addressed, both the Sahara and Central Africa were.

The smaller of the 2 projects was the Quatrra(sp?) depression. It involved drilling tunnels/canals to the Mediterranean for water and runing said water thru turbines for electricity.  The water could then be deslinated with the electricity for irrigation, and the salt used for what salt is used for.  After the depression filled up in a few hundred years, you get a new great lake,  That lake could then be used as an irrigation reservoir.........  Macro with a big M engineering.  The angle that makes this germane to the thread would be that the increased availability of electrical power, irrigation, etc. would all raise the quality of living for the human population in the whole region.  That has always lessened the instance of disease, less instances makes for less mutation.  That would help stop both the spread and evolution of new diseases. This is the least active but here are some links: ( ( ( (

The larger of the projects was Lake Congo.  Dam up the congo river where it passes thru the gorge on the way to the coast.  That would drown 3 countries interior to africa, and incidentaklly some of the nastiest hell holes created by man and nature to date.  This area is the breeding ground of Filiarisis, HIV, Malaria, a large number of parasites, and who knows what new stuff is bubbling away in the rancid tidal swamp and swamplands of the congo river.  That dam alone would power a lot of the african coast from Lesotho on down to Nigeria it wouls also allow the congo alluvial plain to dry abnd be developed into some pretty rich farmlands like the Nile and Missisippi have along their banks eh? Once lake congo filled up you could tap the north end and develop hydro electric/irrigation to the chad region and restart the flow of the Niger river?  That would give a secondary supply of water to that whole region.......   The east and southern edges of the lake could be tapped too, that lake is basically in a tropical rainforest zone so you have a rain barrel practically overflowing and need to do something with that water............ Maybe all tha free clean power right on the equator could be used to build our first deliberately developed space/star port?  It would have a certain justice and balance about it wouldn't it? A small part of this would be the Inga Project
Links: ( ( (

How many Trillions have we spent trying to help africans of all tribes and nations only to discover we are not getting anywhere?  Make a big project and a big dream and get them more interested in building rather than fighting.  In the process you get a whole bunch of apprentices who earn money and...... well we have brains.  2 bootstrap projects that could transform the part of the world that is the most miserable and let them join the rest of us...........

Hey it is a dream, but why not?
Title: WSJ: Towards AIDs vaccine
Post by: Crafty_Dog on July 09, 2010, 07:11:17 AM
HIV research is undergoing a renaissance that could lead to new ways to develop vaccines against the AIDS virus and other viral diseases.

In the latest development, U.S. government scientists say they have discovered three powerful antibodies, the strongest of which neutralizes 91% of HIV strains, more than any AIDS antibody yet discovered. They are now deploying the technique used to find those antibodies to identify antibodies to influenza viruses.

Mark Schoofs discusses a significant step toward an AIDS vaccine, U.S. government scientists have discovered three powerful antibodies, the strongest of which neutralizes 91% of HIV strains, more than any AIDS antibody yet discovered.
The HIV antibodies were discovered in the cells of a 60-year-old African-American gay man, known in the scientific literature as Donor 45, whose body made the antibodies naturally. The trick for scientists now is to develop a vaccine or other methods to make anyone's body produce them as well.

That effort "will require work," said Gary Nabel, director of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases, who was a leader of the research. "We're going to be at this for a while" before any benefit is seen in the clinic, he said.

The research was published Thursday in two papers in the online edition of the journal Science, 10 days before the opening of a large International AIDS Conference in Vienna, where prevention science is expected to take center stage. More than 33 million people were living with HIV at the end of 2008, and about 2.7 million contracted the virus that year, according to United Nations estimates.

Vaccines, which are believed to work by activating the body's ability to produce antibodies, eliminated or curtailed smallpox, polio and other feared viral diseases, so they have been the holy grail of AIDS research.

Last year, following a trial in Thailand, results of the first HIV vaccine to show any efficacy were announced. But that vaccine reduced the chances of infection only by about 30%, and controversy erupted because in one common analysis the results weren't statistically significant. That vaccine wasn't designed to elicit the new antibodies.

The new discovery is part of what Wayne Koff, head of research and development at the nonprofit International AIDS Vaccine Initiative, calls a "renaissance" in HIV vaccine research.

Antibodies that are utterly ineffective, or that disable just one or two HIV strains, are common. Until last year, only a handful of "broadly neutralizing antibodies," those that efficiently disable a large swath of HIV strains, had been discovered. And none of them neutralized more than about 40% of known HIV variants.

But in the past year, thanks to efficient new detection methods, at least a half dozen broadly neutralizing antibodies, including the three latest ones, have been identified in peer-reviewed journals. Dennis Burton of the Scripps Institute in La Jolla, Calif., led a team that discovered two broadly neutralizing antibodies last year; he says his team has identified additional, unpublished ones. Most of the new antibodies are more potent, able to knock out HIV at far lower concentrations than their previously known counterparts.

HIV is a highly mutable virus, but one place where the virus doesn't mutate much is where it attaches to a particular molecule on the surface of cells it infects. Building on previous research, researchers created a probe, shaped exactly like that critical site, and used it to attract only those antibodies that efficiently attack it. That is how they fished out of Donor 45 the special antibodies: They screened 25 million of his cells to find 12 that produced the antibodies.

Donor 45's antibodies didn't protect him from contracting HIV. That is likely because the virus had already taken hold before his body produced the antibodies. He is still alive, and when his blood was drawn, he had been living with HIV for 20 years.
While he has produced the most powerful HIV antibody yet discovered, researchers say they don't know of anything special about his genes that would make him unique. They expect that most people would be capable of producing the antibodies, if scientists could find the right way to stimulate their production.

Dr. Nabel said his team is applying the new technique to the influenza virus. Like HIV, influenza is a highly mutable virus—the reason a new vaccine is required every year.

"We want to go after a universal vaccine" by using the new technique to find antibodies to a "component of the influenza virus that doesn't change," said NIAID director Anthony Fauci. In principle, Dr. Fauci said, the technique could be used for any viral disease and possibly even for cancer vaccines.

Some of the new HIV antibodies discovered over the past year attack different points on the virus, raising hopes that they could work synergistically.

In unpublished research, John Mascola, deputy director of the Vaccine Research Center, has shown that one of Dr. Burton's antibodies neutralizes virtually all the strains that are resistant to the antibody from Donor 45. He also found the reverse: The antibody from Donor 45 disables HIV strains resistant to one of Dr. Burton's best antibodies. Only one strain out of 95 tested was resistant to both antibodies, he said. Dr. Mascola is one of the authors of Thursday's papers.

Researchers say they plan to test the new antibodies, likely blended together in a potent cocktail, in three broad ways.

First, the antibodies could be given to people in their raw form, somewhat like a drug, to prevent transmission of the virus. But they would likely be expensive and last in the body for a limited time, perhaps weeks, making that method impractical for all but specialized cases, such as to prevent mother-to-child transmission in childbirth.

The antibodies could also be tested in a "microbicide," a gel that women or gay men could apply before sex to prevent infection.

The antibodies might even be tried as a treatment for people already infected. While the antibodies are unlikely to completely suppress HIV on their own, say scientists, they might boost the efficacy of current antiretroviral drugs.

Dr. Nabel said that the Vaccine Research Center has contracted with a company to produce an antibody suitable for use in humans so that testing in people could begin.

A second way to use the new research is to stimulate the immune system to produce the antibodies. Jonas Salk injected people with a whole killed polio virus, and virtually everyone's immune system easily made antibodies that disabled the polio virus. But for HIV, the vast majority of antibodies are ineffective. Now, scientists know the exact antibodies that must be made—those found in Donor 45 and in Dr. Burton's lab, for example. So researchers need "a reverse engineering technology" to find a way to get everyone to produce them, said Greg Poland, director of vaccine research at Mayo Clinic in Rochester, Minn.

That's what scientists at Merck & Co. have done. In a study published this year in the Proceedings of the National Academy of Sciences, the Merck Scientists knew that an old antibody, weaker than the newly discovered ones, attaches to a particularly vulnerable part of HIV. They created a replica of that piece of the virus to train the immune system to produce antibodies aimed at that exact spot. It was a painstaking process, requiring researchers to add chemical bonds to stabilize the replica so that it wouldn't collapse and lose its shape. Eventually, Merck was able to make experimental vaccine candidates capable of spurring guinea pigs and rabbits to produce antibodies that home in on the target site and neutralize HIV. Those vaccines weren't nearly powerful enough, but, said Dr. Koff, Merck's research provides a "proof of principle" that reverse engineering can work for the much stronger new antibodies.

There are other potential pitfalls. There is evidence that Donor 45's cells took months or possibly even years to create the powerful antibodies. That means scientists might have to give repeated booster shots or devise other ways to speed up this process.

Finally, there are experimental methods that employ tactics such as gene therapy. Nobel laureate David Baltimore is working on one such approach.
His team at the California Institute of Technology in Pasadena, Calif., has stitched genes that code for antibodies into a harmless virus, which they then inject into mice. The virus infects mouse cells, turning them into factories that produce the antibodies.

Write to Mark Schoofs at
Title: POTH: AIDs
Post by: Crafty_Dog on July 12, 2010, 08:06:05 AM
Buried in this piece are some really scary data about transmssion rates:
WASHINGTON — President Obama will unveil a new national strategy this week to curb the AIDS epidemic by slashing the number of new infections and increasing the number of people who get care and treatment.

“Annual AIDS deaths have declined, but the number of new infections has been static and the number of people living with H.I.V. is growing,” says a final draft of the report, obtained by The New York Times.

In the report, the administration calls for steps to reduce the annual number of new H.I.V. infections by 25 percent within five years. “Approximately 56,000 people become infected each year, and more than 1.1 million Americans are living with H.I.V.,” the report says.

Mr. Obama plans to announce the strategy, distilled from 15 months of work and discussions with thousands of people around the country, at the White House on Tuesday.

While acknowledging that “increased investments in certain key areas are warranted,” the report does not propose a major increase in federal spending. It says the administration will redirect money to areas with the greatest need and population groups at greatest risk, including gay and bisexual men and African-Americans. The federal government now spends more than $19 billion a year on domestic AIDS programs.

On average, the report says, one person is newly infected with H.I.V. every nine and a half minutes, but tens of thousands of people with the virus are not receiving any care. If they got care, the report says, they could prolong their own lives and reduce the spread of the virus to others. By 2015 the report says, the United States should “increase the proportion of newly diagnosed patients linked to clinical care within three months of their H.I.V. diagnosis to 85 percent,” from the current 65 percent.

The first-ever national AIDS strategy has been in the works since the start of the administration. It comes in the context of growing frustrations expressed by some gay rights groups. They say that more money is urgently needed for the AIDS Drug Assistance Program, and they assert that the White House has not done enough to secure repeal of the law banning military service by people who are openly gay or bisexual.

The report tries to revive the sense of urgency that gripped the nation in the first years after discovery of the virus that causes AIDS. “Public attention to the H.I.V. epidemic has waned,” the report says. “Because H.I.V. is treatable, many people now think that it is no longer a public health emergency.”

The report calls for “a more coordinated national response to the H.I.V. epidemic” and lays out specific steps to be taken by various federal agencies.

Mr. Obama offers a compliment to President George W. Bush, who made progress against AIDS in Africa by setting clear goals and holding people accountable.

The program begun by Mr. Bush, the President’s Emergency Plan for AIDS Relief, “has taught us valuable lessons about fighting H.I.V. and scaling up efforts around the world that can be applied to the domestic epidemic,” the report says.

Mr. Obama’s strategy is generally consistent with policies recommended by public health specialists and advocates for people with H.I.V. But some experts had called for higher goals, more aggressive timetables and more spending on prevention and treatment.

The report makes these points:

¶Far too many people infected with H.I.V. are unaware of their status and may unknowingly transmit the virus to their partners. By 2015, the proportion of people with H.I.V. who know of their condition should be increased to 90 percent, from 79 percent today.

¶The new health care law will significantly expand access to care for people with H.I.V., but federal efforts like the Ryan White program will still be needed to fill gaps in services.

¶Federal spending on H.I.V. testing and prevention does not match the need. States with the lowest numbers of H.I.V./AIDS cases often receive the most money per case. The federal government should allocate more of the money to states with the highest “burden of disease.”

¶Health officials must devote “more attention and resources” to gay and bisexual men, who account for slightly more than half of new infections each year, and African-Americans, who account for 46 percent of people living with H.I.V.

¶The H.I.V. transmission rate, which indicates how fast the epidemic is spreading, should be reduced by 30 percent in five years. At the current rate, about 5 of every 100 people with H.I.V. transmit the virus to someone in a given year.

If the transmission rate is unchanged, the report says, “within a decade, the number of new infections would increase to more than 75,000 per year and the number of people living with H.I.V. would grow to more than 1.5 million.”

The report finds that persistent discrimination against people with H.I.V. is a major barrier to progress in fighting the disease.

“The stigma associated with H.I.V. remains extremely high,” it says. “People living with H.I.V. may still face discrimination in many areas of life, including employment, housing, provision of health care services and access to public accommodations.”

The administration promises to “strengthen enforcement of civil rights laws” protecting people with H.I.V.

One political challenge for the administration is to win broad public support for a campaign that will focus more narrowly on specific groups and communities at high risk for H.I.V. infection.

“Just as we mobilize the country to support cancer research whether or not we believe that we are at high risk of cancer and we support public education whether or not we have children,” the report says, “fighting H.I.V. requires widespread public support to sustain a long-term effort.”
Title: Prions Form on Metal Surfaces?
Post by: Body-by-Guinness on July 26, 2010, 03:20:05 PM
Scripps research study shows infectious prions can arise spontaneously in normal brain tissue
Scripps Research Institute ^ | July 26, 2010cimon

Metal surfaces spur conversion of normal prion protein into disease-causing prions

JUPITER, FL, July 26, 2010 – In a startling new study that involved research on both sides of the Atlantic, scientists from The Scripps Research Institute in Florida and the University College London (UCL) Institute of Neurology in England have shown for the first time that abnormal prions, bits of infectious protein devoid of DNA or RNA that can cause fatal neurodegenerative disease, can suddenly erupt from healthy brain tissue.

The catalyst in the study was the metallic surface of simple steel wires. Previous research showed that prions bind readily to these types of surfaces and can initiate infection with remarkable efficiency. Surprisingly, according to the new research, wires coated with uninfected brain homogenate could also initiate prion disease in cell culture, which was transmissible to mice.

The findings are being published the week of July 26, 2010, in an advance, online edition of the journal Proceedings of the National Academy of Sciences (PNAS).

"Prion diseases such as sporadic Creutzfeldt-Jakob disease in humans or atypical bovine spongiform encephalopathy, a form of mad cow disease, occur rarely and at random," said Charles Weissmann, M.D., Ph.D., chair of Scripps Florida's Department of Infectology, who led the study with John Collinge, head of the Department of Neurodegenerative Disease at UCL Institute of Neurology. "It has been proposed that these events reflect rare, spontaneous formation of prions in brain. Our study offers experimental proof that prions can in fact originate spontaneously, and shows that this event is promoted by contact with steel surfaces."

Infectious prions, which are composed solely of protein, are classified by distinct strains, originally characterized by their incubation time and the disease they cause. These toxic prions have the ability to reproduce, despite the fact that they contain no nucleic acid genome.

Mammalian cells normally produce harmless cellular prion protein (PrPC). Following prion infection, the abnormal or misfolded prion protein (PrPSc) converts PrPC into a likeness of itself, by causing it to change its conformation or shape. The end-stage consists of large aggregates of these misfolded proteins, which cause massive tissue and cell damage.

A Highly Sensitive Test

In the new study, the scientists used the Scrapie Cell Assay, a test originally created by Weissmann that is highly sensitive to minute quantities of prions.

Using the Scrapie Cell Assay to measure infectivity of prion-coated wires, the team observed several unexpected instances of infectious prions in control groups where metal wires had been exposed only to uninfected normal mouse brain tissue. In the current study, this phenomenon was investigated in rigorous and exhaustive control experiments specifically designed to exclude prion contamination. Weissmann and his colleagues in London found that when normal prion protein is coated onto steel wires and brought into contact with cultured cells, a small but significant proportion of the coated wires cause prion infection of the cells – and when transferred to mice, they continue to spawn the disease.

Weissmann noted that an alternative interpretation of the results is that infectious prions are naturally present in the brain at levels not detectable by conventional methods, and are normally destroyed at the same rate they are created. If that is the case, he noted, metal surfaces could be acting to concentrate the infectious prions to the extent that they became quantifiable by the team's testing methods.


The first author of the study, "Spontaneous Generation of Mammalian Prions," is Julie Edgeworth of the UCL Institute of Neurology. Other authors of the study include Nathalie Gros, Jack Alden, Susan Joiner, Jonathan D.F. Wadsworth, Jackie Linehan, Sebastian Brandner, and Graham S. Jackson, also of the UCL Institute of Neurology.

The study was supported by the U.K. Medical Research Council.

About The Scripps Research Institute

The Scripps Research Institute is one of the world's largest independent, non-profit biomedical research organizations, at the forefront of basic biomedical science that seeks to comprehend the most fundamental processes of life. Scripps Research is internationally recognized for its discoveries in immunology, molecular and cellular biology, chemistry, neurosciences, autoimmune, cardiovascular, and infectious diseases, and synthetic vaccine development. Established in its current configuration in 1961, it employs approximately 3,000 scientists, postdoctoral fellows, scientific and other technicians, doctoral degree graduate students, and administrative and technical support personnel. Scripps Research is headquartered in La Jolla, California. It also includes Scripps Florida, whose researchers focus on basic biomedical science, drug discovery, and technology development. Scripps Florida is located in Jupiter, Florida. See
Title: Smallpox Precedents
Post by: Body-by-Guinness on April 29, 2011, 07:38:29 PM
The Shot Heard Round the World

By 1947, smallpox in the U.S. was rare, but when two people died from the disease in New York, officials urged residents who hadn't been vaccinated in the past 7-10 years to get the shot. Above: Morrisania Hospital in the Bronx.

A vaccine that is intended to save countless lives. Parents suspicious of the shots, terrified of what the vaccine will do to their children. The government insisting on vaccinations for the general good.

Sounds like recent history, when a British doctor's study linking autism to the three-in-one vaccine for measles, mumps and rubella panicked some parents into barring their children from being vaccinated. But long before actress Jenny McCarthy prominently stirred fears about MMR shots, the vaccination campaign to eradicate smallpox was met with similar trepidation. One significant difference: The study that caused the anti-MMR hysteria has been proved to be bogus, while the smallpox vaccine used a century ago carried genuine dangers.

When some states introduced mandatory smallpox vaccinations during the epidemic of 1898-1903, Americans resisted by the thousands. The ensuing battles produced medical conventions and case law that altered the balance between government authority and medical practice, in favor of federal control. The effects of the smallpox fight continue to this day: The Obama health-care law and the infrastructure required to administer it rely on some of these century-old precedents.

In "Pox: An American History," Michael Willrich meticulously traces the story of how the smallpox vaccine was pressed into service during a major outbreak. Sometimes the shots were physically forced on people, outraging their sense of personal freedom and—when the vaccine sickened some and killed others—galvanizing suspicion of vaccination programs. The episode, Mr. Willrich says, prompted large swaths of Americans to insist that "the liberty protected by the Constitution also encompassed the right of a free people to take care of their own bodies and children according to their own medical beliefs and consciences."

Historical records show that smallpox was a human scourge for thousands of years. The virus produces high fever, severe back pain and scarring eruptions of flat red spots on the skin that turn into pustules and then into scabs—a two-week process during which the disease is highly contagious. Smallpox can vary in its severity, with some strains killing many sufferers and others relatively few. In the late 18th century, the British scientist Edward Jenner discovered that scratching the arms of healthy children with a bit of pus from cowpox immunized them against smallpox. The revelation was jeered by skeptics, but soon many governments were encouraging smallpox shots—and cowpox-based vaccines would eventually rout the disease from the modern world.

The smallpox outbreak in the U.S. that began in 1898 was not as virulent as some earlier ones, but memories of past horrors and mounting deaths across the country stirred officials to action. Over the epidemic's five-year course, an estimated 4,000 to 5,600 Americans died from smallpox, and tens of thousands suffered from nonfatal but often disfiguring infections.

Prior to the epidemic, public heath was largely the province of state and local authorities. But many officials proved incapable, or unwilling, to intervene when faced with the epidemic itself. In some cases, money was at issue. In other cases, racism. In the South and elsewhere, Mr. Willrich says, local officials refused to invest in stopping a virus that they saw as a blight of "dark people" who who were forced to live in close quarters with poor sanitary conditions. Mostly, though, the failure was a matter of ineptitude: Many doctors and others who focused on the infectious smallpox pustules didn't understand that the virus could be easily transmitted by a cough or a sneeze. And the vaccination programs were at best haphazard.

Walter Wyman, the U.S. surgeon general for two decades beginning in 1891, "railed against the short-sightedness of local and state officials who, he believed, had allowed smallpox to rage out of control," Mr. Wallrich writes. Whatever the cause of the anemic response to the epidemic, it prompted federal intervention in public-health matters—opening a door that has never closed.

Invoking what Mr. Willrich calls "a precedent in the American legal tradition of police power, which allowed for broad governmental intrusions into everyday lives of American citizens" when the public welfare was at stake, the feds stepped in. The government deployed "virus squads" of vaccinators who fanned out across the country, aided by Texas Rangers along the Mexico border and by billyclub-swinging policemen in New York. Health officials opened "pesthouses," where the ill were sequestered; sometimes whole towns were quarantined. The vaccinators visited factories and schools and railroad stations. In some cases, people who had been exposed to the smallpox virus were vaccinated at police gunpoint.

Pox: An American History

By Michael Willrich
Penguin Press, 422 pages, $27.95

Their reluctance was understandable: The smallpox vaccine was sometimes shoddily produced. In Camden, N.J., in 1901, the deaths of nine schoolchildren were linked by newspapers to a commercially produced vaccine tainted with tetanus. (Around that time, 13 children in St. Louis died of tetanus after being vaccinated for diphtheria.) It wasn't just civil libertarians who opposed the compulsory vaccinations; many practical people did the math and preferred to take a chance with the virus, not the vaccine. It was not just a fear of death that scared people: Reports of excruciating arm soreness caused by the vaccine made manual laborers, worried about having to miss work, avoid the shots. People produced fake vaccination certificates and sometimes injured their skin to simulate the telltale scar caused by the vaccine.

The feds realized that if they were going to mandate vaccination, the government would have to ensure that the shots were safe. In 1902, President Theodore Roosevelt signed the Biologics Control Act, the first federal law to regulate drug products. It was a precursor to today's Food and Drug Administration.

This being America, the vaccine tempest also gave rise to litigation. Mr. Willrich, a history professor at Brandeis University, says that the most significant of what became a series of legal rulings was the 1905 Supreme Court decision in Jacobson v. Massachusetts. The complex opinion gave the high court's blessing to compulsory-vaccination schemes. But the justices also established a set of standards for balancing governmental power and individual rights during public emergencies. The decision was invoked in 2004 by Justice Clarence Thomas in his dissent from the court's ruling in Hamdi v. Rumsfeld, granting certain rights to U.S. citizens detained as "illegal enemy combatants."

In the end, vaccination methods were dramatically improved, the epidemic was stopped—and over the next few decades smallpox was wiped out of human circulation by concerted vaccination campaigns and the swift isolation of the infected. Today, the virus is confined to frozen storage inside a lab in Atlanta and one in Koltsovo, Russia. But the federal role in the practice of medicine remains very much alive.

—Dr. Gottlieb is a clinical assistant professor at the New York University School of Medicine and an American Enterprise Institute resident fellow.
Title: Re: Epidemics: Bird Flu, TB, etc
Post by: Crafty_Dog on April 30, 2011, 10:31:09 AM
That was interesting BBG.
Title: What were these fg morons thinking?
Post by: Crafty_Dog on December 16, 2011, 10:38:51 AM
At least someone is challenging the deed, and the difusion of the knowledge:
Title: WSJ: Progress towards AIDs vaccine
Post by: Crafty_Dog on January 05, 2012, 05:34:36 AM
The quest for a vaccine against AIDS is gaining momentum, with research published Wednesday identifying promising new candidates that protected monkeys against a powerful strain of the virus and that soon could be tested in humans.

The study, published in the online edition of the journal Nature, also shed light on how the first human vaccine to have conferred limited protection against the AIDS virus may have worked.

In the research, several experimental vaccines partially prevented infection in monkeys from a highly potent, highly immune-resistant strain of simian immunodeficiency virus, an unusual finding, researchers said. SIV is similar to human immunodeficiency virus, or HIV, the virus that causes AIDS, and SIV infection in monkeys resembles HIV infection in humans.

Decades of Progress and Setbacks
Recent advances have followed years of frustration in HIV research and prevention.

View Interactive
..The new vaccines, combining two different technologies to generate an immune response, reduced the chances that a monkey would be infected by the virulent SIV strain in each exposure by 80% to 83%, compared with a placebo. The vaccines also significantly reduced the amount of virus in the blood of monkeys who did become infected.

The protection was only partial—most of the vaccinated monkeys eventually became infected after multiple exposures. Still, the study was among the first to prevent infection against a virulent, highly immune-resistant SIV strain.

Plans are under way for clinical trials of a human-adapted version of one of the vaccines used in the monkeys, said Dan Barouch, professor of medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and lead author of the study. The vaccine will be tested in people both in the U.S. and internationally, including in populations in Africa where HIV infection rates are high, he said.

"There's more hope than ever before that an AIDS vaccine might be possible," said Dr. Barouch.

The findings are part of a renaissance in AIDS research, with multiple vaccine candidates under exploration and a landmark study published last year showing that AIDS drugs can reduce the spread of HIV from an infected person to others. But HIV researchers still don't fully understand how to prevent infection.

Vaccines, which work by spurring the body's ability to produce antibodies or immune cells, are considered the holy grail of AIDS research, because of the powerful role they played in eradicating smallpox and eliminating or sharply reducing the spread of other infectious diseases.

About 34 million people globally are infected with HIV, with about 2.7 million more infected each year, according to United Nations estimates.

In 2009, results of the first HIV vaccine to confer any protection against HIV were announced, after a large clinical trial in Thailand. That vaccine reduced the chances of infection only 31%, and prompted some controversy when one analysis found the results weren't statistically significant.

Still, the results helped rejuvenate the field. The latest study helps explain what many scientists suspected after the Thai trial: that the surface protein of the HIV virus, or its envelope, is involved in preventing infection.

"It clearly demonstrated you need to make antibodies against the outer coating of the virus," said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, the part of the National Institutes of Health that oversees AIDS research and co-funded the latest study.

"It confirms what was seen in the Thai trial was real," said Louis Picker, associate director of the Vaccine and Gene Therapy Institute at Oregon Health & Science University, who reviewed the study led by Dr. Barouch but wasn't involved in it.

One strength of the study, said Dr. Fauci, was that the researchers made their vaccines with one strain of SIV and infected monkeys with another—replicating a likely real-world scenario, because the ever-mutating AIDS virus comes in many strains.

Many previous studies have used the same virus, but "that's not the way the real world works," he said. "There are so many different varieties of HIV out there. You've got to protect the person against potentially any strain."

While monkey models are considered highly reliable in HIV research and the findings resemble those of the Thai trial in humans, HIV researchers cautioned that it won't be known whether these vaccines work in humans until they are tried.

"HIV is progressively revealing its secrets and each time it gets us closer to the goal, but this isn't like a basketball game where it's the last two minutes," said Bruce Walker, a veteran HIV researcher and director of the Ragon Institute, an enterprise of Massachusetts General Hospital, the Massachusetts Institute of Technology and Harvard University. Ragon Institute helped fund the latest study and has raised $11 million of about $22 million needed for the clinical trials, Dr. Walker said.

Mark Schwartz, chairman and founding partner of MissionPoint Capital Partners, a private equity firm, donated $1 million of his own funds, together with his wife Lisa, toward the clinical trials. "Is it risky in a venture capital kind of way? Yes, it is," he said. But, he said," Ultimately, we think the real payoff is going to be in a vaccine."

Title: POTH calls for destruction of engineered Avian flu
Post by: Crafty_Dog on January 08, 2012, 05:10:30 AM

ALthough I have not studied the issue closely, I must say my intuitive reaction is the same.

Scientists have long worried that an influenza virus that has ravaged poultry and wild birds in Asia might evolve to pose a threat to humans. Now scientists financed by the National Institutes of Health have shown in a laboratory how that could happen. In the process they created a virus that could kill tens or hundreds of millions of people if it escaped confinement or was stolen by terrorists.

We nearly always champion unfettered scientific research and open publication of the results. In this case it looks like the research should never have been undertaken because the potential harm is so catastrophic and the potential benefits from studying the virus so speculative.

Unless the scientific community and health officials can provide more persuasive justifications than they have so far, the new virus, which is in the Netherlands, ought to be destroyed. Barring that, it should be put in a few government-controlled laboratories with the highest containment rating, known as biosafety level 4. That is how the United States and Russia contain samples of smallpox, which poses nowhere near the same danger of global devastation.

In the future, it is imperative that any such experiments be rigorously analyzed for potential dangers — preferably through an international review mechanism, but also by governmental funding agencies — before they are undertaken, not after the fact as is happening in this case.

The most frightening research was done by scientists at the Erasmus Medical Center in Rotterdam, who sought to discover how likely it is that the “bird flu” virus, designated A(H5N1), might mutate from a form that seldom infects or spreads among humans into a form highly transmissible by coughing or sneezing. Thus far the virus has infected close to 600 humans and killed more than half of them, a fatality rate that far exceeds the 2 percent rate in the 1918 influenza pandemic that killed as many as 100 million people.

Working with ferrets, the animal that is most like humans in responding to influenza, the researchers found that a mere five genetic mutations allowed the virus to spread through the air from one ferret to another while maintaining its lethality. A separate study at the University of Wisconsin, about which little is known publicly, produced a virus that is thought to be less virulent.

These findings led to an unprecedented request from an American federal advisory board that the researchers and the two scientific journals that plan to publish the studies omit any details that might help terrorists figure out how to unleash a devastating pandemic. That presumably includes details on how the engineered virus was made and details on the precise mutations that allowed it to go airborne.

We doubt that anything at all should be published, but it seems clear that something will be.

The two journals reviewing the papers seem inclined to follow the advisory board’s recommendations that the research be published in a redacted form, provided there is some way for researchers who need the information to gain access to the full details. The Erasmus team believes that more than 100 laboratories and perhaps 1,000 scientists around the world need to know the precise mutations to look for. That would spread the information far too widely. It should suffice to have a few of the most sophisticated laboratories do the analyses.

Defenders of the research in Rotterdam claim it will provide two major benefits for protecting global health. First, they say the findings could prove helpful in monitoring virus samples from infected birds and animals. If genetic analysis found a virus somewhere that was only one or two mutations away from going airborne, public health officials would then know to bear down aggressively in that area to limit human contact with infected poultry and ramp up supplies of vaccines and medicines.

But it is highly uncertain, even improbable, that the virus would mutate in nature along the pathways prodded in a laboratory environment, so the benefit of looking for these five mutations seems marginal.

A second postulated benefit is that the engineered virus can be used to test whether existing antiviral drugs and vaccines would be effective against it and, if they come up short, design new drugs and vaccines that can neutralize it. But genetic changes that affect transmissibility do not necessarily change the properties that make a virus susceptible to drugs or to the antibodies produced by a vaccine, so that approach may not yield much useful new information.

We cannot say there would be no benefits at all from studying the virus. We respect the researchers’ desire to protect public health. But the consequences, should the virus escape, are too devastating to risk.

Title: POTH/NYT editorial
Post by: Crafty_Dog on March 04, 2012, 08:55:40 AM

The Truth About the Doomsday Virus?
Published: March 3, 2012

Two months ago we warned that a new bird flu virus — modified in a laboratory to make it transmissible through the air among mammals — could kill millions of people if it escaped confinement or was stolen by terrorists. Now Ron Fouchier, the Dutch scientist who led the key research team, is saying that his findings, which remain confidential, were misconstrued by the press.
•   Genetically Altered Bird Flu Virus Not as Dangerous as Believed, Its Maker Asserts (March 1, 2012)
•   Health Guide: Avian Influenza
He says that the virus did not spread easily and was not lethal when transmitted from one ferret to another by coughing or sneezing, and that it became highly lethal only when big doses were injected into the animals’ windpipes.
That is hard to square with his original assertions. Experts who read his original manuscript say it reported that the new virus spread through the air and remained as virulent as the natural virus, which has killed 60 percent of the humans it has infected.
Dr. Fouchier’s new claims are only the latest bizarre twist in a global health debate that badly needs an objective, independent arbiter. The public needs to know whether this virus is a potentially big killer, and if so, how it should be contained. It needs to know what details can be published without giving terrorists a recipe for a biological weapon. And it needs to know that a mechanism will be put in place to assess all the risks and benefits of such research before it is approved — not after a new virus has been created.
The debate became public after a federal advisory board, the National Science Advisory Board for Biosecurity, recommended that papers prepared by Dr. Fouchier’s group and researchers doing similar work at the University of Wisconsin-Madison be published only after omitting details that might help terrorists. That drew charges of censorship from some scientists, and others warned that restricting the information would make it harder to track and combat an outbreak of a similar strain.
The World Health Organization convened a closed meeting of 22 experts last month, which concluded that the research should eventually be published in full. The group was dominated by participants with a clear stake in publication — including the researchers who made the viruses, the journals that want to publish their papers in full, and developing countries that want access to full details in exchange for having contributed the viruses that were studied.
Now this country’s National Institutes of Health, which financed the research and has its own reputation on the line, is asking the biosecurity advisory board to reconsider its call to redact details before publication.
We welcome a new appraisal from a board that has already shown considerable independence. We hope it will look beyond the security and terrorism issues and voice its opinion on what safety precautions should be required to prevent the virus from escaping and whether the work should proceed at multiple labs or possibly be halted.
These issues need to be resolved by experts who do not have institutional biases or turf to protect. The World Health Organization should be in the best position to oversee a response to what is a global problem. Its first effort was one-sided and disappointing, but it has pledged to convene further meetings with a much broader range of experts and interested parties. It must ensure that these forums are not rubber stamps for what the narrower special-interest group just concluded.
These are complicated issues, and the stakes are enormous. Governments and scientists have a clear responsibility to get this judgment and future efforts right.

Title: WSJ: Bird Flu could be transmitted through air
Post by: Crafty_Dog on June 21, 2012, 12:19:05 PM

Bird Flu Type Could Be Transmitted Through Air .

In an experiment showing how the virus that causes bird flu might trigger a human pandemic, scientists induced five genetic changes in the bug, transforming it into a type capable of airborne transmission between mammals.

The findings signal how the virus, which has killed nearly 60% of about 600 people known to have been infected in more than a dozen countries since 2003, could pose a much greater public health risk in the future. Two of the mutations the scientists created in the experiment already circulate in birds and people, and natural evolution could bring about the remaining three mutations, researchers said.

The findings appear in the journal Science, which on Friday is publishing several papers and commentaries about the virus, which is also known as H5N1. The studies were funded by the U.S. National Institutes of Health and other groups.

The genetic-alteration paper in Science is one of two controversial experiments whose planned publication sparked fears it would give terrorists a blueprint for making a biological weapon. The first such paper described an alternative genetic technique for creating a pandemic version of H5N1 and appeared in Nature in May.

If public-health officials know which bird-flu genetic signatures to look for, they can obtain swabs from people infected with H5N1 and see whether the critical mutations have started to accumulate.

The authors of the latest studies caution that they cannot predict when or if the remaining three genetic mutations might emerge. Nor are these the only possible mutations that could start a pandemic, they say.

"We only know that it's within the realm of possibility that the [three mutations] could evolve in a human or other mammalian host," said Derek Smith of the University of Cambridge. In one of the Science papers, co-authored by Dr. Smith, a 15-year analysis of surveillance data found that two of the five mutations seen in the lab-engineered viruses had occurred in several existing bird flu strains.

The H5N1 virus, which causes bird flu, can move from birds to people through physical contact. But it isn't yet efficient at jumping from person to person, a necessary ingredient for sparking a pandemic.

The flu-surveillance benefit of the research "far outweighs the risk of nefarious" use posed by terrorists or anyone else pursuing a biological-weapons program, said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, part of the NIH. Dr. Fauci and NIH director Francis Collins co-authored one of the commentaries in Science examining the benefits and risks of flu research.

The latest studies also indicate that the risk of an H5N1-pandemic may be greater than previously believed.

In the experiment published in Nature in May, scientists combined H5N1 and swine flu and came up with a hybrid bug that could leap from mammal-to-mammal. That experiment was based on the long-held notion that a pandemic strain is more likely to emerge when a flu virus mixes its genes with another virus in an animal host, such as a pig.

But one of the Science studies suggests that such "re-assortment" may not be necessary to give rise to a pandemic strain, and that it might emerge from mutations in H5N1 alone.

Scientists first changed three amino acids of H5N1 in a way they believed would boost the bug's affinity for human hosts, and then infected ferrets with the mutated virus. Ferrets are a good model because they sneeze like humans and show similar symptoms when infected by flu.

The researchers swabbed the noses of the infected ferrets and used virus samples from their bodies to infect another round of ferrets, thus "passaging" the virus several times through different ferrets. At each stage, they took tissue samples from the animals and analyzed how H5N1 was evolving.

"After about 10 passages, we found the virus had acquired the ability to transmit" from animal to animal, said Ron Fouchier of the Erasmus Medical Center in Rotterdam, Netherlands, and co-author of the study. That suggests that "in humans it would take a low number of transmissions for the mutations to accumulate."

Five mutations gave the virus the ability to jump from ferret to ferret: three of the initial amino-acid changes, plus two that emerged through evolutionary selection in the animals' bodies.

Four of the genetic substitutions were in hemagglutinin, a protein on the surface of H5N1 that helps it to enter host cells. The fifth was in the polymerase 2, a protein that helps the virus replicate its genetic material.

Although the lab-made virus had acquired the ability to leap between animals, it wasn't lethal and most of the infected ferrets eventually recovered from the flu. The animals succumbed only when large doses of the mutant virus were introduced directly into their throats.

Test-tube experiments also suggested that the engineered virus responded to the antiviral drug oseltamivir and to antbodies from ferrets that had received experimental H5N1 vaccines, according to the study by Dr. Fouchier and his colleagues.

Write to Gautam Naik at

Title: Home test kit for AIDs
Post by: Crafty_Dog on October 06, 2012, 07:29:11 AM
Title: Hope for an AIDs vaccine
Post by: Crafty_Dog on October 30, 2012, 08:35:10 AM
Title: WSJ: Govt panel says everyone 15-65 should be tested for AIDs
Post by: Crafty_Dog on November 19, 2012, 05:53:04 PM

A government health panel on Monday for the first time recommended testing for the human immunodeficiency virus for all Americans aged 15 to 65, in an effort to slow its spread.

An estimated 200,000 people in the U.S. are infected with the virus that can cause AIDS and don't realize it. The U.S. Preventive Services Task Force said the new draft recommendation is aimed at preventing those people from infecting others or developing AIDS themselves.

The panel's recommendation is significant because, if finalized, private insurers would have to pay for the test. Past recommendations haven't always been embraced by doctors. But in this instance, the weight of medical evidence has already been trending in favor of screening and earlier treatment of people with HIV.

It is estimated that 1.1 million Americans have HIV, with about 50,000 new cases annually.

Focusing tests only on those at high risk hasn't been very effective, the panel said. "Targeted screening misses a substantial proportion of infected persons because of undisclosed or unknown risk factors," said an article in Annals of Internal Medicine published Monday to support the task force's recommendation.

Until now, the task force had only recommended that doctors screen all pregnant women for HIV, and that younger adolescents and older adults who are at increased risk also be screened. Those at high risk include men who engage in sex with other men, people who take drugs by injection, and those who have sex with infected people, the task force has said.

Monday's recommendation doesn't say precisely how often people should get HIV screening. "One reasonable approach," the task force wrote, "would be onetime screening of adolescent and adult patients to identify persons who are already HIV positive, with repeat screening of persons who are known to be at risk for HIV infections."

Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases and a leading researcher and White House adviser on AIDS, said more than half of new HIV infections in the U.S. are a result of people who don't realize they have the virus. Testing and treating people, he said, "makes it highly unlikely that people with HIV will transmit their infection to their sexual partners."

Carl Schmid, deputy executive director of The AIDS Institute, a public-policy advocacy group, called the decision "a monumental shift in how HIV in the U.S. can be prevented, diagnosed and treated." He called the current risk-based approach "an ineffective screening strategy."

But there are many people who are skeptical about wider HIV testing, said Michael S. Lyons, an emergency room physician at the University of Cincinnati. "The benefits of diagnosing someone as early as possible are basically proven," he said, "but the difficulty is how do you do that?"

Mr. Lyons said many relatively poor people who show up at the emergency room may well be HIV-positive, "but emergency departments are very strained at this point. This is a compelling example of the tension between what would be good to do and what practically can be done."

The Centers for Disease Control and Prevention declined to comment on the significance of the recommendation because it is only in draft form and subject to public comment. Since 2006, the CDC has recommended routine HIV testing for everyone aged 13 to 64.

Jonathan Mermin, director of the CDC's HIV/AIDS prevention program, has said HIV testing should be "as routine as cholesterol screening."

From here, the task force's draft would have to become a final recommendation. At an unspecified time after that, insurance plans would be obligated to pay for the test. Ultimately, it would be up to doctors to order the test.

Robert Zirkelbach, spokesman for America's Health Insurance Plans, said, "If a physician orders a test, the insurer will cover it, and that won't change." The new Affordable Care Act requires insurers to pick up the costs.

The HIV tests are either blood or oral-swab tests, and the results of some are known in minutes. A 2010 study found that the quick test cost on average $48 for a negative test and $64 for a positive test, with the difference being the cost of counseling.
Title: WSJ: How fight to tame TB made it stronger
Post by: Crafty_Dog on November 23, 2012, 08:27:12 AM

How Fight to Tame TB Made It Stronger .
By GEETA ANAND in Mumbai and BETSY MCKAY in Atlanta

The World Health Organization's long-standing strategy for fighting tuberculosis is showing deadly unintended consequences: By focusing for years on the easiest-to-cure patients, it helped allow TB strains to spread that are now all but untreatable by modern medicine.

The WHO and a growing chorus of global health experts are now calling for a significant overhaul in the way nations with widespread drug-resistant TB combat the disease. It amounts to a de facto acknowledgment that the WHO's TB strategy, and the countries that use it, failed to adapt quickly enough as the disease formed more powerful, resistant strains.

"The TB community has been too conservative" on a global scale, said Puneet Dewan, until recently a senior officer in the WHO's India tuberculosis program. "We should have pushed sooner for a more aggressive, comprehensive approach" toward drug resistance, he said this month in an interview. "There was a cost in failing to do that. We're paying that cost today."

The WHO played a particularly sizable role in designing the tuberculosis program in India, which has seen a steep decline in regular TB. But India and other poor countries are now in the midst of an epidemic of drug-resistant strains—deadlier and harder-to-treat varieties of one of the world's top infectious-disease killers.

G.R. Khatri, who headed India's TB program more than a decade ago, called the epidemic of resistant TB in Mumbai "a recipe for disaster." The WHO should have known it was so bad and bears responsibility, he said. "What has the WHO been doing?"

In pilot testing across India this year of a new diagnostic method, some 6.6% of untreated TB patients were drug-resistant—suggesting far higher rates than the 2% to 3% levels India and the WHO have cited for years. The test was a collaboration of international aid groups and India's government.

At one clinic in Mumbai, research showed more than one quarter of 566 TB patients tested in recent months were resistant to the most powerful treatment, according to data obtained by The Wall Street Journal through India's Right to Information Act. The results are preliminary, but in the absence of any nationwide survey they offer a sense of what India's drug-resistance rates might be.

Enlarge Image

Close.The WHO is in the midst of a "complete rethinking" of its strategy toward drug resistance that involves helping countries move more quickly to address their epidemics, said Mario Raviglione, the WHO's top tuberculosis official. Countries with the largest epidemics, such as India, China, South Africa and Russia, haven't moved rapidly enough against drug resistance, he said. "That is why you see no global progress."

Dr. Dewan said that perhaps he and others should have recognized Mumbai's epidemic sooner. But partly because drug-resistant TB was a slow-moving emergency, he said, it was hard to get a full sense of the scope.

"It's a bit like the frog in a pot on a stove," Dr. Dewan said. "If you turn up the heat fast, the frog jumps out. If you turn up the heat slowly, the frog doesn't jump out, it slowly dies."

Only now is India planning its first national survey of drug resistance in TB patients, according to Prahlad Kumar, director of the National Tuberculosis Institute, the government's Bangalore-based research center. A timetable hasn't yet been set.

In-Depth: A Killer Quietly Gains Strength
The Wall Street Journal is chronicling the world's imperfect response to the rise of drug-resistant tuberculosis, an ancient disease that modern medicine, until recently, could defeat.

A selection of reports:

One woman's case of nearly incurable tuberculosis echoes around the world. (9/8/12)
India's slow reaction appears to be nurturing an all-but-untreatable strain of TB, raising the prospect of a global health hazard. (6/20/12)
A top doctor in Mumbai reports finding 12 cases of tuberculosis that are all but untreatable by current methods. (1/19/12)
.The policy changes are vindication for Zarir Udwadia, a prominent Indian physician whose controversial findings earlier this year—he identified several patients in Mumbai who were so drug-resistant that virtually none of the usual medicines worked—helped sound the alarm. Patients like these reflect the way drug-resistant TB "is mismanaged in India," Dr. Udwadia said.

Dr. Dewan said he has been taken by surprise by "crazy" levels of resistance like those identified by Dr. Udwadia. Dr. Dewan's own views have shifted quickly: As recently as last year, he said at a presentation in India that there was too much "hype" regarding drug-resistant TB.

Globally, studies suggest that drug-resistant TB is likely far more common than the WHO's own estimate of 3.7% of previously untreated patients. Resistance is worsening in many countries, the research indicates, even as the WHO's widely praised program to fight regular TB has succeeded in reducing the overall number of TB cases since the 1990s.

For decades, the WHO, aid groups and nations have been fighting TB world-wide. But the governmental effort focused almost exclusively on traditional, treatable strains, which are inexpensive to diagnose and defeat with drugs. However, this approach largely ignored drug-resistant strains.

In India, that has left the lives of patients like 22-year-old Amol Dhuri hanging in the balance. In January he was diagnosed with extensive drug-resistance—but the lab that tested him hasn't yet been accredited by the government to do this kind of testing. In fact, Mumbai, India's largest city, doesn't yet have a single lab accredited to diagnose extensive drug-resistance.

Because India's government will give patients the more powerful drugs only if they are tested by an accredited lab, Mr. Dhuri hadn't until this week started taking the drugs that have a shot at curing his strain.

Mumbai Grapples With Drug Resistant TB Strain
The Wall Street Journal's Investigation on Tuberculosis
.He was taking a cocktail of drugs provided by the government at no charge, most of which he was resistant to.

"I just don't understand why I'm taking these medicines and they're having no effect at all," Mr. Dhuri said.

Mr. Dhuri's drug regimen wasn't merely ineffective, it was potentially dangerous. Giving a patient medicines not strong enough to kill the TB bacteria increases the chance that it will mutate into drug-resistant strains.

It also left Mr. Dhuri wandering around, possibly spreading his drug-resistant disease to others. The average TB patient infects 10 to 15 people a year, according to the WHO.

Neither Ashok Kumar, head of India's TB program, nor P.K. Pradhan, secretary of the Ministry of Health & Family Welfare, returned calls seeking comment on Mr. Dhuri's case. But after the Journal's inquiries, Mr. Dhuri's drug-resistance report from an accredited lab elsewhere in the country showed up by email late last week, confirming his extensive drug resistance, Mumbai TB officials said. They said they would put him on the correct treatment this week.

The WHO, the United Nations agency dedicated to public health, once insisted that countries tackle only regular TB first before trying to treat resistant strains. Now, it urges poor countries to treat both simultaneously.

That, however, requires much more money. There will be a shortfall of $3 billion a year out of the $8 billion a year needed to fight TB in developing countries between 2013 and 2015, according to the WHO's Dr. Raviglione.

In India, medicines to treat regular TB cost $9 a month, compared with $2,000 for resistant strains.

Globally, TB receives much less money from international donors than other major deadly infectious diseases, according to data from the Institute for Health Metrics and Evaluation at the University of Washington. International assistance for TB was $1 billion in 2009. By contrast, malaria, which killed nearly half as many people, received $2 billion that same year. HIV received $6.5 billion, although HIV also costs more to treat and kills about 20% more people a year.

"There needs to be a giant leap in funding, thinking and innovation," said Soumya Swaminathan, director of the National Institute of Research in Tuberculosis, one of the Indian government's premier research centers.

Tuberculosis, an ancient, airborne disease that mostly affects the lungs, is spread by coughing and sneezing. In the 19th century, it was the biggest killer of adults in most of Europe.

In the 1940s researchers discovered they could cure it, over many months, with a cocktail of medicines. In many western nations, TB went into retreat. But in poor countries, it thrived and spread amid poverty and a lack of treatments and diagnostic tools.

The WHO in 1993 declared TB a global public-health emergency, following a resurgence driven largely by the HIV epidemic. At the time, there were approximately eight million cases a year world-wide.

Globally, there was almost no funding for TB, no unified strategy to fight it, and hundreds of treatment regimens in effect. Arata Kochi, the WHO's TB chief at the time, called it "treatment chaos."

The solution, many believed, was to devise a standard, simple-to-understand treatment cheap enough to work in the world's poorest places. The WHO developed a strategy known as DOTS, or Directly Observed Therapy Short-Course, so named because patients were to be directly supervised to make sure they took their medicine. Skipping doses, even briefly, gives the disease a chance to mutate and become drug-resistant.

The WHO, which produces health standards and policies, urged countries to adopt its DOTS program, though it can't oblige them.

The WHO played a particularly large role in India because of the size of the country's TB burden. Dozens of WHO consultants provided technical support nationwide.

Under DOTS, India relied on a rudimentary but affordable diagnostic—peering at a patient's spit under a microscope to spot the bacteria. Patients got a six-month treatment of four standard medicines. Anyone still sick went back on the same regimen for eight more months, plus one additional drug.

This could cure most people with regular TB. But it wasn't strong enough to cure multi-drug resistant, or MDR, strains.

The WHO decided that tackling MDR was unfeasible in places with poor infrastructure, little money and millions of patients lacking even basic treatment.

At that time, "there were two million new cases of TB in India each year"—almost none of which were being treated effectively—and "97% of them weren't MDR," said Thomas Frieden, the physician who spearheaded the India program on behalf of the WHO in its initial years. He is now director of the Centers for Disease Control and Prevention in Atlanta.

Dr. Khatri, who set up the India DOTS program with Dr. Frieden in 1997, agreed with the WHO's philosophy of treating regular TB first. "Every one minute, a patient was dying of TB in India," he said. "So I believed we should not plow a penny into MDR TB in India—and I did not." Dr. Khatri now heads the nonprofit World Lung Foundation for South Asia.

"It was well-intentioned reasoning in a resource-limited world," said Dr. Dewan, who left the WHO in recent weeks to join the Bill & Melinda Gates Foundation's TB program in India.

Dr. Raviglione, too, supports the WHO's original strategy. Without it, he said, drug resistance would now be "enormous." DOTS eliminated many of the slipshod medical practices that let the bacteria to mutate into super-resistant strains.

Meanwhile, however, evidence showed drug resistance emerging globally. Resistance was found in all 35 countries surveyed for a 1997 WHO-affiliated report. In 2000, a subsequent report found worrisome resistance rates in several countries, including parts of China and India.

In 2000, the WHO began a new program to tackle drug resistance and to "mop up" the damage caused by TB programs that had been "careless in how they treat the disease." But that program was never widely implemented, aside from some pilot programs.

This pilot program didn't even reach Mumbai, India's largest city, until mid-2010.

Around the same time, evidence emerged that resistant strains were more lethal than thought.

In one South Africa neighborhood, some 40% of patients with multi-drug-resistant TB—and 51% with higher levels of resistance—were dead within 30 days of their initial TB diagnosis, a 2010 study showed.

If that many people were dying within just 30 days, India's pilot program looked inadequate: It waited 14 months from initial diagnosis before even testing for resistance.

"We knew it was bad, but we didn't know it was this bad," Dr. Dewan said of the study.

Then, this year Dr. Udwadia and others at Mumbai's P.D. Hinduja National Hospital & Medical Research Center identified an even more menacing threat. The researchers called it "total drug resistance," because virtually none of the 12 treatments used to treat TB worked.

The report "sounded an alarm" globally, Dr. Dewan said. India quickly formulated a plan to increase its TB spending fourfold over five years, although that plan is still awaiting funding. It would establish more labs and 120 drug-resistance specialty centers.

Because most TB patients bypass the government's program when they first seek treatment, the new plan emphasizes engaging India's burgeoning private health-care providers.

Still, even this proposal falls short. By 2017, the plan says, India would only be able to treat fewer than half its estimated 100,000 multi-drug-resistant cases annually. Meanwhile India is home to the world's largest population of TB patients—2.2 million of last year's 8.7 million new cases—and treatment delays remain typical.

Last year the WHO began overhauling its "global architecture" for fighting drug resistance, Dr. Raviglione said. Instead of one committee in Geneva advising the world, regional expert groups will work with governments to help them develop and fund programs to attack drug resistance.

The WHO is also helping countries implement a new test, GeneXpert, that can diagnose TB and a common form of resistance in just 100 minutes, instead of several weeks. This marks the first major diagnostic advance in more than a century.

Eleven new or repurposed TB drugs are also in clinical trials. Dr. Raviglione said a task force is now studying how best to use them without fostering more drug resistance. Meanwhile, India's central TB office says it has established 43 testing labs and plans to build 30 more by 2015.
Title: POTH: Anti-biotics losing , , ,
Post by: Crafty_Dog on December 10, 2012, 06:33:02 AM

Published: December 9, 2012


I hope you never have this experience: a loved one is hospitalized. Her doctors tell you her infection is resistant to antibiotics. She dies. More than 60,000 American families go through that experience each year — and the number is almost certain to rise.

Connect With Us on Twitter

For Op-Ed, follow @nytopinion and to hear from the editorial page editor, Andrew Rosenthal, follow @andyrNYT.

Multidrug-resistant organisms are showing up in top-flight hospitals — like the klebsiella found in the National Institutes of Health’s Clinical Center this year, which may have led to the deaths of seven patients. Even infections that used to be a breeze to treat, like gonorrhea, are becoming incurable.

In much of the world, of course, bacterial disease is a routine cause of tragedy. Tuberculosis alone kills 1.4 million people a year. One reason for this staggeringly high figure is that most people in the world are too poor to pay for most medicines. But another reason is that some strains of tuberculosis bacteria have become resistant to most of the drugs we have. Even after two years of toxic treatment, drug-resistant tuberculosis has a fatality rate of about 50 percent.

What makes the rapid loss of antibiotics to drug resistance particularly alarming is that we are failing to make new ones. We are emptying our medicine chest of the most important class of medicines we ever had. And the cause can be traced, for the most part, to two profound problems.

The first is economic. Historically, the drug industry thrived on antibiotics. But if an antibiotic is useful against only one type of bacterium, relatively few people need it during its patent life. And if an antibiotic is “broad spectrum,” meaning it works on many different types of bacteria, wider use shortens its commercial life because it quickens the pace at which bacteria develop resistance. Moreover, antibiotics are designed to cure an acute disease — not to palliate a chronic one — so people need them only for a limited time. Compared with drugs that are used for years to treat widespread conditions like high cholesterol or asthma, antibiotics pale as a corporate investment.

The second challenge stems from the nature of bacteria. Though brainless, they are brainy, enjoying a highly effective collective intelligence. Large numbers of independently mutating bacteria test adaptations to group problems, like how to survive antibiotics. What works — like modifying the bacterial proteins to which antibiotics would otherwise bind — wins. As bacteria become more adept at evading antibiotics, it has become much harder to find drugs that can beat them back.

Merge these two problems — scientific and economic — and the result is a drug-development disaster: the prospects are so discouraging that few companies bother to try anymore.

How can we confront the critical shortage of new antibiotics when both the scientific approach and the economic model are letting us down? We can change both paradigms.

Drug makers survive by selling what people or governments buy in amounts and at prices that maximize profit. Monopoly protects the ability to set price for profit. Patents allow monopoly. Secrecy protects intellectual property until it is patented.

But what if we take a page out of the pathogen playbook? Many pathogens exchange DNA, sharing what they learn. Drug makers can operate in the same way: they can do science “open lab”-style, working in teams with academic and government scientists and other drug companies to share what they learn and to bring fresh scientific ideas and technological tools to bear. Relaxing the traditional insistence on secrecy allows collaboration, and with it, innovation.

Did I hear you say, “It’ll never happen”? It already has. GlaxoSmithKline opened its campus at Tres Cantos, Spain, to outside academic, government and biotech scientists in order to collaborate on finding antibiotics for neglected infectious diseases. The independent Tres Cantos Open Lab Foundation selects the projects and helps cover visiting researchers’ expenses.

In another version of the open lab concept, the Bill and Melinda Gates Foundation organized a TB Drug Accelerator program that brings together research teams from seven major companies (Abbott Laboratories, AstraZeneca, Bayer, Eli Lilly, GlaxoSmithKline, Merck and Sanofi) with scientists from four academic and government institutions. The companies have exchanged more than a thousand compounds and provided the academic and government scientists with access to millions.

These experiments show that even competing research teams can share knowledge, risk and reward in anti-infective drug development, test diverse approaches and avoid redundant efforts. (I’m involved in both of these projects.)

Philanthropic efforts have financed these open labs, but they can’t substitute for market forces. Nor can the current economic model give antibiotic development a permanent, prominent place in drug company portfolios.

There are, however, other ways for drug makers to profit beyond using monopoly to protect prices. As Thomas Pogge of Yale and Aidan Hollis of the University of Calgary have pointed out, an intergovernmental fund for drug discovery could reward drug makers for products in proportion to their impact in reducing the loss of healthy years of life. The lower the cost of a lifesaving drug, the greater the number of people who could use it; the more lives protected, then, the greater the monetary reward. An investment of $20 billion a year could encourage more open-lab collaborations to find new medicines in challenging settings like antibiotic discovery and make them accessible to all who need them.

If we don’t make new antibiotics, we will lose the ability to practice modern medicine. A new collaborative model for drug discovery can help make sure this doesn’t happen.

Carl F. Nathan is chairman of the department of microbiology and immunology at Weill Cornell Medical College.
Title: New Superbug infection
Post by: Crafty_Dog on March 10, 2013, 08:28:01 PM

I raise once again the possibility that a major factor to this long threatened appararently now imminent disaster is that massive use of antibiotics by the beef and poultry agro-industries , , ,
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs etc
Post by: Crafty_Dog on April 07, 2013, 08:44:07 AM
I gather the avian bird flu thing is happening again in China  , , ,
Title: New Chinese Bird Flu
Post by: Crafty_Dog on April 09, 2013, 06:16:55 AM
In China, a New Bird Flu Emerges
April 9, 2013 | 1045 GMT


The first three human cases of H7N9, a new strain of bird flu, were reported in eastern China at the end of March. The emergence of a new disease in China can bring back the fears associated with the 2003 outbreak of Severe Acute Respiratory Syndrome, or SARS. But there are key differences in this case, including the mode of infection and the governmental response. Any impact will be from preventative or reactive actions and not from the disease itself.

China notified the World Health Organization on March 31 of three human cases of H7N9 in Shanghai and neighboring Anhui province. The two Shanghai cases resulted in deaths. As of April 8, 24 cases and 7 deaths have been reported in eastern Chinese provinces, and the disease has been detected in Jiangsu and Zhejiang provinces as well. New cases of H7N9 are likely to be identified frequently in the near term, since the region and the virus are under scrutiny.
While the disease is still new in humans, hundreds of people who have come into contact with the infected individuals are being monitored and there have been no confirmed infections.  This indicates strongly that H7N9 cannot be transmitted between humans, and the World Health Organization has said that there is no proof of human-to-human transmission. Although the possibility of an eventual mutation cannot be ruled out, the current lack of human-to-human transmission is an important difference between this flu strain and the SARS virus, which infected more than 8,000 people in 2003. The H7N9 virus is more similar to its H5N1 bird flu cousin, which also is not typically transmitted between humans.


Official Responses and Precautions
Another apparent difference between the first occurrence of SARS in China and the new H7N9 virus is the response from Beijing. With the SARS outbreak, several months lapsed between the first case (November 2002) and identification of the disease (March 2003), despite a cluster of 305 cases of an unknown respiratory illness in February 2003 in Guangdong. These delays, along with the fact that the disease could be passed between humans, enabled SARS to spread to Hong Kong and Vietnam. With H7N9, there was less than a month between infection and identification of the disease. 
Moreover, international health organizations, such as the World Health Organization, appear to be very involved and informed with this case. The Chinese government did not disclose information regarding the SARS virus as readily as it has with the H7N9 virus. The ready exchange of information aids in the prevention of pandemics. For instance, the World Health Organization Collaboration Center in China has determined that while there is no vaccine, H7N9 does appear to be susceptible to anti-viral treatment. Additionally, the Centers for Disease Control and Prevention has taken measures to prepare a vaccine if necessary, although making the vaccine would take at least six months. Even so, the ongoing openness and sharing of relevant information will be key to proper management of the disease. 
In the wake of announcements about H7N9, surrounding countries have begun to take preventive measures. Vietnam has banned poultry imports from China, although illicit trade is prevalent in the area. Japan is taking precautions at its airports, which are on heightened alert for people with flu-like symptoms coming from China.
Potential Economic Effects
The H7N9 virus has been detected in a pigeon in Shanghai, the first detection in an animal since a person contracted the virus. This detection has resulted in the culling of more than 20,000 birds in the Shanghai markets and closures of live poultry markets in Shanghai and Nanjing, Jiangsu province. More than 400 million birds were culled after the H5N1 version of bird flu was first detected in 2003. For China, a large producer of poultry, the birds culled since the H7N9 outbreak make up a relatively small portion of the industry; the country produces on average a little more than 300,000 metric tons of poultry a week. 
A key difference between H7N9 and H5N1 is that H7N9 does make the birds visibly sick. Infected birds could then act as carriers without outward symptoms. This could result in broader culling to prevent the spread of the disease between birds. Poultry is a large source of protein in China, and large-scale culling could lead to higher prices for consumers.
The H7N9 outbreak could have more economic effects if culling continues and escalates or if the movement of people changes because of either policy or fear, which could come from the spread of misinformation. International markets for corn and soy fell following news of the culling, since China's poultry industry is a large consumer of both products for poultry feed. Since the announcement of the discovery of the virus, stock prices for Chinese airlines have also fallen.
In studies of the overall economic impact of the SARS outbreak, models have shown that the short-term economic impact was 1 percent of gross domestic product for China and 2.6 percent of GDP for Hong Kong. This would amount to more than $16 billion in losses for China that would have been temporally and geographically acute, most likely affecting specific regions of the country. Overall, China's GDP still grew 10 percent in 2003, and Hong Kong saw growth of 3 percent that same year. Tourism was greatly affected, with travel to infected areas decreasing by more than 50 percent during the peak of the outbreak.
At this point, the overall economic impact of H7N9 appears to be minimal. As measures continue to be taken to prevent any potential pandemic, it is possible that certain sectors, such as tourism and the poultry sector, could see short-term losses. But barring a shift in the behavior of the new virus, the long-term macroeconomic impact is likely to be minimal.

Read more: In China, a New Bird Flu Emerges | Stratfor
Title: Green Death
Post by: bigdog on April 15, 2013, 04:03:23 AM

From the article:

In 2005, Experiment Station researchers were unnerved to learn that a bacterial disease called citrus greening had arrived in Florida citrus groves. Citrus greening, also called huanglongbing or yellow dragon disease, is carried by an insect called the Asian citrus psyllid. It cannot, as yet, be cured; while infected trees may not show symptoms for months or years, they eventually begin to produce yellow foliage and misshapen, bitter fruit that drops prematurely to the ground. Researchers consider greening a mortal threat: it is so damaging to fruit crops that in 2003, the U.S. classified the bacteria that causes it as a bioterror tool.
Title: WSJ: The Changing Bird Flu Threat
Post by: Crafty_Dog on April 26, 2013, 06:48:59 AM
April 25, 2013, 7:15 p.m. ET.
The Changing Bird Flu Threat
Why China and the U.S. may be better equipped today for a pandemic than a decade ago..

The outbreak of avian flu in China has killed at least 22 people and infected more than 108—including a man in Taiwan who had traveled in the eastern Chinese city of Suzhou. For two months airline stocks have been buffeted and officials have raised concerns about a possible pandemic. So why does the American public seem so unconcerned?

There are some good and some bad reasons for the relatively blasé reaction. Most obvious is that the disease seems far away. In addition, talk of pandemics is often overblown. The 2009 swine flu was bad but nowhere near the disaster that some experts feared.

On the positive side, public health has made significant advances in dealing with flu. These suggest cause for optimism about this outbreak and possible future ones.

The first major improvement is in the cooperative posture of the Chinese government—a far cry from the unfortunate experience with the SARS virus a decade ago. Back then, Beijing kept outside organizations such as the World Health Organization in the dark about the outbreak, which ultimately infected 8,000 people and killed about 800.

SARS spread across the Pacific (to Canada) and cost the global economy as much as $50 billion. A quicker and more open Chinese response could have limited the outbreak.

This time, by contrast, China is sharing information with the World Health Organization, closely monitoring the disease and aggressively culling flocks of chickens that could be infected.

Not that we should all sing kumbaya. Shanghai, where this flu began, is a relatively open part of China, which may account for some of the government's new transparency. In addition, the current director-general of the World Health Organization is China's own Margaret Chan. Her successors may not be viewed as favorably by Beijing.

Another positive story has to do with vaccine development and production. Thanks in large part to a push for greater vaccine capacity during the Bush administration, the United States now has a more reliable annual supply of the regular flu vaccine. Researchers in the U.S. have also seen improvements in cell-based vaccine technology that can supplement and perhaps even supplant traditional egg-based vaccines—meaning that vaccine quantity wouldn't be limited by the supply of eggs and wouldn't risk harming people with food allergies.

Regarding this outbreak's particular strain (H7N9), Chinese authorities have shared the virus with international flu labs, and U.S. health officials are developing lab strains that would allow American manufacturers to produce large amounts of a vaccine if needed.

The U.S. Biomedical Advanced Research and Development Authority and Novartis NOVN.VX -0.58%have a partnership that enabled them to start creating a vaccine before H7N9 even left China, based on the posted genetic sequence. This virus is particularly concerning because the H7 strain is hard for vaccine makers to match (and this year's flu vaccine had a not atypical effectiveness rate of only 62%). Still, Americans are much better off than they were just a decade ago.

The third cause for optimism is that there have been no recorded cases of so-called sustained human-to-human transmissions, meaning the movement of the virus from a single infected person to more than one other person. That occurred with SARS but not in previous cases of avian flu. If it did, it would be the nightmare scenario for public-health officials.

We aren't out of the woods just yet. While China has been tracking severe cases, it is unknown whether any individuals are mildly affected—having few symptoms but still being contagious. A recent World Health Organization report revealed that 40% of those infected had no obvious interactions with poultry, but they must have been infected somehow. The source of those transmissions is unknown.

Because of the uncertainties about transmission, the difficulties in matching H7 strains, and concerns about asymptomatic transmitters, the H7N9 outbreak bears careful watching. But the global public-health system is far more capable of dealing with flu than it was 10 years ago. Here's hoping that the current outbreak doesn't spread and test the limits of this improved system.

Mr. Troy is a senior fellow at the Hudson Institute and a former deputy secretary of Health and Human Services
Title: This bacteria is highly resistant to all known antibiotics
Post by: ccp on April 27, 2013, 10:48:00 AM
Another health threat.

It is still contained but if it gets into community settings like MSRA has there will be big problems.  No antibiotics are consistently effective for this and the death rate is reported at 50%.  I've read the development of new antibiotics are several years away at least.
Title: POTH: The next contagion is closer than you think
Post by: Crafty_Dog on May 10, 2013, 05:46:53 AM
The Next Contagion: Closer Than You Think
Published: May 9, 2013

THERE has been a flurry of recent attention over two novel infectious agents: the first, a strain of avian influenza virus (H7N9) in China that is causing severe respiratory disease and other serious health complications in people; the second, a coronavirus, first reported last year in the Middle East, that has brought a crop of new infections. While the number of human cases from these two pathogens has so far been limited, the death rates for each are notably high.

Alarmingly, we face a third, and far more widespread, ailment that has gotten little attention: call it “contagion exhaustion.” News reports on a seemingly unending string of frightening microbes — bird flu, flesh-eating strep, SARS, AIDS, Ebola, drug-resistant bugs in hospitals, the list goes on — have led some people to ho-hum the latest reports.

Some seem to think that public health officials pull a microbe “crisis du jour” out of their proverbial test tube when financing for infectious disease research and control programs appears to be drying up. They dismiss warnings about the latest bugs as “crying wolf.” This misimpression could be deadly.

It’s important to understand our relationship with the microbial world. Most microscopic organisms benefit humans, other organisms or the environment in some way — for example, they help us digest our food and keep bad bugs in check.

At the same time, we are never far away from one of the 1,400 kinds of disease-causing microbes that are capable of infecting people; many infect animals, too. Of these microbes, known as pathogens, about 500 can be transmitted from humans to other humans. And around 150 of them can cause epidemics — rapidly spreading outbreaks of serious, sometimes life-threatening, disease.

Each pathogen has its own “footprint” (or potential footprint) on our human health and social, political and economic landscapes. Far too often the public — and policy makers and journalists — confuse those infectious diseases that can be life-threatening for a limited number of individuals with those that can cause widespread damage to society as a whole.

A disease in the former category is “flesh-eating strep” (invasive group A streptococcal disease). Approximately 9,000 to 11,500 cases are recognized each year in the United States, and about 1,000 to 1,800 of these patients die. When outbreaks of this type occur in this country, particularly if they affect schools or day-care centers, they generate front-page news and widespread concern.

Conversely, last year worldwide 1.7 million of the 34 million people infected with H.I.V. died from AIDS. There was little front-page news coverage about these cases. Nor was there much coverage last year of the estimated 1.5 million tuberculosis-related deaths, of the 1.1 million young children who died of infectious diarrheal illness, or of the 825,000 deaths from malaria. Infectious diseases like these plague the world but, because they don’t occur in our backyard, they remain relatively invisible to Americans.

In the case of the two latest threats — the H7N9 influenza virus and the new coronavirus — the number of infected people is small, and the infections are occurring thousands of miles away from the United States. Yet we should be seriously concerned about both.

Diseases like H7N9 influenza and the new coronavirus are different from noninfectious causes of serious illness and death — and even most microbial causes of disease. They can kill large numbers of people quickly and simultaneously around the world. The 1918 flu pandemic killed an estimated 50 million people worldwide in less than 18 months. The 2003 SARS pandemic, while more limited, resulted in more than 8,275 cases and 775 deaths.

Why does this suddenly happen? Both animal influenza and coronaviruses normally infect animals, not humans. But when these viruses undergo very specific genetic changes that occur as a result of everyday microbial evolution, we have a whole new ballgame; one that is largely played by their rules and on their schedule. Now a virus that once could infect only animals and maybe very rarely infect humans is readily transmitted by people to other people. You could get infected just by breathing shared air with the airplane passenger next to you, or by standing next to the wrong person in an elevator or even by lying next to your sleeping mate. We call this respiratory transmission.

Consider how quickly the H1N1 influenza virus spread in 2009: within the first month of that pandemic, the virus had infected people in at least 42 countries. The only thing keeping these viruses from becoming pandemic killers is their genetics. With few exceptions, all the current human H7N9 and coronavirus cases represent sporadic animal-to-human transmission. But if these viruses continue to spread in their respective animal reservoirs, repeated transmissions of the viruses to humans may lead to the genetic changes that will make either virus readily transmitted by humans to humans. Add in the fact that humans have little to no natural immunity to these viruses, and we could have the next pandemic.

Our public health tools to fight these viruses are limited. We have no vaccines or effective drugs readily available to stop or treat the new coronavirus in the Middle East. And while we have influenza vaccines, my colleagues and I have detailed in an article this week in the Journal of the American Medical Association why we most likely will have limited global impact on an H7N9 pandemic with our current outdated influenza vaccine technology.

In short, we won’t be saved by vaccines if a pandemic emerges from these two new threats. At best, in the case of H7N9, we can only hope that vaccines can help somewhat.

The toll is economic, not just human. Studies have shown that a severe global pandemic, caused by viruses like influenza or coronavirus, could bring the global economy, which is ever reliant on global communications and transportation networks, to its knees. When people are too sick or too afraid to work, borders are closed and global supply chains break, and trade falls. Over months, the economic costs could send the world into recession.

Are either H7N9 or coronavirus pandemics inevitable? We don’t know. But each time one of these viruses infects a human or even another mammal, it’s one more throw at the genetic roulette table.

To reduce the odds of a pandemic, China and the Middle Eastern countries where these viruses are now circulating in animals must do everything they can to identify the animal sources and use every tool they have to eliminate the spreading of the disease. To cull millions of apparently healthy chickens or other domestic animals is not easy, but it is essential.

The world as whole must invest in a new generation of effective influenza and coronavirus vaccines. They are the ultimate insurance policy against similar future emerging viruses. These viruses may seem far away, but tomorrow they could be at America’s doorstep.

Michael T. Osterholm, an epidemiologist, is a professor of environmental health sciences in the School of Public Health, and the director of the Center for Infectious Disease Research and Policy, at the University of Minnesota. .
Title: WSJ: Hepatitis C
Post by: Crafty_Dog on May 16, 2013, 08:49:08 PM
As Hepatitis C Spreads, Scotland Steps In

DUNDEE, Scotland—Sam Nicoll, an unemployed laborer with a history of heroin use in this down-and-out city, has recently been released from prison. He's just become a father. And on a recent morning, he ran out of injection needles.

But a nurse here, Brian Stephens, wants the 24-year-old to focus on a different problem: hepatitis C.

Mr. Nicoll recently took a blood test for the virus at a local needle exchange, and it came back positive. In most parts of the world, he wouldn't be diagnosed or considered for treatment. Few countries conduct widespread testing of injection drug users or offer them medication for hepatitis C, in part because they are considered too unreliable to turn up for appointments or to stick to the costly, monthslong treatment regimen.

Scotland, however, is ignoring conventional wisdom and making a bold push to control a virus that may be one of the biggest ticking time bombs in medicine. Hepatitis C kills about 350,000 people a year globally, and in many Western countries it infects far more people than HIV. The disease can lead to cirrhosis or cancer of the liver and is the leading cause of liver transplants in many countries.

Yet because the virus often strikes injection drug users, the homeless and other hard-up populations, efforts to tackle the problem have lagged behind, health experts say. While hepatitis C now kills more Americans each year than HIV does, the U.S. Centers for Disease Control and Prevention spends only about $30 million a year on prevention of viral hepatitis, compared with almost $800 million for HIV.

For its part, Scotland, with a population of only five million, has launched a £100 million (about $150 million) program, running from 2008 to 2015, to diagnose and treat hepatitis C, regardless of the patient's history. Medication alone can cost anywhere from $10,000 to $40,000 per patient.

Because Scotland was hit with a wave of hepatitis C in the 1980s and it can take 20 years or more for infections to seriously damage the liver, the country is "just at the moment beginning to see this increase in end-stage liver disease," says David Goldberg, head of Health Protection Scotland's hepatitis C and HIV programs and professor of public health at University of Glasgow. "That clearly is going to have a major impact on demand for liver transplants over the next decade."

The country's taxpayer-funded health system is scrambling to find and treat infections in all hepatitis-prone communities, including Pakistani immigrants and people who received blood transfusions before the virus was discovered in 1989. But it is mostly focusing on current and former injection drug users, who account for about 90% of infections here.

Cities such as Dundee and Edinburgh—setting of the heroin-drenched 1996 film "Trainspotting"—have been particularly hard hit by injection drug use since an economic downturn in the 1980s. Within the European Union, Scotland has one of the highest reported prevalence levels of injection drug use, according to the European Monitoring Centre for Drugs and Drug Addiction.

Early results of the Scottish program are promising. About half of the 38,000 Scots estimated to have been chronically infected have now been diagnosed, compared with 39% in 2007. Of those, about 1,100 new patients a year are receiving treatment, nearly triple the number from 2007. Dr. Goldberg says the aim is to reach 2,000 new patients a year, which should help prevent up to 5,200 cases of cirrhosis by 2030.

Tackling hepatitis C is a difficult assignment. It typically is spread when an infected person's blood enters another person's body, as often happens when drug users share needles. According to the U.K.'s National Health Service, the virus can also be found in some other body fluids, including saliva and semen, but this is far less common, making sexual transmission more rare than it is with HIV.

Because symptoms often don't surface until decades after infection, many people don't know they are infected.

To find infections in current drug users, Scotland is blanketing needle exchanges with simple finger-prick diagnostic kits. After identifying people with infections, many parts of Scotland try to start weaning them off heroin before offering hepatitis C medication. The typical approach is to prescribe methadone, a synthetic opiate that can help reduce heroin cravings, and wait for the patient to gain some stability, says John Dillon, a doctor in Dundee who helps run the hepatitis C program, which is staffed with about 85 doctors and nurses.

But Dundee and other regions have started treating drug users without necessarily trying to stabilize them on methadone first. They are motivated by research from University of Bristol, London School of Hygiene and Tropical Medicine and other institutions suggesting that if just 20 out of 1,000 active injection drug users are treated each year, it could stop them infecting others and reduce the rate of hepatitis C prevalence by nearly 30% in 10 years.

Doing that requires a ton of support, says Mr. Stephens, 41, the nurse at the hepatitis C program in Dundee. But for many, it may be years before they are ready to quit their drug habit, he says. "And how many people will they have infected in that time?"

Much of the program involves sending nurses like him out into the field. A 16-year veteran in nursing, he is known for going to extremes to stay in touch with patients, sometimes phoning them many times to remind them to turn up for appointments. He gives them his cellphone number, answers their calls on weekends, helps them inject the weekly interferon shots they need to kill the virus and sometimes spends hours at needle exchanges and methadone clinics waiting in vain for them to appear.

On a recent morning, Mr. Stephens met with Mr. Nicoll, who had come to a needle exchange program for a new set of syringes. Mr. Stephens invited him into a private room to discuss the results of the blood test he had taken at the exchange about seven months previously, which indicated that he probably had the hepatitis C virus. Mr. Nicoll had missed several appointments to return for a second test needed to confirm the infection. "I've been quite scared to come back," he acknowledged.

Mr. Stephens seized the moment and drew the blood on the spot, explaining what treatment would involve. Clutching a small bag of syringes, Mr. Nicoll mentioned that his life was about to get more hectic: "I've got a baby daughter coming. She's due soon."

About two weeks before meeting Mr. Stephens, Mr. Nicoll had started taking methadone in an effort to tame his drug habit. But like many methadone recipients—particularly in the early stages of treatment—he was continuing to use heroin. Mr. Stephens said that wouldn't disqualify him from hepatitis C treatment. "If someone is continuing to use heroin and they continue to come to appointments, we don't really care. We'll go ahead and treat them anyway," he said. (In a subsequent interview, Mr. Nicoll said he had stopping using heroin, which Mr. Stephens said was confirmed in a urine test. The two are awaiting more blood test results before deciding on the next step in his hepatitis treatment.)

Mr. Stephens said he wound up specializing in hepatitis C after a London surgeon once told him: "Whatever you do, get into hepatitis, because it's going to be huge." The work takes its own form of patience: At a nearby methadone clinic that afternoon, Mr. Stephens met with George Nelson, a 44-year-old addict who was successfully cured of hepatitis C a few years ago, only to find recently that he had reinfected himself through risky drug use.

"I remember getting cleared last time and saying, 'I'll never do that again,'" Mr. Nelson told Mr. Stephens. "For 14 months I was clean. Then I put myself at risk again."

Many countries don't treat active drug users or patients taking methadone because of this risk: they fear the money and effort will be wasted if the person continues using illicit drugs and gets reinfected. "There's been an argument, if you have constrained resources, who would you treat first? Obviously not drug users. But actually there's an argument that you should treat them first," says Charles Gore, president of the World Hepatitis Alliance in London. In Scotland and many places, injection drug use is by far the biggest source of the virus's transmission. Stopping that transmission is "a way to turn off the tap, and then we can empty the pool," Mr. Gore says.

In a recent study, University of Dundee analyzed treatment results for 291 patients in the region, comparing outcomes for people who had never injected drugs to those of active and former users. They found that 61% of noninjection-drug-users achieved a sustained virological response, or SVR, the clinical term for a cure. About 55% of former users and 47% of active users obtained an SVR, the study showed. The authors concluded that active injection drug use "is not a barrier to treatment or a successful achievement of SVR."

In the U.S., few doctors offer hepatitis C treatment to people taking drugs or methadone, says Michael Ninburg, executive director of the Hepatitis Education Project in Seattle. There are also few needle exchanges or methadone clinics in many communities, and even those that do exist don't typically test people for hepatitis C. John Ward, director of the CDC's viral hepatitis division, says the disease is simply "underrecognized, undermanaged and undertreated."

Still, the Scottish approach is being tried in a few places.

Diana Sylvestre, an assistant clinical professor of medicine at University of California, San Francisco, runs a nonprofit clinic in Oakland that treats many people with drug addictions. When she started the clinic 15 years ago, "it became apparent hepatitis C was a huge problem," she says. She started out treating people who had achieved some stability in their lives while taking methadone, later branching out to addicts in more of a "state of disarray," she says. The clinic conducts blood tests and doles out medicine at weekly meetings that also include lunch and hepatitis C education sessions.

"We find that some people you would never predict are able to organize themselves around this schedule," she says, adding that "virtually 100%" of patients who start treatment complete it, and that 80% to 85% are cured.

The lack of medical insurance among many U.S. drug users makes it hard to tackle the hepatitis C problem in a comprehensive way, says Brian Edlin, an associate professor at Weill Cornell Medical College in New York who treats injection drug users for hepatitis C.

Indeed, in a recent study he led to evaluate hepatitis C treatment in active drug users, some of the patients didn't have health insurance, Dr. Edlin says. He provided free care to everyone in the study and helped eligible patients get enrolled in Medicaid to cover the cost of medication. For those who weren't eligible, he obtained free drugs from manufacturers. He also offered mental-health and substance-abuse treatment to anyone who wanted it. Overall, 72% of the patients were cured of hepatitis C, a result he called "very successful." Next he is aiming to recruit up to 200 injection drug users for a larger trial that will more rigorously test the benefits of treatment.

"Doctors raise legitimate uncertainties about treating this population that need to be addressed through research," Dr. Edlin said.

In Dundee, Mr. Stephens and his colleagues are also attempting to enroll injection drug users in a similar study. To encourage them to sign up, they are offering participants a regular supply of high-protein drinks and vouchers to buy food at supermarkets. That is an incentive because "heroin users don't eat very well," Mr. Stephens says. "They spend most of their money on drugs."

Still, recruitment so far has been tough. One young woman he was hoping to enroll didn't turn up for a meeting at the needle exchange. Later, he learned she was due in court on charges she had assaulted a shopkeeper after she had been caught stealing. He ultimately tracked her down and enrolled her in the study. If she goes to prison, he says, "we'll continue her treatment" there.

Meanwhile, Mr. Stephens says he has seen anecdotal evidence that current and recent heroin users can make it through treatment. One patient recently cured, 35-year-old Leanne Petrie, took heroin for 16 years before quitting in late 2011. In an interview, she said she tested positive for hepatitis C around the age of 25 but didn't seek treatment for years.

In 2010, while living in the Scottish county of Fife, she was taking methadone to try to withdraw from heroin, and attending hepatitis C support meetings to learn about treatment. But because she was drinking heavily, her substance-abuse counselor cut off her methadone, which she says prompted her to drink more—about a bottle of vodka a day. She was also still dabbling in heroin.

In 2011, she says she got involved with a violent man who also took heroin. In December 2011, he burned her hand with a cigarette and wrecked her apartment, she says. A few days later, she took an overdose of sleeping pills. "I felt I couldn't get out," she says.

She woke up in the hospital, and, at the encouragement of her family, decided to move to Dundee to say with her cousin. She stopped drinking and taking heroin, and in January 2012, sought treatment for hepatitis C. In the middle of her treatment, she had to leave her cousin's house and stay in a homeless shelter for three months, but she eventually got an apartment from social services. She completed her treatment in November.

Seeing progress with her hepatitis C treatment helped her cope with the instability in her life and stay off drugs, she says. "Since I moved to Dundee I've achieved a lot," she says. "When you see the treatment is working, it helps you keep going."
Title: New SARs variant
Post by: Crafty_Dog on May 28, 2013, 08:15:31 PM
Title: POTH: No cure: Cocci (Valley Fever) epidemic
Post by: Crafty_Dog on July 05, 2013, 08:26:46 AM

BAKERSFIELD, Calif. — In 36 years with the Los Angeles police, Sgt. Irwin Klorman faced many dangerous situations, including one routine call that ended with Uzi fire and a bullet-riddled body sprawled on the living room floor.

But his most life-threatening encounter has been with coccidioidomycosis, or valley fever, for which he is being treated here. Coccidioidomycosis, known as “cocci,” is an insidious airborne fungal disease in which microscopic spores in the soil take flight on the wind or even a mild breeze to lodge in the moist habitat of the lungs and, in the most extreme instances, spread to the bones, the skin, the eyes or, in Mr. Klorman’s case, the brain.

The infection, which the Centers for Disease Control and Prevention has labeled “a silent epidemic,” is striking more people each year, with more than 20,000 reported cases annually throughout the Southwest, especially in California and Arizona. Although most people exposed to the fungus do not fall ill, about 160 die from it each year, with thousands more facing years of disability and surgery. About 9 percent of those infected will contract pneumonia and 1 percent will experience serious complications beyond the lungs.

The disease is named for the San Joaquin Valley, a cocci hot spot, where the same soil that produces the state’s agricultural bounty can turn traitorous. The “silent epidemic” became less silent last week when a federal judge ordered the state to transfer about 2,600 vulnerable inmates — including some with H.I.V. — out of two of the valley’s eight state prisons, about 90 miles north of here. In 2011, those prisons, Avenal and Pleasant Valley, produced 535 of the 640 reported inmate cocci cases, and throughout the system, yearly costs for hospitalization for cocci exceed $23 million.

The transfer, affecting about a third of the two prisons’ combined population, is to be completed in 90 days, a challenge to a prison system already contending with a federal mandate to reduce overcrowding. Jose Antonio Diaz, 44, who has diabetes and was recently relocated to Avenal, is feeling “very scared of catching it,” said his wife, Suzanne Moreno.

Advocates for prisoners have criticized state agencies for not moving the inmates sooner. “If this were a factory, a public university or a hotel — anything except a prison — they would shut these two places down,” said Donald Specter, the executive director of the Prison Law Office, which provides free legal assistance to inmates.

The pending transfer has underscored the complexities and mysteries of a disease that continues to baffle physicians and scientists. In Arizona, a study from the Department of Health Services showed a 25 percent risk of African-Americans with newly diagnosed valley fever developing complications, compared with 6 percent of whites.

“The working hypothesis has to do with genetic susceptibility, probably the interrelationships of genes involved in the immune system,” said Dr. John N. Galgiani, a professor at the University of Arizona and the director of the Valley Fever Center for Excellence, founded in 1996. “But which ones? We’re clueless.”

Kandis Watson, whose son Kaden, 8, almost died, had a gut feeling that “something was not right,” she said, when Kaden began feeling sick two years ago. The pediatrician prescribed antibiotics, but Kaden’s health deteriorated, with a golf ball-size mass developing at the base of his neck. The infection enveloped Kaden’s chest, narrowing his trachea.

Kaden was essentially breathing through an opening the size of a straw, said Dr. James M. McCarty, the medical director of pediatric infectious diseases at Children’s Hospital Central California in Madera, where Kaden spent six months. Today the boy is back to his mischievous self, surreptitiously placing a green plastic lizard in his mother’s hair.

But how he contracted valley fever is still guesswork. “I think he got it being a boy, digging in the dirt,” Mrs. Watson said.

Kern County, where Bakersfield is located, had more than 1,800 reported cases last year. At Kern Medical Center, Dr. Royce H. Johnson and his colleagues have a roster of nearly 2,000 patients. Many, like Mr. Klorman, have life-threatening cocci meningitis.

“I got a bad break,” said Mr. Klorman, who is known as Joe. Until illness forced his retirement, he preferred a squad car to a desk job. Now he travels four hours round trip three times a week so Dr. Johnson can inject a powerful antifungal drug into his spinal fluid. In other patients, the disease has been known to eat away ribs and vertebrae.

“It destroys lives,” said Dr. Johnson, whose daughter contracted a mild form. “Divorces, lost jobs and bankruptcy are incredibly common, not to mention psychological dislocation.”

Once athletic, Deandre Zillendor, 38, dropped to 145 pounds from 220 in two weeks, and lesions erupted on his face and body. “You keep it forever, like luggage,” he said of the disease.


Page 2 of 2)

Todd Schaefer, 48, who produces award-winning pinot noirs in Paso Robles, was told by his doctors that he had 10 years to live. That was 10 years ago. But valley fever has disseminated into his spinal column and brain, and his conversation is interrupted by grimaces of pain. Ruggedly handsome, he still outwardly resembles the archetype of the California good life. But Mr. Schaefer has had a stroke, a hole in his lung, two serious heart episodes and relapses that “put me on the edge of life,” he said.

Mr. Schaefer, 48, has had serious heart problems, and can no longer drink the wine he and his wife, Tammy, produce.

He believes he got infected with valley fever atop a tractor during the construction of Pacific Coast Vineyards, which he runs with his wife, Tammy. One doctor initially suggested bed rest, chicken soup and cranberry juice.

Today Mr. Schaefer can no longer can drink wine, and he begins every morning retching. “I told her to leave me,” he said at one low point, of his wife, who is 37. “She’s too young, too beautiful.”

Dr. Benjamin Park, a medical officer with the C.D.C., said that the numbers of cases are “under-estimates” because some states do not require public reporting. They include Texas, where valley fever is endemic along the Rio Grande. In New Mexico, a 2010 survey of doctors and clinics by the state’s public health department revealed that 69 percent of clinicians did not consider it in patients with respiratory problems.

Numbers spike when rainfall is followed by dry spells. Many scientists believe that the uptick in infections is related to changing climate patterns. Kenneth K. Komatsu, the state epidemiologist for Arizona, where 13,000 cases were reported last year, said that another factor may be urban sprawl: “digging up rural areas where valley fever is growing in the soil,” he said.

In Avenal, citizens have become activists, looking into possible environmental factors, including a regional landfill that accepts construction waste. Three of the four children of James McGee, a teacher, have contracted the disease, including Marivi, 17, who was found convulsing in the ladies’ room at school. Dr. McCarty of Children’s Hospital is seeing an increasing number of children from Avenal.

Valley fever was a familiar presence during the Dust Bowl, and in Japanese internment camps throughout the arid West. Yet there is still no cure, and research on a fungicide and a potential vaccine have been stalled by financing issues. One company, Nielsen Biosciences Inc., has developed a skin test to identify cocci but has not yet been able to make it financially viable.

Part of the difficulty is that cocci is “a hundred different diseases,” Dr. Johnson said, depending on where in the body it nests. His patients include farm workers, oil field workers and construction workers.

One of his patients, Barbara Ludy, 61, had a job that involved taking care of a man who is quadriplegic. She was strong enough to lift his 175-pound frame, plus his wheelchair, into a van. Cocci meningitis affected her ability to think, to remember, to walk, to live independently. When her weight dropped to 71 pounds, her distraught daughters went to Goodwill to buy their mother size zero clothes.

One daughter, Jennifer Gillet, now takes care of her mother full time. Ms. Ludy is recuperating, slowly. And things are looking up: She is now a size 10.
Title: polio vaccination causing cancer
Post by: Crafty_Dog on July 17, 2013, 05:53:43 PM
I have no idea of the reliability of this site:
Title: Mandatory HIV tests?
Post by: Crafty_Dog on July 18, 2013, 06:24:20 PM
Title: WSJ: Austism panic leads to measles outbreak
Post by: Crafty_Dog on July 20, 2013, 10:35:19 AM
Fifteen Years After Autism Panic, a Plague of Measles Erupts
Legions spurned a long-proven vaccine, putting a generation at risk
PORT TALBOT, Wales—When the telltale rash appeared behind Aleshia Jenkins's ears, her grandmother knew exactly what caused it: a decision she'd made 15 years earlier.

Ms. Jenkins was an infant in 1998, when this region of southwest Wales was a hotbed of resistance to a vaccine for measles, mumps and rubella. Many here refused the vaccine for their children after a British doctor, Andrew Wakefield, suggested it might cause autism and a local newspaper heavily covered the fears. Resistance continued even after the autism link was disproved.

The bill has now come due.

A measles outbreak infected 1,219 people in southwest Wales between November 2012 and early July, compared with 105 cases in all of Wales in 2011.

One of the infected was Ms. Jenkins, whose grandmother, her guardian, hadn't vaccinated her as a young child. "I was afraid of the autism," says the grandmother, Margaret Mugford, 63 years old. "It was in all the papers and on TV."

    Brooklyn Measles Outbreak Shows Risks

The outbreak presents a cautionary tale about the limits of disease control. Wales is a modern society with access to modern medical care and scientific thought. Yet legions spurned a long-proven vaccine, putting a generation at risk even after scientists debunked Dr. Wakefield's autism research.

The outbreak matters to the rest of the world because measles can quickly cross oceans, setting back progress elsewhere in stopping it. By 2000, the U.S. had effectively eliminated new home-grown cases of measles, though small outbreaks persist as travelers bring the virus into the country. New York City health officials this spring traced a Brooklyn outbreak to someone they believe was infected in London.

Measles outbreaks are a "canary in the coal mine," says James Goodson, the lead measles expert at the U.S. Centers for Disease Control and Prevention. People who refuse one vaccine may be spurning others, setting communities up for outbreaks of other dangerous diseases that are slower to propagate, he says, such as diphtheria and whooping cough.

"Despite the fact that it's one of the greatest health measures ever invented by man or woman, there seems to still be a small residue of humanity that objects to the very idea of immunization," says Dai Lloyd, a doctor in Wales who treated many of the recent measles cases. "If you go around the cemetery you can see the historical evidence of childhood slaughter from pre-immunization days."

Measles is a respiratory condition causing fever, cough and rash. Most people who catch it recover fully. But measles can lead to deafness and pneumonia, and, in about one in 1,000 cases, death. It is one of the most contagious diseases, spread by coughing and sneezing.

It is also among the most preventable, with an effective inoculation since the 1960s that is now commonly given with mumps and rubella vaccines in a combined "MMR" vaccine. The U.K., as did the U.S., categorized measles as "eliminated" over a decade ago, meaning it was no longer circulating from within its borders.

Child deaths from measles world-wide fell 71% to 158,000 in 2011 from 2000, says the Measles & Rubella Initiative, a partnership of global-health groups.

Most measles occurs in developing countries. But it is resurging in some of the very countries that have led global campaigns against it. France was close to eliminating it in 2007 before an outbreak infected more than 20,000 people between 2008 and 2011. Philosophical opposition to vaccines helped cause the outbreak, says the European Centre for Disease Prevention and Control.

The 117 U.S. cases reported so far this year are up from 54 in all of 2012 and could put the U.S. on track to match the 220 logged in 2011, the highest since 1996. England reported 1,168 cases in 2013 through May, up 64% from the year-earlier period and the highest recorded level since 1994.

"It's very galling we had measles eliminated and now we've got it again" in the U.K., says Paul Cosford, medical director of Public Health England, the government public-health agency.

The autism scare behind the Wales outbreaks tracks to the era of Dr. Wakefield, then a researcher at London's Royal Free Hospital, whose suggestion of a vaccine-autism link began to get press in 1997.

A paper Dr. Wakefield published in 1998 in the Lancet, a medical journal, described 12 "previously normal" children who developed gastrointestinal problems and developmental disorders including autism. His paper concluded that "in most cases, onset of symptoms was after measles, mumps, and rubella immunization. Further investigations are needed to examine this syndrome and its possible relation to this vaccine."

Medical experts immediately warned parents that they considered the research incomplete and speculative, and said there was no evidence of a link. Among other studies debunking his research, a 2004 review of epidemiological studies by the U.S. Institute of Medicine found no evidence MMR caused autism.

The Lancet retracted Dr. Wakefield's paper in 2010 after the U.K.'s General Medical Council concluded that his work was "irresponsible and dishonest." The council that year stripped him of his medical license, saying in a report that he had engaged in "serious professional misconduct."

Dr. Wakefield says he questioned MMR's safety but strongly urged parents to continue with a measles-only vaccine. "MMR doesn't protect against measles," he says. "Measles vaccine protects against measles." He says he stands by his work despite contrary conclusions by other scientists. He didn't respond to subsequent requests for comment on his license revocation.

His report helped spark backlash against MMR, especially in English-speaking countries, say health officials in the U.S., U.K., Australia and other countries. An estimated 2.1% of U.S. children who received other routine vaccines weren't immunized with MMR in 2000, up from 0.77% in 1995, according to a 2008 study published in Pediatrics that concluded the change was "associated with" Dr. Wakefield's study.

Dr. Wakefield says he rejects the idea that his research helped cause measles outbreaks, because he told parents to keep vaccinating with measles-only vaccine.

U.S. critics, including some who questioned vaccines in general, continued to campaign against the vaccine. Among them, former Playboy model and actress Jenny McCarthy, who has been named a co-host of ABC's "The View," became a leader of the anti-vaccine movement in the U.S. several years ago when in televised interviews she linked her son's autism to vaccinations. A publicist for Ms. McCarthy, who wrote the forward to a 2010 book by Dr. Wakefield, didn't respond to requests for comment.

Dr. Wakefield's work especially reverberated in the U.K. MMR vaccination rates among 2-year-olds in England fell to 80% in the 2004 fiscal year from about 92% in 1997.

But nowhere did the toxic mix of dubious science, sensational headlines and parental fear take a bigger toll than in southwest Wales. As Dr. Wakefield's concerns gathered steam in Britain's national media in 1997, a Port Talbot mother, Jackie Eckton, phoned the South Wales Evening Post to ask whether other parents had experienced problems with MMR.

In one 1997 article, Ms. Eckton told the Post the vaccine turned her 3-year-old, Daniel, who had been diagnosed with autism, into a "distant and silent recluse." She told the paper she wanted to form "some sort of action group so people can help each other fight this thing and what it does."

The Post instructed parents wanting to join her campaign to phone its news desk.

Within days, parents of 20 other children formed a group led by Ms. Eckton, and demanded an investigation into whether the shots—"jabs" in the U.K.—were faulty. The Post ran a headline: "Jab Mums Fear a Rogue Batch."

The health department told parents there was nothing wrong with the vaccine. The U.K.'s state-run health system encourages parents to vaccinate children but, unlike the U.S. system, doesn't require vaccinations for school enrollment.

Ms. Eckton's group grew, and stories about other children followed, with headlines like "Mum fears twins may be jab victims." After Dr. Wakefield's paper was published in February, 1998, the Post stepped up its coverage, with dozens of stories about worried parents.

Health experts in Wales say the Post's coverage was probably the main reason vaccination rates fell further here than elsewhere. By the third quarter of 1998, uptake of the vaccine in 2-year-olds fell by 14% in the newspaper's distribution area, compared with a 2.4% drop in the rest of Wales, according to a report in the Journal of Epidemiology & Community Health.

Doctors urged parents to vaccinate anyway, says Charlotte Jones, a general practitioner in Swansea, Wales. "We'd chase them up by letter, by telephone," she says, but many "weren't having it."

Ms. Jenkins's grandmother, Ms. Mugford, wasn't having it. "I got frightened—what if she ends up with autism? And I just let it go," she says of her decision not to vaccinate.

The backlash lingered for years. Hannah Williams, a 31-year-old mother of two boys, ages five and six, says she skipped their MMR vaccinations over autism fears. Her nephew had been vaccinated and developed autism, she says, so she and her husband "decided we weren't willing to take the risk."

Their pediatrician badgered them to vaccinate, she says, but "we'd just say no."

    “A Welsh mother urged a local paper to report vaccine fears after her son became a 'distant and silent recluse.”

It can take years for an outbreak to follow dropping vaccination rates. Doctors in Wales reported from 104 to 223 cases a year from 1999 to 2008. Reported cases rose to 567 in 2009 and fell to 117 in 2010.

Then, in November 2012, doctors started seeing a marked increase. There were dozens of new cases a week, and authorities declared an outbreak.

The outbreak especially hit children 10 to 18 years old who went unvaccinated during the autism scare.

About 10% of infected children in the outbreak area were admitted to the hospital, with complications including severe dehydration and pneumonia, says Sara Hayes, a director of public health in the outbreak area. Most of the infected have recovered. A 25-year-old man died of pneumonia related to the measles, according to Public Health Wales.

Ms. Jenkins in April joined thousands of other children who lined up for belated vaccinations. It was too late: She found the rash soon thereafter, she says. Ms. Jenkins, now 16, says her measles got so bad she had to visit the hospital. She recovered, as have most others.

"It took her getting measles for me to realize how dangerous it was," her grandmother says.

Dr. Wakefield rejects the idea that he helped cause the Welsh outbreak. The government's decision not to offer a measles-only vaccine, he says, "lays the blame fairly on their shoulders."

Measles-only vaccines weren't approved in Britain at the time, says Brendan Mason, an epidemiologist with Public Health Wales. Global health officials have long viewed single-disease vaccines as inferior to combination shots because they increase the likelihood children will miss some doses.

Dr. Wakefield in 2005 moved to Austin, Texas, where he helped found an autism research-and-treatment center. He resigned from the center in 2010 after the U.K. revoked his medical license and says he is now helping run an Austin-based video-production company.

Efforts to reach George Edwards, who edited the Post during the autism scare, were unsuccessful. In April, the BBC quoted him as saying that "at no time did the newspaper ever say to parents 'do not let your children have this jab.'"

The Post's current editor, Jonathan Roberts, wrote in an April editorial: "It is clear that there were genuine concerns in the mid-1990s about MMR and the Post gave them full and responsible coverage." Mr. Roberts says he doesn't have anything to add to his editorial.

Wales declared the outbreak over on July 3. But there may be other ripples from the late-1990s scare. U.K. health officials say the drop in MMR vaccination has contributed to a spike in mumps in the U.K. in recent years.

Public Health Wales warned in recent weeks that many people remain unvaccinated with MMR and leave Wales vulnerable to future outbreaks of measles and mumps.

And resistance persists: Even some Welsh parents who belatedly inoculated remain suspicious of MMR.

Ms. Williams, who had skipped her sons' vaccinations, took her boys to an emergency vaccination clinic during the outbreak. She says she isn't as worried about autism now that her children are older but still isn't convinced of MMR's safety.

Ms. Eckton, who started the parents' group, says she still believes MMR damaged her son, now 18, who she says is severely autistic.

"I'm only a parent who watched what happened to my son," says Ms. Eckton, 46. "When you feel guilt for that, that's quite hard."
Title: Re: Polio vaccination causing cancer? Their own link says No.
Post by: DougMacG on July 20, 2013, 06:10:56 PM
I have no idea of the reliability of this site:

Some of the anti-vaccine hype in our culture is over-zealous (or misleading) on facts.  Polio vaccine succeeded on eliminating a horrible disease.  The alleged contamination of the virus occurred before the virus was discovered. From the link, the majority of the studies determined that virus did not cause cancer.  All of the current evidence indicates that polio vaccines have been free of SV40 since 1963.

It's good to do your homework ... and to always be skeptical of government, but - on this one - they did not show a reason to decline a vaccination, as one might think is implied by those sending this out.
Title: Antibiotics, animals, and dangers to humans
Post by: Crafty_Dog on July 30, 2013, 08:40:49 AM
I made this point a few years ago here:

There is a vid-clip as part of the article.  Text follows here:

 Twice a month for a year, Lance Price, a microbiologist at George Washington University, sent his researchers out to buy every brand of chicken, turkey and pork on sale in each of the major grocery stores in Flagstaff, Ariz. As scientists pushed carts heaped with meat through the aisles, curious shoppers sometimes asked if they were on the Atkins diet.

Lance Price, a microbiologist, is using genetic sequencing to try to match bacteria found in grocery meat to urinary infections in a study in Arizona.

In fact, Professor Price and his team are trying to answer worrisome questions about the spread of antibiotic-resistant germs to people from animals raised on industrial farms. Specifically, they are trying to figure out how many people in one American city are getting urinary infections from meat from the grocery store.

Professor Price describes himself as something of a hoarder. His own freezer is packed with a hodgepodge of samples swabbed from people’s sinuses and inner ears, and even water from a hookah pipe. But the thousands of containers of broth from the meat collected in Flagstaff, where his nonprofit research institute is based, are all neatly packed into freezers there, marked with bar codes to identify them.

He is now using the power of genetic sequencing in an ambitious attempt to precisely match germs in the meat with those in women with urinary infections. One recent day, he was down on his hands and knees in his university office in Washington, studying a family tree of germs from some of the meat samples, a printout of more than 25 pages that unfurled like a roll of paper towels. Its lines and numbers offered early clues to Professor Price’s central question: How many women in Flagstaff get urinary infections from grocery store meat? He expects preliminary answers this fall.

Researchers have been warning for years that antibiotics — miracle drugs that changed the course of human health in the 20th century — are losing their power. Some warn that if the trend isn’t halted, there could be a return to the time before antibiotics when people died from ordinary infections and children did not survive strep throat. Currently, drug resistant bacteria cause about 100,000 deaths a year, but mostly among patients with weakened immune systems, children and the elderly.

There is broad consensus that overuse of antibiotics has caused growing resistance to the medicines. Many scientists say evidence is mounting that heavy use of antibiotics to promote faster growth in farm animals is a major culprit, creating a reservoir of drug resistant bugs that are finding their way into communities. More than 70 percent of all the antibiotics used in the United States are given to animals.

Agribusiness groups disagree and say the main problem is overuse of antibiotic treatments for people. Bugs rarely migrate from animals to people, and even when they do, the risk they pose to human health is negligible, the industry contends.

Scientists say genetic sequencing will bring greater certainty to the debate. They will be able to trace germs in people to their origins, be it from a farm animal or other patients in a hospital. Representative Louise Slaughter, a Democrat from New York who has pushed for legislation to control antibiotic use on farms, said such evidence would be the “smoking gun” that would settle the issue.

Professor Price is seeking to quantify how extensively drug-resistant bugs in animals are infecting people. He is trying to do that by analyzing the full genetic makeup of germs collected from both grocery store meat and people in Flagstaff last year. The plummeting cost of genomic sequencing has made his research possible.

He is comparing the genetic sequences of E. coli germs resistant to multiple antibiotics found in the meat samples to the ones that have caused urinary tract infections in people (mostly women).

Urinary infections were chosen because they are so common. American women get more than eight million of them a year. In rare cases the infections enter the bloodstream and are fatal.

Resistant bacteria in meat are believed to cause only a fraction of such infections, but even that would account for infections in several hundred thousand people annually. The E. coli germ that Professor Price has chosen can be deadly, and is made even more dangerous by its tendency to resist antibiotics.

The infection happens when meat containing the germ is eaten, grows in the gut, and then is introduced into the urethra. Dr. Price said the germ could cause infection in other ways, such as through a cut while slicing raw meat. The bugs are promiscuous, so once they get into people, they can mutate and travel more easily among people. A new strain of the antibiotic-resistant bug MRSA, for example, was first detected in people in Holland in 2003, and now represents 40 percent of the MRSA infections in humans in that country, according to Jan Kluytmans, a Dutch researcher. That same strain was common in pigs on farms before it was found in people, scientists say. Dr. Price, 44, began his career testing anthrax for resistance to the Cipro antibiotic for biodefense research in the 1990s. His interest in public health led him to antibiotic resistance in the early 2000s. It seemed like a less theoretical threat.

First line antibiotics were no longer curing basic infections, and doctors were concerned. “I thought, ‘Wow this is so obviously crazy, I have to do something about this,’ ” he said. He has done his research on antibiotics at a nonprofit founded in 2002, the Translational Genomics Research Institute, in Phoenix. His lab in Flagstaff, an affiliate, is financed mostly by federal sources, including the National Institutes of Health and the Defense Department.

Dr. Price, trained in epidemiology and microbiology, has been sounding the alarm about antibiotic resistance for a number of years. He recently told a Congressional committee that evidence of the ill effects of antibiotics in farming was overwhelming.

He thinks the Food and Drug Administration’s efforts to limit antibiotic use on farms have been weak. In 1977, the F.D.A. said it would begin to ban some agricultural uses of antibiotics. But the House and Senate appropriations committees — dominated by agricultural interests — passed resolutions against the ban, and the agency retreated. More recently, the agency has limited the use of two important classes of antibiotics in animals. But advocates say it needs to go further and ban use of all antibiotics for growth promotion. Sweden and Denmark have already done so.

Ms. Slaughter said aggressive lobbying by agribusiness interests has played a major role in blocking passage of legislation. According to her staff, of the 225 lobbying disclosure reports filed during the last Congress on a bill she wrote on antibiotic use, nearly nine out of ten were filed by organizations opposed to the legislation.

But the economics of food presents perhaps the biggest obstacle. On large industrial farms, animals are raised in close contact with one another and with big concentrations of bacteria-laden feces and urine. Antibiotics keep infections at bay but also create drug resistance. Those same farms raise large volumes of cheap meat that Americans have become accustomed to.

Governments have begun to acknowledge the danger. The United States recently promised $40 million to a major drug company, GlaxoSmithKline, to help it develop medications to combat antibiotic resistance. But Dr. Price says that new drugs are only a partial solution.

“A lot of people say, ‘let’s innovate our way out of this,’ ” he said. “But if we don’t get a handle on the way we abuse antibiotics, we are just delaying the inevitable.”
Title: Gene sequencing to the rescue
Post by: Crafty_Dog on September 05, 2013, 06:45:27 AM
Title: Superbug deaths
Post by: Crafty_Dog on September 17, 2013, 08:51:47 AM
Title: MERS
Post by: Crafty_Dog on September 25, 2013, 07:28:59 PM
A World Health Organization emergency committee on Wednesday asked countries to step up monitoring for a lethal, year-old virus as Muslim pilgrims from around the world return home from the annual hajj in Saudi Arabia, home to most of the victims so far.  Many questions remain to be answered, but the most pressing is "we don't understand what kind of risk this poses for global spread," Keiji Fukuda, WHO assistant director-general, told reporters after the committee's third meeting on Middle East Respiratory Syndrome coronavirus, or MERS.  Nine European and Middle East countries have confirmed a total of 130 cases of the illness, with a 42% death rate, since the virus was identified in September 2012. More than 100 of the confirmed cases were in Saudi Arabia.  International disease experts convened Wednesday under the remit of the WHO concluded that the disease so far doesn't merit declaration of a health emergency, Dr. Fukuda said.  Members have asked to confer again after next month's hajj, he said. The world's largest annual gathering, the hajj draws more than 3 million pilgrims from dozens of countries for worship in the Muslim holy cities of Mecca and Medina.  The MERS committee is the second emergency panel created under WHO procedures established after the 2003 outbreak of SARS, a virus related to MERS that killed 750 people, mostly in China. The first WHO emergency committee addressed the H1N1 pandemic in 2009.  MERS committee members heard from health officials of Saudi Arabia and Qatar, another Gulf country that has confirmed MERS cases recently, Dr. Fukuda said. The United Arab Emirates, which also had recent confirmed cases, didn't make a representative available Wednesday, Dr. Fukuda said.

The experts expressed concern that many of the pilgrims will be returning to countries in sub-Saharan Africa and other developing regions that are unlikely to screen those who fall ill for MERS, the WHO official said.

Health officials have yet to determine how MERS, which typically causes respiratory infections, and sometimes kidney problems, infects humans. Studies on camels and bats as possible hosts have been inconclusive.  Newly concluded animal studies in Saudi Arabia by the U.N. Food and Agriculture Organization and others should provide new information soon, Dr. Fukuda said.  The emergency committee urged countries to do more MERS diagnostic testing and investigation. A committee statement emphasized "the importance of timely sharing of relevant information and of coordinating actions with WHO."

Dr. Fukuda declined to say whether Saudi Arabia was doing enough to investigate the disease. "We would like to have more information on the situation" from countries overall, he said.

One reason for the lingering uncertainty over the most basic facets of MERS is that the new virus has spread steadily, rather than in a surge of cases that yielded a corresponding surge of information, as SARS and other recent pandemics did, the WHO official said.
Title: WSJ: A good idea for fighting superbugs
Post by: Crafty_Dog on September 25, 2013, 07:44:07 PM
second post

A Big Step in the Fight Against Superbugs

Our study zeroed in on an effective way to prevent deadly MRSA infections in hospitals. .
In the U.S. and abroad, humans are at risk of increasingly weak antibiotics and increasingly strong superbugs. Before the discovery of penicillin in the early 20th century, a significant portion of people unlucky enough to contract a bacterial infection died. With increasing antibiotic resistance, we risk a post-antibiotic era every bit as frightening.

A report out this month from the Centers for Disease Control and Prevention highlights multidrug-resistant bacteria as one of the world's most serious and pressing health threats. "Antibiotic Resistance Threats in the United States, 2013" notes that drug resistance is often the result of poor stewardship, defined as the lack of careful use of antibiotics in humans and animals.

When antibiotics are used unnecessarily or inappropriately, we kill the most susceptible organisms and, in their void, create a more favorable environment for the selection of more-resistant bacteria. This has resulted in a scary alphabet soup of superbugs, including C. diff, CRE, MRSA, multidrug-resistant TB, and VRE, that can be deadly to those with suppressed immune systems and are threatening even the healthiest patients.

The CDC's strategies to address resistance include tracking resistant bacteria, improving uses of antibiotics, and developing new antibiotics and diagnostic tests for resistant bacteria. But success also means reducing the overuse of antibiotics and requires a commitment from more than health professionals. Patients need to change their expectations for receiving an antibiotic when an illness is likely viral—in which case it will never respond to an antibiotic—or self-limited, like a cold that will go away on its own. Doctors need to feel supported by patients, not pressured, when they exhibit prudent stewardship in prescribing only those medicines that will be effective.

Enlarge Image

imageAssociated Press
Plates of MRSA
Preventing infection is another critical piece of the CDC's national strategy, and we still have a lot to learn on that front. That is why Hospital Corporation of America, in partnership with researchers from the CDC, Harvard Pilgrim Health Care Institute and Harvard Medical School, University of California Irvine School of Medicine, Rush Medical College and Washington University, recently conducted a study known as Reduce MRSA (short for the Randomized Evaluation of Decolonization Versus Universal Clearance to Eliminate MRSA).

The study set out to address the question: What could hospitals do right now to dramatically reduce their infection rates? The answer turned out to be a surprisingly simple intervention to cleanse patients who potentially carry the virulent organism.

Methicillin-resistant Staphylococcus aureus, more commonly known as MRSA, was identified in the CDC report as a serious threat to human health. MRSA is a common organism, and individuals who have been exposed to it can become carriers. In the hospital, carriers are at particular risk of developing MRSA infections. MRSA may be transmitted to other patients and can cause bloodstream infections known as sepsis. There are some 80,000 cases of invasive MRSA infections per year, resulting in about 11,000 deaths annually. MRSA, and staphylococcus in general, account for approximately one-quarter of the 80,000 deaths from hospital-acquired infections in the U.S.

The Reduce MRSA trial, conducted across 74 intensive-care units at 43 hospitals, involved more than 74,000 patients over an 18-month period. Results show that hospitals urgently need to better define their standards for infection prevention.

Before this trial, the CDC didn't have enough information to determine which of three alternative approaches is truly best: Would it be most effective to screen patients for MRSA and, if they test positive, isolate them from other patients, or to screen patients for MRSA and, if they test positive, isolate them and apply the "decolonization," which means eradicating bacteria by using antimicrobial soap and nasal ointment to prevent bacteria from entering the bloodstream? Or would it be better to decolonize all patients immediately on admission to intensive-care units?

The third approach proved unequivocally best. Universal decolonization reduced all bloodstream infections, including those caused by MRSA, by 44%. The other approaches were not nearly as successful. There was negligible change in the reduction of bloodstream infections using the first approach; the second approach saw a 22% reduction.

While this study was notable for its outcome, it was also notable for its efficiency. It didn't take a single hospital dozens of years to amass the power of this study—it took 43 hospitals collaborating for 18 months. It didn't take a research team focused only on answering one question. The research was implemented by nurses and infection-prevention professionals during routine patient care, and not in a laboratory, but within the real-world environment of community hospitals. This suggests the prevention strategy can be implemented in hospitals everywhere, as it already has been by all HCA facilities.

The stakes are high. Breeding superbugs threatens a return to the vulnerability of the pre-antibiotic era, when untreatable bacterial diseases and TB were responsible for countless deaths. The Reduce MRSA study demonstrated that government, the private sector and academia, by conducting research collaboratively, can accelerate creating the best scientific evidence for practice. By using that evidence, we can change outcomes for patients, and maybe even the way history records our fate.

 Dr. Perlin is president, Clinical & Physician Services of Hospital Corporation of America. Dr. Platt, an infectious diseases specialist, is a professor at the Harvard Pilgrim Health Care Institute.
Title: Hunting the Nightmare Bacteria
Post by: bigdog on October 20, 2013, 05:42:27 PM

"Has the age of antibiotics come to an end? From a young girl thrust onto life support in Arizona to an uncontrollable outbreak at one of the nation’s most prestigious hospitals, FRONTLINE investigates the alarming rise of a deadly type of bacteria that our modern antibiotics can’t stop."
Title: Before and after antibiotics
Post by: Crafty_Dog on November 22, 2013, 11:51:22 PM
Title: FDA restricts antibiotics use for livestock
Post by: Crafty_Dog on December 12, 2013, 09:43:04 AM
As this thread attests, I have been calling for action on this for quite some time:

F.D.A. Restricts Antibiotics Use for Livestock
Published: December 11, 2013 207 Comments

WASHINGTON — The Food and Drug Administration on Wednesday put in place a major new policy to phase out the indiscriminate use of antibiotics in cows, pigs and chickens raised for meat, a practice that experts say has endangered human health by fueling the growing epidemic of antibiotic resistance.

This is the agency’s first serious attempt in decades to curb what experts have long regarded as the systematic overuse of antibiotics in healthy farm animals, with the drugs typically added directly into their feed and water. The waning effectiveness of antibiotics — wonder drugs of the 20th century — has become a looming threat to public health. At least two million Americans fall sick every year and about 23,000 die from antibiotic-resistant infections.

“This is the first significant step in dealing with this important public health concern in 20 years,” said David Kessler, a former F.D.A. commissioner who has been critical of the agency’s track record on antibiotics. “No one should underestimate how big a lift this has been in changing widespread and long entrenched industry practices.”

The change, which is to take effect over the next three years, will effectively make it illegal for farmers and ranchers to use antibiotics to make animals grow bigger. The producers had found that feeding low doses of antibiotics to animals throughout their lives led them to grow plumper and larger. Scientists still debate why. Food producers will also have to get a prescription from a veterinarian to use the drugs to prevent disease in their animals.

Federal officials said the new policy would improve health in the United States by tightening the use of classes of antibiotics that save human lives, including penicillin, azithromycin and tetracycline. Food producers said they would abide by the new rules, but some public health advocates voiced concerns that loopholes could render the new policy toothless.

Health officials have warned since the 1970s that overuse of antibiotics in animals was leading to the development of infections resistant to treatment in humans. For years, modest efforts by federal officials to reduce the use of antibiotics in animals were thwarted by the powerful food industry and its substantial lobbying power in Congress. Pressure for federal action has mounted as the effectiveness of drugs important for human health has declined, and deaths from bugs resistant to antibiotics have soared.

Under the new policy, the agency is asking drug makers to change the labels that detail how a drug can be used so they would bar farmers from using the medicines to promote growth.

The changes, originally proposed in 2012, are voluntary for drug companies. But F.D.A. officials said they believed that the companies would comply, based on discussions during the public comment period. The two drug makers that represent a majority of such antibiotic products — Zoetis and Elanco — have already stated their intent to participate, F.D.A. officials said. Companies will have three months to tell the agency whether they will change the labels, and three years to carry out the new rules.

Additionally, the agency is requiring that licensed veterinarians supervise the use of antibiotics, effectively requiring farmers and ranchers to obtain prescriptions to use the drugs for their animals.

“It’s a big shift from the current situation, in which animal producers can go to a local feed store and buy these medicines over the counter and there is no oversight at all,” said Michael Taylor, the F.D.A.’s deputy commissioner for foods and veterinary medicine.

Some consumer health advocates were skeptical that the new rules would reduce the amount of antibiotics consumed by animals. They say that a loophole will allow animal producers to keep using the same low doses of antibiotics by contending they are needed to keep animals from getting sick, and evading the new ban on use for growth promotion.


Page 2 of 2)

More meaningful, said Dr. Keeve Nachman, a scientist at the Johns Hopkins Center for a Livable Future, would be to ban the use of antibiotics for the prevention of disease, a step the F.D.A. so far has not taken. That would limit antibiotic uses to treatment of a specific sickness diagnosed by a veterinarian, a much narrower category, he said.

Another skeptic, Representative Louise M. Slaughter, a Democrat from New York, said that when the European Union tried to stop companies from using antibiotics to make farm animals bigger, companies continued to use antibiotics for disease prevention. She said antibiotic use only declined in countries like the Netherlands that instituted limits on total use and fines for noncompliance.

But another longtime critic of the F.D.A. on antibiotics, Dr. Stuart B. Levy, a professor of microbiology at Tufts University and the president of the Alliance for the Prudent Use of Antibiotics, praised the new rules. He was among the first to identify the problem in the 1970s. “I’m kind of happy,” he said. “For all of us who’ve been struggling with this issue, this is the biggest step that’s been taken in the last 30 years.”

Mr. Taylor, the agency official, said the F.D.A. had detailed what veterinarians needed to consider when they prescribed such drugs. For example, use has to be for animals at risk for developing a specific disease, with no reasonable alternatives to prevent it.

“It’s far from being a just-trust-them system,” he said. “Given the history of the issue, it’s not surprising that there are people who are skeptical.”

He added that some food producers had already curbed antibiotic use.

A spokeswoman for Zoetis, a major drug producer that said it would abide by the new rules, said the new policy was not expected to have a big effect on the revenues of the company because many of its drug products were also approved for therapeutic uses. (Dr. Nachman said that was an indication that overall use might not decline under the new rules.)

The Animal Health Institute, an association of pharmaceutical companies that make drugs for animals, said that it supported the policy and “will continue to work with the F.D.A. on its implementation.”

The National Pork Producers Council was less enthusiastic, saying, “We expect that hog farmers, and the federally inspected feed mills they purchase feed from, will follow the law.”

“It is part of our ethical responsibility to utilize antibiotics responsibly and part of our commitment to public health and animal health,” the council said in a statement.

The National Chicken Council said in a statement that its producers already worked closely with veterinarians, and that much of the antibiotics used in raising chickens were not used in human medicine.

Title: WSJ: Antibiotics of the future
Post by: Crafty_Dog on December 17, 2013, 08:32:39 AM
Antibiotics of the Future
Scientists hunt for new antibiotics amid a rise in resistant germs
By Shirley S. Wang
Dec. 16, 2013 7:06 p.m. ET

As bacteria continue to develop resistance to existing antibiotics, scientists are working on new strategies to combat bug-borne infections and diseases, Shirley Wang reports. Photo: AP.

Scientists are working to develop new strategies to combat the growing threat of germs that current antibiotics can't fight.

Some researchers are testing new substances, such as silver, to combine with antibiotics to boost their killing power. Other researchers are making use of genetic sequencing of bacteria to help develop killer drugs at a faster pace than medical science was capable of in the past.

Another strategy aims to render harmful bacteria incapable of infecting people, rather than killing the germs outright. One such technique would neutralize disease-causing toxins by disrupting the bacteria's internal mechanisms.

Antibiotic resistance is a growing threat to public health, medical officials say. Common germs such as Escherichia coli, or E. coli, which can cause urinary tract and other infections, and Neisseria gonorrhoeae, which causes gonorrhea, are becoming harder to treat because they increasingly don't respond to antibiotics. Some two million people in the U.S. are infected each year by antibiotic-resistant bacteria and 23,000 die as a result, according to the Centers for Disease Control and Prevention. The CDC says it doesn't have historical numbers.
View Graphics

One of the biggest threats is from Enterobacteriaceae, a family of germs that naturally lives in the gut and includes E. coli, the CDC says. There are about 9,000 cases a year of infections from the germs that can't be treated with usual antibiotics, resulting in 610 deaths. In 1998, there was just one case. Patients who don't respond to normal antibiotics are given older drugs that had been discontinued because of severe side effects, such as kidney damage, the CDC says.

Scientists say that Enterobacteriaceae are particularly hard to kill because of an outer cell wall that prevents many antibiotics from penetrating. James J. Collins, a professor of biomedical engineering at Boston University and Harvard University, and his colleagues recently discovered that adding trace amounts of silver—long known to have antimicrobial properties—allows the common antibiotic vancomycin to work against E. coli, whereas the antibiotic isn't effective against the microbe on its own. The silver appears to make the outer walls of the bacteria more permeable, allowing the antibiotic to get in and do its job, says Dr. Collins, who published the findings in the journal Science Translational Medicine in June.

(Some pharmaceutical companies are experimenting with other types of additives with the aim of short-circuiting bacteria's defenses.)

Researchers at Merck & Co., in Whitehouse Station, N.J., are targeting an enzyme called beta-lactamase that lives in certain bacteria and neutralizes antibiotics sent to destroy them. By adding an enzyme-inhibiting agent called MK-7655 to the antibiotic imipenem, researchers managed to kill about 97% of a type of antibiotic-resistant bacteria that causes urinary-tract infections and pneumonia, according to Nicholas Kartsonis, head of clinical development of antibacterial, antifungals and non-hepatology viruses at Merck Research Labs.

Synthetic Biologics Inc. is taking advantage of beta-lactamase's ability to neutralize antibiotics by adding a modified version of the enzyme to the drugs. The aim is to prompt the antibiotic to break down when it reaches the bowel, where side effects and drug resistance for bacteria called Clostridium difficile, or C. difficile, develops, but to leave the antibiotic intact in the bloodstream. The process should allow larger doses of antibiotics to be administered without the patient suffering typical side effects such as gastrointestinal problems, says John Monahan, who heads research and development for the Rockville, Md.-based company.

C. difficile, which causes life-threatening diarrhea and is blamed for 14,000 deaths a year, can spread rapidly in hospital patients on antibiotics. Although there are drugs to treat C. difficile, the bacteria are resistant to many antibiotics used to treat other types of infections.

Antibiotics naturally lose their effectiveness over time as bacteria populations build up resistance, and new drugs need to be continually developed to take their place. But antibiotic development by pharmaceutical companies slowed sharply after about 1990, in part because they are less profitable than other drugs used to treat chronic diseases. Compounding the problem has been an overuse of antibiotics in people and farm animals, which has accelerated the creation of antibiotic-resistant germs.

"Antibiotics have a finite lifetime because resistance is inevitable," says Michael Fischbach, a bioengineering and therapeutic sciences professor at the University of California, San Francisco. "Therefore, there's always a need to innovate."

Bacteria have ways of defending themselves against other bacteria, and most antibiotics are derived from the toxins they use. Identifying and developing new antibiotics is a long and slow process. Now, scientists are able to more efficiently scrutinize microbes for undiscovered antibiotics by sequencing their genomes and then using computer analysis to look for gene patterns that suggest a new antibiotic recipe. Typically, antibiotics are encoded by anywhere from 10 to 40 genes.

Sean Brady, head of the Laboratory of Genetically Encoded Small Molecules at Rockefeller University in New York, and his colleagues recently zeroed in on half a dozen gene sequences. The team found that the genes were encoded for toxins that appeared in lab testing to be active against pathogens resistant to the antibiotic vancomycin, which is commonly used to treat infections in the gut. The research was published in the Proceedings of the National Academy of Science in June.
2 million

The number of U.S. patients per year whose infections aren't treatable with the existing array of antibiotics

Whether the antibiotic will be useful in treating people remains to be seen, says Dr. Brady. The main problem with identifying new antibiotics isn't that they don't work, but that they cause severe side effects or toxicity, drug makers say.

Another group of researchers, headed by Dr. Fischbach at the University of California, has found a handful of new antibiotics that kill methicillin-resistant Staphylococcus aureus, or MRSA, by sequencing genomes of bacteria found in the environment. MRSA can cause a range of illnesses from skin infections to pneumonia and bloodstream infections.

An unusual strategy doesn't aim to kill bacteria at all, but rather to make them less harmful. Since bacteria only cause infections when their population has reached a certain threshold, called a quorum, researchers are looking for ways to disrupt the chemical signals the bugs use to communicate with each other. Another approach aims to neutralize toxins or disrupt other signaling molecules that are necessary for bacteria to be infectious.

"We don't challenge them to a duel but basically confuse them into not causing infection," says Gerry Wright, a professor of biochemistry and biomedical sciences at McMaster University in Hamilton, Ontario.

Dr. Brady and his team at Rockefeller University demonstrated that disrupting a cluster of genes reduced the virulence of a microbe that causes infection affecting the lungs, bones and joints. The researchers published the work late last year in the Journal of the American Chemical Society.
Title: IL outbreak
Post by: bigdog on January 08, 2014, 02:02:35 PM

The largest U.S. outbreak on record of one particular strain of a so-called “nightmare bacteria” is fueling alarm among public health officials about the spread of potentially lethal drug-resistant infections.

The outbreak, which has been traced to Advocate Lutheran General Hospital in suburban Chicago, has so far infected 44 people, according to the Centers for Disease Control and Prevention. Since 2009, just 97 cases of the infection have been reported to the agency.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs etc
Post by: ccp on January 09, 2014, 07:21:45 AM

I haven't seen the CDC reports on this.  I am sure my ID colleagues have.  In NJ we are seeing ESBL infections.  These are the enterobacterioraceae that respond to "penem" and sometimes other antibiotics.   This one would be tough.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs etc
Post by: bigdog on January 09, 2014, 11:22:38 AM
Thanks for the follow up, ccp. If you see anything that adds or contradicts, I'd be interested.
Title: Cranial rectal interface not a solution to declining efficacy of antibiotics
Post by: Crafty_Dog on May 10, 2014, 05:26:14 AM
Title: Even POTH realizes the ROI for antibiotic development is too low
Post by: Crafty_Dog on May 11, 2014, 11:41:33 AM

The Rise of Antibiotic Resistance


The World Health Organization has surveyed the growth of antibiotic-resistant germs around the world — the first such survey it has ever conducted — and come up with disturbing findings. In a report issued late last month, the organization found that antimicrobial resistance in bacteria (the main focus of the report), fungi, viruses and parasites is an increasingly serious threat in every part of the world. “A problem so serious that it threatens the achievements of modern medicine,” the organization said. “A post-antibiotic era, in which common infections and minor injuries can kill, far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century.”

The growth of antibiotic-resistant pathogens means that in ever more cases, standard treatments no longer work, infections are harder or impossible to control, the risk of spreading infections to others is increased, and illnesses and hospital stays are prolonged.

All of these drive up the costs of illnesses and the risk of death. The survey sought to determine the scope of the problem by asking countries to submit their most recent surveillance data (114 did so). Unfortunately, the data was glaringly incomplete because few countries track and monitor antibiotic resistance comprehensively, and there is no standard methodology for doing so.

Still, it is clear that major resistance problems have already developed, both for antibiotics that are used routinely and for those deemed “last resort” treatments to cure people when all else has failed.

Carbapenem antibiotics, a class of drugs used as a last resort to treat life-threatening infections caused by a common intestinal bacterium, have failed to work in more than half the people treated in some countries. The bacterium is a major cause of hospital-acquired infections such as pneumonia, bloodstream infections, and infections in newborns and intensive-care patients. Similarly, the failure of a last-resort treatment for gonorrhea has been confirmed in 10 countries, including many with advanced health care systems, such as Australia, Canada, France, Sweden and Britain. And resistance to a class of antibiotics that is routinely used to treat urinary tract infections caused by E. coli is widespread; in some countries the drugs are now ineffective in more than half of the patients treated. This sobering report is intended to kick-start a global campaign to develop tools and standards to track drug resistance, measure its health and economic impact, and design solutions.
Continue reading the main story
Recent Comments
8 minutes ago

Big Pharma already gets plenty of money from the government for R&D. They only want to develop medicines that will make a huge profit....
Bob H
25 minutes ago

When you find a solution that doesn't hurt the PROFITS of any industry, then you'll get somewhere. So, basically, we're all in a lot of...
26 minutes ago

Sure, the pharmaceutical industry needs to be more involved in developing solutions, but responsibility doesn't stop there. Doctors need to...

    See All Comments
    Write a comment

The most urgent need is to minimize the overuse of antibiotics in medicine and agriculture, which accelerates the development of resistant strains. In the United States, the Food and Drug Administration has issued voluntary guidelines calling on drug companies, animal producers and veterinarians to stop indiscriminately using antibiotics that are important for treating humans on livestock; the drug companies have said they will comply. But the agency, shortsightedly, has appealed a court order requiring it to ban the use of penicillin and two forms of tetracycline by animal producers to promote growth unless they provide proof that it will not promote drug-resistant microbes.

The pharmaceutical industry needs to be encouraged to develop new antibiotics to supplement those that are losing their effectiveness. The Royal Pharmaceutical Society, which represents pharmacists in Britain, called this month for stronger financial incentives. It said that no new class of antibiotics has been discovered since 1987, largely because the financial returns for finding new classes of antibiotics are too low. Unlike lucrative drugs to treat chronic diseases like cancer and cardiovascular ailments, antibiotics are typically taken for a short period of time, and any new drug is apt to be used sparingly and held in reserve to treat patients resistant to existing drugs.

Antibiotics have transformed medicine and saved countless lives over the past seven decades. Now, rampant overuse and the lack of new drugs in the pipeline threatens to undermine their effectiveness.
Title: Bio Bombers
Post by: Crafty_Dog on August 06, 2014, 01:48:31 PM
The REAL Pandemic Threat: BioBombers
Hope for the Best -- Prepare for the Worst
By Mark Alexander • August 6, 2014     
"A universal peace, it is to be feared, is in the catalogue of events, which will never exist but in the imaginations of visionary philosophers, or in the breasts of benevolent enthusiasts." --James Madison (1792)

The 24-hour news recyclers have lately devoted a lot of airtime to the Ebola epidemic in West Africa and concerns about its spread to the U.S.
In recent weeks, more than 1,300 Africans have been infected with the deadly virus, and most of them have died. There would likely not be much coverage of this regional epidemic if not for the fact that two "humanitarian workers" (read: heroic Christians), an American doctor and nurse, are infected with the virus and have been transported to Emory University Hospital in Atlanta for treatment.
The Centers for Disease Control (CDC) has assured Americans that, while Ebola is deadly in each of its variant forms -- it is much like AIDS or HIV -- transmission requires substantial direct contact with an infected person. Of course, given that in the last three months the CDC's stellar status was tarnished by reports that its personnel were very careless with some deadly pathogens -- including anthrax, avian flu and smallpox -- it's understandable many Americans question CDC's assessment of the Ebola risk.
The fact is, CDC's risk assessment regarding the threat of an Ebola epidemic in the U.S. is correct. There is, however, right now, a very real pandemic threat posed by what we can call "BioBombers."
BioBombers are Islamist "martyrs" who, instead of strapping on a bomb and detonating themselves in a crowded urban area, become human hosts for virulent strains of deadly contagions. Once infected, they fly into the U.S. legally and park themselves in major airport hubs around the nation for days, where they can infect others traveling across country whose symptoms may take days to manifest -- which is to say others unknowingly become hosts and spread the virus to a much wider circle in their communities and work places.
For historical background, the greatest mortal threat to indigenous American populations when 15th- and 16th-century European explorers arrived was not from armed conflict with other native peoples; it was from European strains of diseases for which they had no immunity. The reverse was also true -- many Europeans suffered from American diseases.
In the 19th century, of the estimated 620,000 deaths recorded in the War Between the States, more than 430,000 died from "camp diseases." When soldiers and support personnel from different regions of the country congregated in camps, those who arrived with a virulent strain of influenza or other contagion quickly passed it on to others, and the consequences were devastating.
In the 20th century, there were 5.1 million combatant deaths in the four years of World War I, but the 1918 H1N1 influenza virus, commonly referred to as the "Spanish Flu," infected an estimated 500 million people globally, including even those in remote Pacific and Arctic regions. Indeed, as many as 75-100 million people died in that pandemic -- up to five percent of the world's population, in two years.
In World War II, disease in the Pacific campaign claimed far more casualties than combat.
So how have we avoided another devastating Spanish Flu pandemic?

We've learned how to restrain the spread of these diseases because of our notable early detection of outbreaks and well-rehearsed preventive measures to contain and isolate the infected. (Early detection and containment is critical when dealing with bacterial and viral infections.)
We have learned a lot from managing outbreaks. In 1976, a bacterial contagion called Legionnaires' disease claimed 29 victims in Philadelphia. More recently, a viral SARS outbreak killed 775 people in 37 countries, most of them in Asia. There have also been recurring concerns about "bird flu," which has been spreading worldwide since 2003 and claimed its first victim two years ago in Canada.
There are also inoculation programs that have helped eliminate the spread of disease, and treatment is much better now than it was in the early part of the 20th century.
But pathogens such as these are decimating if health care providers are slow to recognize the symptoms and correctly diagnose the disease. They can spread quickly if not properly reported to the CDC for entry into its early warning and response protocols. Fortunately, dangerous strains of H5N1 influenza and other flu viruses have not adapted, or mutated, into dramatically more virulent and deadly strains.
But there are plenty of artificially engineered bio-warfare viral strains that, if released into urban population centers, would overwhelm medical facilities and claim millions of casualties. The prospect of bio-terrorism, particularly a simultaneous attack across the nation from a cadre of BioBombers, would quickly overload health care service providers and exhaust pharmaceutical reserves. In the event of such an attack, the CDC's epidemic early warning detection map would not merely blink with one or two markers -- the entire board would light up, and the probability of containment would be lost.
In fact, the possibility of such an attack was the impetus last week for the largest bio-terrorism drill in New York City's history.
So, how real is the threat?
The primary symmetric deterrent to weapons of mass destruction in warfare between nation states is the doctrine of mutually assured destruction. But in asymmetric warfare, where Islamic martyrs serve as surrogates for states like Iran, the MAD doctrine is of little deterrence.

The prospect of another catastrophic attack on our homeland by asymmetric terrorist actors is greater now than it was in 2001, and the reason is as plain as it was predictable. But the impact of BioBombers on continuity of government and commerce will be far greater than 9/11.
In his first annual address to the nation in 1790, George Washington wrote, "To be prepared for war, is one of the most effectual means of preserving peace." The eternal truth of those words is plainly evident today.
Indeed, as our nation's erstwhile "community organizer" leads our nation's retreat from its post as the world's sole superpower, the inevitable consequences have been dramatic. Of greatest concern now is the resurgence of the enemies of Liberty, most notably al-Qa'ida jihadists in the wake of the Middle East meltdown (AKA, Arab Spring) in Egypt, Libya, Syria, Yemen and Jordan, and now the disintegration of Iraq and the conflagration in Gaza.
At present, all eyes are on the unabated rise of the nuclear Islamic Republic of Iran, a major benefactor of worldwide Islamic terror. Iran could eventually put a compact fissile weapon into the hands of Jihad surrogates with the intent of detonating that weapon in a U.S. urban center.
But the scope and consequences of a coordinated attack by Islamic BioBombers is far greater than that of a nuclear attack. The impact on continuity of government and commerce will be far greater than the 9/11 attack.
So if the threat of a catastrophic bio-terrorism attack has increased, and if the CDC and our homeland security apparatus are not properly prepared to respond to such an attack (the response to Hurricane Katrina comes to mind), then what can be done?
Fact is, there is a lot you can do to protect yourself and your family in the event of a biological attack on our nation with a little knowledge, preparation and not much expense -- and that preparation will also suffice for other types of emergencies.

The bedrock foundation of survival is individual preparedness and being prepared is not difficult. The primary means of protection in a pandemic is sheltering in place. But the Web is flooded with all kinds of preparedness and overwhelming advice from doomsday preppers. But your Patriot Post team has prepared a one-stop reliable reference page with basic instructions and advice.
As a resource to communities across the nation, we convened a knowledgeable team of emergency preparedness and response experts in 2012, including federal, state and local emergency management professionals, and specialists from the fields of emergency medicine, urban and wilderness survival, academia, law enforcement and related private sector services. They compiled basic individual preparedness recommendations to sustain you and your family during a short-term crisis. The result is a Two Step Individual Readiness Plan that enables you to shelter in place in the event of a local, regional or national catastrophic event, including a pandemic.
The most likely scenario requiring you to shelter in place would be the short-term need to isolate yourself from chemical, biological or radiological contaminants released accidentally or intentionally into the environment. (This could require sheltering for 1-7 days.)
But in the event of a bio-terrorism attack setting into motion a pandemic or a panic, you must be prepared to isolate yourself and your family from other people in order not to contract an illness. The best location to shelter in place during such an event is in your residence, and the length of time required could be 1-6 weeks.
Be prepared.
1.   Link to our Disaster Preparedness Planning resource page.
2.   Link to our Two Step Individual Readiness Plan
Pro Deo et Constitutione — Libertas aut Mors
Semper Vigilo, Fortis, Paratus et Fidelis
Mark Alexander
Publisher, The Patriot Post
Title: Ebola
Post by: G M on August 19, 2014, 03:56:18 PM
Title: Weaponized plague is a jihadi pipe dream
Post by: Crafty_Dog on September 04, 2014, 08:51:52 AM
 Weaponized Plague Is Just Another Jihadist Pipe Dream
Security Weekly
Thursday, September 4, 2014 - 03:00 Print Text Size

By Scott Stewart

On Aug. 28, Foreign Policy magazine released an exclusive story by Harald Doornbos and Jenan Moussa titled Found: The Islamic State's Terror Laptop of Doom. The story noted that among a cache of documents found on a computer captured from the Islamic State in Syria was a 19-page document purported to be instructions for creating a biological weapon by weaponizing plague extracted from infected animals. According to the article, the document noted: "The advantage of biological weapons is that they do not cost a lot of money, while the human casualties can be huge."

This document provides a good example of the terrorist tradecraft conundrum militant organizations often face, in which their intent outstrips their capability. While biological weapons do appear to be easy to manufacture and deploy in theory, history shows a successful biological weapons program is far harder to achieve than it may appear at first glance.

As we noted in 2009 in response to rumors that al Qaeda in the Islamic Maghreb was experimenting with the plague as well, the plague, sometimes referred to as the Black Death, is a naturally occurring disease that is caused by the bacterium Yersinia pestis. This pathogen is found in rodents and fleas that infest them and exists in many parts of the world, including the western United States. According to the U.S. Centers for Disease Control and Prevention, there are some 1,000 to 2,000 cases of plague diagnosed in humans every year, with between one and 17 of those cases occurring in the United States. It is notable, however, that according to the World Health Organization, plague does not occur naturally in Syria or Iraq, although it does in Libya and Algeria.

Y. pestis can infect humans in three ways. The bacteria cause pneumonic plague when inhaled, though pneumonic plague can also occur when plague bacteria from another form of transmission infect the lungs. Bubonic plague results when the bacteria enter through a break in the skin (such as a fleabite) and septicemic plague occurs when the bacteria multiply in the victim's blood, usually after being infected by one of the other types. In general, a fleabite is the primary form of infection, and if the infection is left untreated, it can evolve into a case of bubonic (the most common outcome) or septicemic plague.

Y. pestis is a fragile bacterium that does not last long in sunlight or after it is dried, and plague is treatable with antibiotics, which are especially effective if administered early. However, pneumonic plague can be contagious if a person inhales respiratory droplets containing the bacteria from an infected person. Such a transmission usually requires close contact with the infected individual. Merely wearing a simple surgical mask can protect a person from pneumonic plague infection.
Weaponized Plague

Before we assess the Islamic State's capability and intent to create a weapon using plague, let's first look briefly at the history of plague as a weapon.

Plague has long been of interest as a weapon in biological warfare, with reports from Tatars catapulting plague-infected bodies at Genoese sailors in the City of Caffa in the Crimea in the 14th century, to Japan's efforts to drop clay pots of plague-infected fleas over Manchuria, to the Soviet weapons programs during the Cold War and perhaps beyond. While the Tatars and Japanese used the bubonic form of the plague, according to former Soviet scientist Ken Alibek, the Soviet program focused on and perfected an aerosolized form of the bacterium designed to cause pneumonic plague.

Without question, the best example of a modern non-state actor developing a biological weapons program was the Japanese Aum Shinrikyo, which in the late 1980s assembled a team of trained scientists and spent millions of dollars to develop a series of state-of-the-art biological weapons research and production laboratories.

Aum experimented with botulinum toxin, anthrax, cholera and Q fever and even tried to acquire the Ebola virus. However, despite multiple attempts to produce mass casualty attacks using botulinum toxin and anthrax from 1990 to 1993, Aum was not able to produce a virulent agent -- indeed, nobody outside of the group was even aware that the attacks happened. It was only when the group switched to producing chemical weapons, such as the nerve agent sarin and sodium cyanide gas, that it was able to conduct fatal attacks in 1995. The investigation into the chemical attacks produced the evidence of the group's extensive biological weapons program. Frankly, they could have killed far more people, with far less expense and effort, using firearms or bombs, but such conventional weapons could never produce the global apocalypse the group's leadership aspired to.

Despite the difficulties inherent in developing a biological weapons program, radical groups have not given up. It has long been known that jihadist groups such as al Qaeda have sought to develop chemical and biological weapons, believing that using such weapons is not only permissible but even an obligation. In an interview aired on ABC News in December 1998, Osama bin Laden said, "If I have indeed acquired these weapons, then this is an obligation I carried out, and I thank God for enabling me to do so." While terrorist groups have experimented with crude biological toxins such as ricin and crude chemical compounds such as sodium cyanide gas, they have not been able to parlay those experiments into viable weapons capable of creating mass casualties.
Radical Intent

To properly understand the threat posed by the Islamic State's employing biological weapons, we must examine both the group's intent and capability. First, as noted above, the group has ample ideological justifications. Second, by design, terrorist attacks are intended to have a psychological impact far outweighing the physical damage they cause. As their name suggests, they are meant to cause terror that amplifies the actual attack. The Islamic State has a long history of conducting brutal actions intended to cause panic, and a successful biological terrorist attack would certainly create such a panic.

Clearly, if the Islamic State were able to develop effective biological weapons, it would employ them, if not against targets in the West, then against regime targets in Iraq and Syria. Indeed, in 2006 and 2007 the group's predecessor, al Qaeda in Iraq, included large quantities of chlorine in vehicle bombs in an effort to cause mass casualties against U.S. and Iraqi troops in Iraq. These weapons proved quite ineffective, and the explosives in the bombs killed more people than the chlorine. This caused the group to discontinue their use when they did not achieve the desired results.

The Islamic State would love to discover a cheap and easy way to create mass casualties, but in pursuing plague as a weapon, the group appears to have bought into some of the many common misconceptions involving biological weapons, namely, that they are easy to obtain, easy to deploy effectively, and, when used, always cause massive casualties. But as illustrated by the above-mentioned Aum Shinrikyo example, in the real world, creating an effective biological weapons program requires extensive investment, scientific know-how, and time and effort -- and they still don't always work as advertised.
Limited Capability

Like many biological agents, there are great challenges associated with producing and employing large quantities of a virulent biological agent. Certainly, plague can be obtained from the environment in a place where it occurs naturally, such as Algeria or Libya, but taking that bacteria and producing a large quantity of it in a virulent form and then disbursing it in an efficient manner is another matter entirely. While the huge Soviet biological weapons program was able to overcome these obstacles and successfully produce an effective aerosolized plague weapon, it would be difficult for a smaller organization like the Islamic State to do so, especially since it lacks access to a large and advanced biological weapons program and the associated and necessary facilities.

In addition to the difficulty of establishing a viable biological weapons program in the Islamic State-controlled areas of Iraq and Syria, there are also some additional problems with the plot as reportedly outlined in the purported Islamic State biological warfare document. According to Foreign Policy, the document advised the attackers to "use small grenades with the virus, and throw them in closed areas like metros, soccer stadiums, or entertainment centers," and said that it is "best to do it next to the air-conditioning. It also can be used during suicide operations."

As noted above, Y. pestis is a fragile bacterium. The heat and shock of a grenade explosion would almost certainly kill most of the bacteria before it could be transmitted to a victim. Even if some of the bacteria were to survive the grenade's explosion, bubonic and septicemic plagues are not easily spread from person to person, and an attack with a small grenade device would therefore be unlikely to cause an epidemic; it would likely cause more panic than deaths.

If Islamic State attack planners could isolate a virulent strain of Y. pestis, infecting a few suicide operatives with pneumonic plague and then dispatching them to cough and sneeze on people, or attempting to release some infected fleas in a targeted area, might better serve them. But even if the group were somehow successful in infecting people, even these scenarios would not produce the type of mass casualties the Islamic State seeks since plague is readily treatable with antibiotics, making weaponized plague just another jihadist pipe dream.

Read more: Weaponized Plague Is Just Another Jihadist Pipe Dream | Stratfor

Title: Ebola projections getting much worse
Post by: Crafty_Dog on September 14, 2014, 09:44:42 AM
U.S. Scientists See Long Fight Against Ebola

The deadly Ebola outbreak sweeping across three countries in West Africa is likely to last 12 to 18 months more, much longer than anticipated, and could infect hundreds of thousands of people before it is brought under control, say scientists mapping its spread for the federal government.

“We hope we’re wrong,” said Bryan Lewis, an epidemiologist at the Virginia Bioinformatics Institute at Virginia Tech.

Both the time the model says it will take to control the epidemic and the number of cases it forecasts far exceed estimates by the World Health Organization, which said last month that it hoped to control the outbreak within nine months and predicted 20,000 total cases by that time. The organization is sticking by its estimates, a W.H.O. spokesman said Friday.

But researchers at various universities say that at the virus’s present rate of growth, there could easily be close to 20,000 cases in one month, not in nine. Some of the United States’ leading epidemiologists, with long experience in tracking diseases such as influenza, have been creating computer models of the Ebola epidemic at the request of the National Institutes of Health and the Defense Department.

The Centers for Disease Control and Prevention declined to comment on the projections. A spokesman, Tom Skinner, said the agency was doing its own modeling and hoped to publish the results soon. But the C.D.C. director, Dr. Thomas R. Frieden, has warned repeatedly that the epidemic is worsening, and on Sept. 2 described it as “spiraling out of control.”

While previous outbreaks have been largely confined to rural areas, the current epidemic, the largest ever, has reached densely populated, impoverished cities — including Monrovia, the capital of Liberia — gravely complicating efforts to control the spread of the disease. Alessandro Vespignani, a professor of computational sciences at Northeastern University who has been involved in the computer modeling of Ebola’s spread, said that if the case count reaches hundreds of thousands, “there will be little we can do.”

What worries public health officials most is that the epidemic has begun to grow exponentially in Liberia. In the most recent week reported, Liberia had nearly 400 new cases, almost double the number reported the week before. Another grave concern, the W.H.O. said, is “evidence of substantial underreporting of cases and deaths.” The organization reported on Friday that the number of Ebola cases as of Sept. 7 was 4,366, including 2,218 deaths.

“There has been no indication of any downturn in the epidemic in the three countries that have widespread and intense transmission,” it said, referring to Guinea, Liberia and Sierra Leone.

The scientists who produced the models cautioned that their dire predictions were based on the virus’s current uncontrolled spread and said the picture could improve if public health efforts started to work. Because conditions could change, for better or for worse, the researchers also warned that their forecasts became shakier the farther into the future they went.
Continue reading the main story
Predicting Ebola’s Future Toll

Assuming current infection rates continue, a new model estimates there could be 20,000 Ebola cases by mid-October. The model’s estimate would nearly triple under deteriorating conditions and an increasing infection rate.

If conditions deteriorate

60 thousand







Cases and deaths

through Aug. 31



Aug. 1

Sept. 1

Oct. 1

At current infection rates



Aug. 1

Sept. 1

Oct. 1

If conditions improve


Aug. 1

Sept. 1

Oct. 1
Source: The Earth Institute, Columbia University

By The New York Times
Continue reading the main story Continue reading the main story
Continue reading the main story

Dr. Lewis, the Virginia Tech epidemiologist, said that a group of scientists collaborating on Ebola modeling as part of an N.I.H.-sponsored project called Midas, short for Models of Infectious Disease Agent Study, had come to a consensus on the projected 12- to 18-month duration and very high case count.

Another Midas participant, Jeffrey L. Shaman, an associate professor of environmental health sciences at the Columbia University Mailman School of Public Health, agreed.

“Ebola has a simple trajectory because it’s growing exponentially,” Dr. Shaman said.

Lone Simonsen, a research professor of global health at George Washington University who was not involved in the modeling, said the W.H.O. estimates seemed conservative and the higher projections more reasonable.

“The final death toll may be far higher than any of those estimates unless an effective vaccine or therapy becomes available on a large scale or many more hospital beds are supplied,” she said in an email.
Continue reading the main story Video
Play Video|3:47
Dying of Ebola at the Hospital Door
Dying of Ebola at the Hospital Door

Monrovia, the Liberian capital, is facing a widespread Ebola epidemic, and as the number of infected grows faster than hospital capacity, some patients wait outside near death.
Video Credit By Ben C. Solomon on Publish Date September 11, 2014.
Continue reading the main story
Recent Comments
1 hour ago

If we do nothing, and a messy civil war in West Africa breaks out, then humanity will begin to lose our most valuable asset in this battle,...
5 hours ago

Lots of people in these countries DO NOT WANT to be helped. They accuse health care workers of spreading/giving them the disease, don't...
Steve Fankuchen
6 hours ago

Perhaps this tragic epidemic will instill a bit of humility in people, as they (hopefully) ponder unintended consequences of the Green...

    See All Comments
    Write a comment

Dr. Vespignani said that the W.H.O. figures would be reasonable if there were an effective campaign to stop the epidemic now, but that there is not.

The modeling estimates are based on the observed growth rate of cases and on factors like how many people each patient infects. The researchers use the past data to make projections. They can test their methods by, for instance, taking the figures from June, plugging them into the model to predict the number of cases in July, and then comparing the results with what actually happened in July.

Dr. Shaman’s research team created a model that estimated the number of cases through Oct. 12, with different predictions based on whether control of the epidemic stays about the same, improves or gets worse. If control stays the same, according to the model, the case count by Oct. 12 will be 18,406. If control improves, it will be 7,861. If control worsens, it will soar to 54,895.

Before this epidemic, the largest Ebola outbreak was in Uganda from 2000 to 2001, and it involved only 425 cases. Scientists say the current epidemic surged out of control because it began near the borders of three countries where people traveled a lot, and they carried the disease to densely populated city slums. In addition, the weak health systems in these poor countries were not equipped to handle the disease, and much of the international response has been slow and disorganized.

But questions have also been raised about whether there could be something different about this strain of Ebola that makes it more contagious than previous ones.

Researchers are doubtful, but Thomas W. Geisbert, an Ebola expert at the University of Texas Medical Branch in Galveston, said it was important to keep an open mind about the possibility. During vaccine tests expected to start next month in monkeys, he said, he and his colleagues will monitor infected animals to see if they develop unusually high virus levels early in the disease that might amplify its infectiousness.

Some scientists have also suggested that as the outbreak continues and the virus spreads from person to person, it will have more opportunities to mutate and perhaps become even more dangerous or contagious. But Stuart T. Nichol, chief of the C.D.C.’s Viral Special Pathogens Branch, said that so far, researchers monitoring the mutations had seen no such changes.
Title: Ebola-- A doctor friend writes
Post by: Crafty_Dog on September 14, 2014, 02:52:50 PM
The US is woefully unprepared for receiving Ebola patients on routine flights from Africa. All of NY city hospitals are preparing for such cases, but the readiness is not great. Hospitals and emergency departments are not equipped for handling of such patients. I can imagine the panic that will occur, if a case is diagnosed at any of the city hospitals. The hospital might even empty!..causing huge financial losses...and if the virus becomes airborne...the panic will be complete. We also have our southern border to think off...what with the declaration of war by Obummer.

On Fri, Sep 12, 2014 at 2:42 PM, , , , wrote:
Title: Obama plans major Ebola offensive
Post by: Crafty_Dog on September 15, 2014, 04:50:03 AM
I actually agree with Obama on this one!

Obama Plans Major Ebola Offensive
More Doctors, Supplies and Portable Hospitals Planned for West Africa
By Carol E. Lee and Betsy McKay
Updated Sept. 15, 2014 5:38 a.m. ET

Volunteers in Centennial, Colo., load medical supplies last week bound for Sierra Leone to combat Ebola. Associated Press

WASHINGTON—President Barack Obama plans to dramatically boost the U.S. effort to mitigate the Ebola outbreak in West Africa, including greater involvement of the U.S. military, people familiar with the proposal said.

Mr. Obama is expected to detail the plan during a visit Tuesday to the Centers for Disease Control and Prevention in Atlanta, these people said. Among the possible moves: sending additional portable hospitals, doctors and health-care experts, providing medical supplies and conducting training for health workers in Liberia and other countries.

Mr. Obama also is expected to urge Congress to approve the request he made last week for an additional $88 million to fund his proposal.

"There's a lot that we've been putting toward this, but it is not sufficient," Lisa Monaco, Mr. Obama's counterterrorism adviser, said in an interview Sunday. "So the president has directed a more scaled-up response and that's what you're going to hear more about on Tuesday."

The strategy has four components: control the outbreak at its source in West Africa; build competence in the region's public-health system, particularly in Liberia; bolster the capacity of local officials through enhanced training for health-care providers; and increase support from international organizations, such as the United Nations and the World Health Organization.

Mr. Obama plans to use a gathering of world leaders at the United Nations next week to seek commitments of funds, materials and health workers for a more robust international response.

The Ebola outbreak has infected at least 4,784 people as of Sept. 12, with 2,400 of them dying—a jump from 3,707 cases and 1,848 deaths as of Aug. 31. The true toll probably is much higher, the WHO says.

The Obama administration has grown increasingly concerned in the last two weeks, as infectious-disease and public-health experts warned that the global response is inadequate to subdue an epidemic that has spiraled out of control, and that it threatens the U.S. and other countries, not just West Africa.

Mr. Obama ordered a bolder U.S. effort about two weeks ago after CDC Director Tom Frieden briefed the White House on his findings from a trip to West Africa, senior administration officials said. Dr. Frieden said publicly on Sept. 2 that he saw dozens of patients lying on the ground in an Ebola treatment center because there weren't enough beds. "I could not possibly overstate the need for an urgent response," he said.

Mr. Obama's plan is a reaction to concern that the epidemic could significantly grow in West Africa, particularly in urban areas. Administration officials stress that the chances of an outbreak in the U.S. are low.

One rising concern among officials is the possibility that the virus could mutate in a way that would make it more dangerous.

The more the virus spreads from one human to another, the more opportunities it has to mutate, virologists say. While not all scientists agree that significant mutations that would change the way the virus is transmitted are likely, one recent study of virus samples over three weeks in Sierra Leone found many mutations.

While an administration official said a dangerous mutation of the virus is unlikely at this stage, "that is a concern that is motivating us to, and the international community more broadly, to get involved even more so now to bring this under control."

The CDC has at least 105 staff in West Africa—one of the largest deployments in CDC history—tracking down people who have been exposed to Ebola, conducting education campaigns, and other tasks. The government has spent more than $100 million on the outbreak since March, and recently committed an additional $75 million in funding, according to a U.S. Agency for International Development official. The money is used to deploy staff and deliver supplies, such as chlorine and water, as well as hospital beds.

The U.S. military has sent eight service members to the region, including doctors, a logistician and medical specialists. It also said it would send a 25-bed portable hospital unit to Liberia to help care for health workers, but it isn't planning to staff it. Many public-health and infectious disease experts have called for a greater U.S. military role, which is highly valued in humanitarian crises for its ability to command and control large operations, as well as its logistics expertise.

U.S. defense officials have ruled out sending hospital ships or the big-deck amphibious ships that frequently respond to humanitarian disasters. One official said if the virus got aboard one of those ships, it could quickly spread and would be difficult to stamp out.

These experts say that is what is needed in West Africa, because the governments of the three most affected countries—Liberia, Sierra Leone and Guinea —have been overwhelmed and their health-care systems have all but crumbled. The crisis also has become too large for aid organizations and health ministries to handle alone, they say. The current response, involving several local and international agencies and organizations, also lacks coordination.

The military could be used to direct supplies, set up tent hospitals, and tap the masses of medical personnel that are needed globally to get the sick into isolation and treatment, so they stop spreading the disease to others and improve their chances of recovery. Now, there are so few hospital beds that many are having to suffer through the disease at home, where they risk spreading it to loved ones.

And while hundreds of millions of dollars in aid have recently been pledged, under current circumstances it won't arrive in West Africa for weeks - by which time thousands more will be infected and dead.

Mr. Obama hopes to begin to turn the situation around with the rollout of his new strategy, administration officials said.

"We think these measures, this enhanced response, will help us bring this under control," an administration official said Sunday. "The military has unique capabilities in terms of logistical capacities, in terms of manpower, in terms of operating in austere environments."

The administration faces formidable challenges in carrying out any response plan. Not only is the virus now spreading fast, but health workers and epidemiologists have been physically attacked or run out of villages by angry or frightened locals. Some locals argue that Ebola is a bioweapon seeded by the West.

Joanne Liu, international president of Doctors Without Borders, called earlier this month for governments to send in their militaries. The aid organization has led treatment efforts since the beginning of the Ebola outbreak and has been warning for months that a bigger response is needed.

"Without this deployment, we will never get the epidemic under control," she said.

—Julian E. Barnes contributed to this article.
Title: Re: Obama plans major Ebola offensive
Post by: DougMacG on September 15, 2014, 10:36:46 AM
I actually agree with Obama on this one! ...

The difference is that you are interested in public health and he is interested in focus group polling.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: G M on September 15, 2014, 12:20:34 PM
It seems like Ebola has already become much more virulent and should be contained ASAP if possible. Hemorrhagic fevers are the stuff of horror movies.
Title: Worst case scenario for Ebola 1.4 million?
Post by: Crafty_Dog on September 23, 2014, 07:52:35 AM
C.D.C.’s Worst-Case Ebola Scenario: 1.4 Million Cases in 4 Months

Yet another set of ominous projections about the Ebola epidemic in West Africa was released Tuesday, in a report from the Centers for Disease Control and Prevention that gave worst- and best-case estimates for Liberia and Sierra Leone based on computer modeling.

In the worst-case scenario, Liberia and Sierra Leone could have 21,000 cases of Ebola by Sept. 30 and 1.4 million cases by Jan. 20 if the disease keeps following its current trajectory, without effective methods to contain it. These figures take into account the fact that many cases go undetected, and estimate that there are actually 2.5 times as many as reported.

The report does not include figures for Guinea because case counts there have gone up and down in ways that cannot be reliably modeled.

In the best-case model — which assumes that the dead are buried safely and that 70 percent of patients are treated in settings that reduce the risk of transmission — the epidemic in both countries would be “almost ended” by Jan. 20, the report said. It showed the proportion of patients now in such settings as about 18 percent in Liberia and 40 percent in Sierra Leone.


Title: Re: Worst case scenario for Ebola 1.4 million?
Post by: DDF on September 23, 2014, 10:48:05 AM
That depends if it is "helped" along by means other than nature and people's will (or lack thereof), to control the flow of people entering and exiting countries. Even then, with all of the ill will in place these days, regardless of side, Ebola will run its course. It matters not. Enjoy the moment.
Title: First "accidental" Ebola case in US
Post by: Crafty_Dog on October 02, 2014, 12:45:07 PM
Title: ISIL plots Ebola for US
Post by: Crafty_Dog on October 05, 2014, 01:54:47 PM
Title: Ebola
Post by: Crafty_Dog on October 07, 2014, 09:01:58 AM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on October 13, 2014, 09:29:17 AM
Feds Underestimating How Easy It Is to Get Ebola

A nurse from one of the best health care systems in the world has contracted Ebola. The nurse cared for Thomas Eric Duncan, the man who traveled to Dallas from Liberia with the disease, and checked herself into her hospital's emergency room Oct. 12. This story challenges the Obama administration's narrative. In a September video message, Barack Obama told the people of Liberia it was safe enough to sit on the bus next to a person infected with the disease and still not contract Ebola. Cue the CDC, which issued a travel warning for the country, telling travelers to "avoid unnecessary travel." Now, doctors are saying it may be easier to contract the disease than previously assumed. Dr. Dennis Maki, an infectious diseases specialist at the University of Wisconsin-Madison, said, "Some of the garb the health worker takes off might brush against a surface and contaminate it. New data suggest that even tiny droplets of a patient's body fluids can contain the virus." The 3,000 American soldiers fighting Ebola in Liberia are in greater danger than Obama lets on.
Title: Diseases from illegal alien minors brought in by Baraq
Post by: Crafty_Dog on October 14, 2014, 08:53:22 AM
Title: Pandemic the Board Game
Post by: Crafty_Dog on October 15, 2014, 11:30:33 AM
Title: Bacterial distopia approaches
Post by: Crafty_Dog on December 06, 2014, 09:00:22 AM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on December 06, 2014, 02:15:35 PM
It makes perfect sense to bring these people here for treatment.  Banning travel to these places will only spread those infections around the world even faster.

Alleges CDC head Friedman.
Title: Good news! New class of antibiotics
Post by: Crafty_Dog on January 12, 2015, 08:39:37 AM
Title: More on new antibiotic class
Post by: Crafty_Dog on January 12, 2015, 10:11:44 AM
Second post

The second half of 2014 saw the mainstream media focused on the West African Ebola outbreak and the potential for a widespread epidemic. But the turn of the calendar year has arrived with much more optimistic news for world health. An article published Wednesday in the scientific journal Nature reported the discovery of a new antibiotic. Representing what could very well be a paradigm shift, the paper chronicles two very important developments. The first is that this new antibiotic targets the bacterial cell in a way that prevents the easy development of resistance.

Teixobactin, the new antibiotic discussed in the article that works by targeting lipids that are essential to forming the cell wall, did not exhibit any antibacterial resistance when tested against bacteria mutated in the lab. The second development is perhaps even more groundbreaking. The researchers developed a new methodology to grow and isolate potential antibiotic targets. Up to this point, only a fraction of possible compounds could be cultivated in the lab, limiting researchers' ability to test new targets for activity against bacteria. This new method opens the door to a whole new world of possibilities.
Dangers of Drug-Resistant Bacteria

These developments are a huge breakthrough for biology and medicine, but what does this mean for us as a geopolitical forecasting firm? Ebola showed us that just because a disease is covered in the news does not mean that it has a global or immediately obvious geopolitical impact. However, the potential for economic disruption from epidemics and endemic diseases, through lower production and increased expenditures because of treatment or trade restrictions, remains a possibility that would have geopolitical implications. Malaria, for instance, hinders the economic growth of developing countries looking to take advantage of low-end manufacturing opportunities as China's economy shifts. And while this new drug will not have an impact on the malaria epidemic, it could stop another in its tracks.

What is a Geopolitical Diary? George Friedman Explains.

Drug-resistant bacterial infections are a growing problem, one that until Wednesday did not have a good solution. Many antibacterial agents utilize the same chemical scaffolds or backbone, some of which have been around since the 1940s. Bacteria can and do easily mutate to adapt, and the overuse of antibiotics has contributed to the development of antibacterial-resistant strains of a number of diseases. Hospitals are seeing a rising number of MRSA (methicillin-resistant Staphylococcus aureus) cases, and drug-resistant tuberculosis is spreading throughout the globe. The high cost of treating drug-resistant tuberculosis, especially prevalent in Russia, Central Asia and Eastern Europe, put increased pressure on already struggling economies. The situation had reached a point to where speculation as to what a post-antibiotic society would look like was not completely unwarranted — and some of the scarier scenarios looked much like a pre-antibiotic society.

With little incentive for pharmaceutical companies to invest in expensive drug development, in part because of the development of resistance inherent in many classes of antibiotics, there had been little development or advancement in the field in decades, and resistance continued to rise. Teixobactin or another yet-to-be-discovered molecule could change that. Teixobactin attacks a specific family of bacteria — gram-positive, which includes the bacteria that causes both strep and staph infections — in a way that is not prone to the development of resistance. Resistance is less likely because of where the drug is active. Whereas some other antibiotics target proteins, teixobactin is believed to target lipids. The formation of proteins lends itself more easily to mutation than the synthesis of lipids. In initial tests, teixobactin showed efficacy in fighting drug-resistant tuberculosis.
Exciting, but Not Immediate

Teixobactin is not a panacea. It does not work on gram-negative bacteria, a family that includes the bacterium that causes cholera. That is where the second and perhaps more important finding of the paper comes into play. The biological and medical communities now have a method to access a wide array of possible drugs that previously could not be studied. To put into perspective the staggering number of new possibilities, previously, only 1 percent of microbial targets could be cultured or grown in a lab, which is required to test for antibacterial activity. This new technique, which utilizes special equipment — a device called the iChip, which enables numerous bacteria to be grown and tested in their natural environments, such as soil, instead of using traditional laboratory methods — opens the door to the other 99 percent.

However, while incredibly exciting, this discovery does not necessarily have immediate geopolitical implications. It will not necessarily make drugs cheaper or more readily accessible to developing nations. It will also take several years to develop teixobactin and many more to discover other new drugs. What it really gives is an insurance policy of sorts. Disease outbreaks are hard to predict and rarely have global geopolitical impacts, but when they do, there is the potential for those implications to be staggering. The fear remains that an outbreak on the scale of the Spanish flu pandemic of 1918 could occur, and in a world that has become far more globalized in the past 100 years, the effects would reverberate through the world much more quickly. Widespread infections, decreased productivity, trade restrictions and border closures could all have economic ramifications that would matter at the geopolitical level.

And while this new discovery does not protect against viruses or parasitic diseases, it does provide a new set of weapons against bacterial infections. The "zombie apocalypse" may still come, but this recent technological advancement makes it far less likely to be in the form of drug-resistant bacteria.

Read more: New Antibiotic Creates Staggering Possibilities | Stratfor
Follow us: @stratfor on Twitter | Stratfor on Facebook
Title: Fed funding for antibiotic research?
Post by: Crafty_Dog on February 04, 2015, 02:05:07 PM
Title: Big Hope for New Molecule against AIDs
Post by: Crafty_Dog on February 18, 2015, 07:26:37 AM
Scientists have engineered a new molecule they say can block infection with the virus that causes AIDS, a discovery that could lead potentially to a new therapy for patients as well as an alternative to a vaccine.

Researchers have been trying for three decades to develop an effective vaccine against the human immunodeficiency virus, which causes AIDS. They are also searching for a way to flush HIV out of the bodies of the infected, to cure them. But the ever-evolving virus has eluded them thus far.

Now, a team from the Scripps Research Institute and other institutions says it has identified a new way to prevent HIV from infecting cells, using an approach that resembles gene therapy or transfer.

HIV normally invades the body through two cellular receptors. The new protein the scientists created blocks the points where the virus binds to both receptors, leaving no point of entry.

Because it attaches to both receptors rather than just one, the protein, called eCD4-IG, blocks more HIV strains than any of several powerful antibodies that have been shown to disable the virus, the researchers said. The research was published online Wednesday by the journal Nature.

“It is absolutely 100% effective,” said Michael Farzan, a professor of infectious diseases at the Scripps Research Institute in Jupiter, Fla. and lead author of the study. “There is no question that it is by far the broadest entry inhibitor out there.”

The approach has been tested only on four rhesus monkeys, and has yet to be tried on humans.

But the researchers and other scientists not involved with the work said it shows promise and should move into human testing quickly. An estimated 35 million people are infected with HIV, but only 13.6 million receive drug treatment to keep the virus from spreading.

“It’s very clever and very powerful,” said Nancy Haigwood, an HIV researcher at Oregon Health & Science University, who wasn’t involved in the study. “This is going to be much better than any vaccine on the horizon,” said Dr. Haigwood, who also wrote about its potential as a vaccine alternative in a commentary in Nature.

The scientists created the protein by fusing together elements of both cellular receptors to which HIV binds. They then injected genetic material from the protein into a muscle of the rhesus monkeys, stimulating production of the new molecule.

They infected the monkeys with multiple hybrid versions of HIV, administering up to four times the amount of virus it took to infect a control group. The protein protected the monkeys for 40 weeks.

Dr. Farzan said the monkeys were uninfected even when given 16 times the amount of virus that it took to infect the control group in experiments conducted after the study was completed.

He said he hoped human trials could begin within a year, after more testing in animals that is already under way. The first step, he said, would be to gauge the ability of the molecule to keep virus levels in HIV-positive people in check.

“We believe our goal now is to show it can work therapeutically,” he said.

The next step would be to test its efficacy as a vaccine, in people who don’t have the virus but are at high risk of infection, Dr. Farzan said.

The work builds on a 2009 study that proposed using gene transfer as an alternative to a traditional vaccine for HIV.

Philip Johnson, a professor at the University of Pennsylvania who led that earlier work, said the new research offers promise for that concept. “It appears to be an extraordinarily potent molecule,” he said. “It’s further validating of the idea that we should be thinking in alternate terms about how to attack HIV vaccines.”

He said it should be tested in humans right away. “To me the nonhuman primate data are outstanding,” he said.

Write to Betsy McKay at
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 01, 2015, 02:18:06 PM
Well wait a second.  It was Obama's policies that allowed the Ebola virus into the US that led to her infection.   This was the same girl shown hugging Obamster.  She should be blaming him.  Not the hospital.
Title: Scientists delete HIV
Post by: Crafty_Dog on March 25, 2015, 05:01:09 AM
Title: Looks like my concerns were well-founded
Post by: Crafty_Dog on April 02, 2015, 08:41:45 AM
Title: POTH: AIDs outbreak in Indiana
Post by: Crafty_Dog on May 06, 2015, 10:13:01 AM
Rural Indiana Struggles to Contend With H.I.V. Outbreak

Sherry McNeely, right, a nurse, testing for H.I.V. on Monday in a mobile testing unit in Austin, Ind. Credit Aaron P. Bernstein for The New York Times

AUSTIN, Ind. — She became addicted to painkillers over a decade ago, when a car wreck left her with a broken back and doctors prescribed OxyContin during her recovery. Then came a new prescription opiate, Opana, easily obtained on the street and more potent when crushed, dissolved in water and injected. She did just that, many times a day, sometimes sharing needles with other addicts.

Last month, the thin, 45-year-old woman learned the unforgiving consequences. She tested positive for H.I.V., one of nearly 150 cases in this socially conservative, largely rural region just north of the Kentucky border. Now a life long hobbled by addiction is, like so many others here, consumed by fear.

She is afraid to start antiretroviral therapy because she does not want to be spotted entering the clinic on Main Street, she says, and afraid to learn her prognosis after hearing a rumor — false, it turns out — that someone else with the virus was given six months to live. Other drug users have refused to be tested at all.

“I thought it was just a homosexual disease,” the woman said one recent evening, twisting a tissue in her manicured hands as tears filled her eyes. She asked that her name not be published out of concerns about being stigmatized. “I didn’t ever think it would be in my small hometown.”

The crisis would test even a large metropolis; Austin, population 4,200, is overwhelmed despite help from the Centers for Disease Control and Prevention, the state and nonprofit groups like the AIDS Healthcare Foundation. H.I.V. had been all but unknown here, and misinformation is rife. Attempts to halt the outbreak have been hindered by strong but misguided local beliefs about how to address it, according to people involved in the response.

Gov. Mike Pence reluctantly authorized a needle exchange program last month, but local officials are not running it according to best practices, outside experts say. Austin residents still must wait for addiction treatment, even though they have been given priority. And getting those who are H.I.V.-positive on medication, and making sure they adhere to the protocol, has been difficult.

Officials here say the need for education is urgent and deep; even local health workers are learning as they go. Brittany Combs, the public health nurse for Scott County, said she was stunned to discover from talking to addicts that many were using the same needle up to 300 times, until it broke off in their arms. Some were in the habit of using nail polish to mark syringes as their own, but with needles scarce and houses full of people frequently shooting up together, efforts to avoid sharing often failed.

Ms. Combs also learned that many addicts were uncomfortable visiting a needle distribution center that opened April 4 on the outskirts of town. So she started taking needles directly to users in their neighborhoods.

At the same time, H.I.V. specialists from Indianapolis — who have evaluated about 50 people with the virus here so far and started about 20 of them on antiretroviral drugs — are fighting a barrage of misinformation about the virus in Scott County, where almost all residents are white, few go to college and one in five live in poverty, according to the census.

“There are still a significant proportion of people in Austin who have biases about H.I.V. and are contributing to the stigma and subsequent fear,” said Dr. Diane Janowicz, an infectious disease specialist at Indiana University, who is treating H.I.V. patients here. “I have to reassure them: If your grandkid wants a sip of your drink, you can share it. It’s O.K. to eat at the same table. You can use the same bathroom.”

Many whose H.I.V. has been newly diagnosed here have strikingly high amounts of it in their blood, Dr. Janowicz said, and in one patient the H.I.V. has progressed to AIDS. Nonetheless, she said, “if they take their medicine for H.I.V., this is a chronic disease, not something they have to die from.”

Another complication is that the needle exchange has faced strong local resistance. Mr. Pence, a Republican, generally opposes such programs, saying they perpetuate drug use. Many residents here feel the same.

“If you would have asked me last year if I was for a needle exchange program, I would have said you’re nuts,” Ms. Combs said. “I thought, just like a lot of people do, that it’s enabling — that you’re just giving needles out and assisting them in their drug habit. But then I did the research on it, and there’s 28 years of research to prove that it actually works.”

But researchers say Scott County’s hastily created exchange has several features that could sharply curb its effectiveness. To get clean needles, drug users have to register, using their birth date and a few letters from their name to create an identification number that goes on a laminated card. The police are arresting anyone found with needles but no card, saying it will prod more people to participate.

Shortly after the needle exchange began, sheriff’s deputies visited a house in Austin and found a man who had joined the program and a woman who had not. They did not arrest the man, Sheriff Dan McClain said, although they confiscated a number of clean needles he had received from a volunteer group that was not part of the official program. But they did arrest the woman, who had “a freshly used needle lying next to her” in a bed spattered with blood, Sheriff McClain said.

“If they’ve got one needle and they’re not in the program, they’re going to jail,” Sheriff McClain said.

Dr. Don Des Jarlais, the director of research for the chemical dependency institute at Mount Sinai Beth Israel hospital in New York, said the most successful needle exchange programs let participants pass out syringes to peers who remain in the shadows instead of requiring everyone to sign up. Arresting drug users who are not officially enrolled in the program “makes it hard to build trust,” Dr. Des Jarlais said, adding, “You’re not going to be able to get enough syringes out to really stop the epidemic if you have those types of restrictions.”

Local supporters of the needle exchange say a limited program is better than none, and believe that improvements will come with time. Last week, the state legislature sent a bill to Mr. Pence that would allow communities to create needle exchange programs for up to a year if they are experiencing an epidemic of H.I.V. or hepatitis C because of intravenous drug use. Mr. Pence said he would sign the measure, noting in a statement that it would allow only “limited and accountable” needle exchange programs, and only “where public health emergencies warrant such action.”

For now, the program here is giving out a maximum of 140 clean needles per user per week to whoever goes to the outreach center or accepts them from the roaming minivan. Ms. Combs said some people told her they injected as often as 15 times a day, and the exchange is erring on the side of providing slightly more than people need. She has passed out needles at a house where the owner, an older woman known as Momma, sits on the porch while a steady stream of visitors comes to shoot up inside. She has knocked on the door of a trailer where, she said, “multiple family members live and the daughters all prostitute themselves out and everyone is doing drugs.” One recent afternoon, on a street fragrant with lilacs, a young woman on a bicycle declined Ms. Combs’s offer of clean needles, saying she already had some — and H.I.V.

“I know I need the medicine to slow it down,” she murmured.

At a run-down house with a wheelchair on the porch, Tiffany Prater, 27, walked out to greet the van, saying, “The needles ain’t lasting me long enough.” She beckoned two men out of the house to get some, too.

“This little boy right here needs a card,” she told Ms. Combs, gesturing toward an expressionless friend whose eyes kept slipping shut. “You got some extra Neosporin and stuff? Because look how bad his arms is.”

The van moved on, stopping as someone yelled from a white house with a broad lawn. A woman in a pink tank top emerged, saying a neighbor had taken some of her clean needles and her daughter’s, too.

The daughter could not come out of the house — she had just injected and “can’t get up from the kitchen table,” the mother said. Ms. Combs gave the woman needles for her and her daughter.

“Spread the word that this white vehicle is a friendly mobile,” she said.

As of Tuesday, the exchange had distributed 9,491 needles to 223 people, including many repeat customers. About 8,300 needles had been returned to the exchange, but not all of them came from the exchange program.

Some participants say they are happy to have clean needles but would be happier in treatment. While some intravenous drug users from Austin have recently gone into treatment at a residential center in Jeffersonville, about 30 miles away, others are still waiting for a bed.

A 23-year-old user with H.I.V. said he had gone to the community outreach center to get clean needles and seek addiction treatment, but was put on a waiting list. Two weeks later, he is still waiting.

Opana remains easy to get, he added, a quarter of a pill selling for $40 — enough of a dose to ease his withdrawal symptoms and enable him to get out of bed.

One unexpected benefit of the H.I.V. outbreak, according to the woman who tested positive and fears starting treatment, is that the men who used to stream into town daily, seeking young female addicts who would prostitute themselves in exchange for drug money, have all but disappeared.

“It took H.I.V. to change our town,” she said. “Those of us who are affected are devastated, but I’m glad H.I.V. is here.”
Title: Scientist creates virus that can kill mankind
Post by: Crafty_Dog on July 23, 2015, 10:20:48 AM
Title: Re: Scientist creates virus that can kill mankind
Post by: G M on July 24, 2015, 04:52:32 PM

No worries. What could go wrong?
Title: The Flip Side
Post by: Body-by-Guinness on August 24, 2015, 06:48:23 PM
A universal flu vacine?
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on August 27, 2015, 11:23:59 AM
We live in wondrous times.
Title: Big step towards AIDs cure
Post by: Crafty_Dog on August 31, 2015, 09:26:07 AM
Title: Zika - latest opinion
Post by: ccp on January 31, 2016, 07:24:02 AM
@this time this is the opinion.  I wonder if the seasons being opposite in S America to N America helps reduce the chance of spread here.  I imagine though that this will be a perineal problem and will be interesting to see if much of it is here in the spring:
Title: wow.
Post by: ccp on February 02, 2016, 01:58:50 PM

Ebola can do this too but seems to be rare.  I wonder how common this is:

Title: Zika virus about to hit Puerto Rico really hard (25%!!!) and from there, into US
Post by: Crafty_Dog on March 20, 2016, 05:55:43 AM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 20, 2016, 08:27:31 AM
25 % in one year is unbelievable.  Guillain Barre is also a concern as well as pregnancy. 

No stopping it.

I wonder if once one has it are they later immune.  Will it mutate?


4 NEW deaths of Ebola in Guinea.  I was part of a response team in NJ for Ebola and we just finished the program screening passengers coming to the US as epidemic seemed over - for this time around.

We still do not know the vector - yes it appears to be from exposure to "bush" meat like monkeys or bats.  But how does it get into the bush meat?  No one knows.  Insects maybe the true carriers as per some of the very brave researchers who go out in the field and study these things.  Often the limits to researching this is money.

CDC does incredible work.  Their facilities are gigantic in Atlanta.  And many of the people we met are brilliant.  I only wish they would not get into issues that every bit as political as oriented to disease.

What is "disease" about gun ownership.  What is disease about sea pollution?  What is disease about trans fat?  etc.

Title: Has Superbug arrived?
Post by: Crafty_Dog on May 26, 2016, 11:24:33 PM
Title: Wow what a coincidence
Post by: ccp on May 31, 2016, 05:32:45 PM
I only post this because there is something strange with the whole story

Women with Zika from Central America breaks out in rash and comes here on "vacation" then gives birth just after arriving in hospital where there just happens to be an OBGyn who works for Fox news.

Sound fishy to me.  Hackensack is definitely is a major publicity seeking hospital:
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on June 04, 2016, 07:20:45 PM
Very curious, very alert of you!
Title: What will happen when anti-biotics stop working?
Post by: Crafty_Dog on June 06, 2016, 11:22:48 AM
Title: Excrement rapidly approaching fan-- superbug!
Post by: Crafty_Dog on December 07, 2016, 04:39:28 PM
Title: Komodo dragon saliva vs. superbugs
Post by: Crafty_Dog on February 24, 2017, 11:32:16 PM
Title: A nasty fungus among us
Post by: Crafty_Dog on March 11, 2017, 09:57:27 AM
Title: Natural counter to Lyme Disease?
Post by: Crafty_Dog on April 25, 2017, 09:14:47 AM
Title: Stratfor: The geopolitics of the Flu
Post by: Crafty_Dog on January 16, 2018, 11:23:07 AM

    On the 100-year anniversary of the 1918 flu pandemic, the Northern Hemisphere's flu season is poised to be a rough one.
    Medical advances and technology have helped people effectively combat a multitude of diseases, but the risk of a flu pandemic remains.
    Technological innovations in data analytics could help prevent the spread of disease, but they could face policy roadblocks.

One hundred years ago on the plains of southwestern Kansas, a storm was brewing. But it was not one bearing rains to support the area's residents, nor would it bring the winds and dust that would ravage the same land less than two decades later. Instead, a microscopic clump of proteins, genetic material, fats and carbohydrates was shaping up to cause the worst global disease pandemic in modern history: In the span of about a year from 1918 to 1919, the Spanish influenza killed an estimated 20 million to 50 million people around the world. Many factors that contributed to the outbreak's severity were unique to their time. The wartime world was more connected, allowing the virus to spread faster than ever, but the still-nascent understanding of how diseases worked meant that sanitation guidelines and treatment methods were lagging. Meanwhile, World War I had ravaged economies and populations across the globe and contributed to media censorship that limited the dissemination of information about the disease.

Since then, vaccines and medicines have been developed to fight diseases of all sorts. Moreover, people now can more closely monitor the spread of disease through social media and the 24-hour news cycle. And yet, the influenza virus, with its ability to rapidly mutate and adapt, remains one of the world's greatest disease threats. Each year, the flu virus kills thousands and poses tens of billions of dollars in treatment costs and equivalent amounts in economic losses in the United States alone. Countries and corporations have long been working to develop a universal vaccine that targets all strains of the flu, and in the coming years, these efforts will continue alongside the increased focus on data sharing, social media and blockchain — all key tools for disease outbreak control. In this way, the flu exists at the intersection of geopolitics and disease. Indeed, as countries continue trying to regulate developing technological sectors, they will also, perhaps inadvertently, effect how diseases are monitored, controlled and contained.

A Lesson 100 Years Long

As December 1917 faded into 1918, World War I raged on, providing perfect breeding grounds for multiple diseases. Training camps and hospitals brimmed with soldiers from around the world, while those on the front lines languished in deplorable conditions. Yet author of The Great Influenza John M. Barry suggests that what would become known as the Spanish flu first emerged in the civilian community of Haskell County, Kansas, in January 1918. Historians may never be certain of its exact origins, but Barry postulates that the disease spread to the nearby Camp Funston military training grounds in the spring, before U.S. troop deployments took it global. The flu did not acquire its moniker until it hit the shores of Spain, a country not at war and therefore more open about recording the presence of the disease in its media. By the fall of 1918, the war was nearing its end, but the flu was at full force, targeting the healthy as well as the very young and old. It had infected hundreds of millions by the time it waned in 1919.

Vaccines, antiviral medication, improved sanitary measures and generally better medical care have dramatically decreased the threat of the flu in the last century. However, the race against evolution continues: None of these advances have been able to completely combat the rapidly evolving nature of the disease. The flu that hit in 1918 was a strain of H1N1, but there are dozens of possible flu types that can arise from combining the proteins on the outside of the virus called hemagglutinin (H) and neuraminidase (N). So far, scientists have identified 18 types of hemagglutinin and 11 types of neuraminidase — any combination of which yields a new and unique flu, from H2N2 to H3N2 to H5N1 to H7N9. Mutations can alter the severity of the illness and limit the effectiveness of existing treatments year after year.

To cause a new pandemic, the virus would need to mutate into a form that makes it transmittable among humans, easily spread and very deadly. The emergence of a flu strain with this trifecta of traits is unlikely, but given the interconnectivity of the current world, if one did, the risks of widespread contagion would be high. And even the most pedestrian flu seasons exact a death toll in the thousands.

The CDC recently changed the topic of its Jan. 16 meeting from nuclear war preparedness to the flu.

A Flu Season Fit for an Anniversary

While unlikely to reach pandemic levels, the 2017-2018 flu season has gotten off to an early and vigorous start. Australia, where the flu season typically runs from April to September, has historically been a harbinger of the severity of each year's emergent strain of influenza elsewhere. This year's vaccine did little to prevent the spread of the virus in the country, leading many to accurately predict a brutal 2018 flu season for those north of the equator. In the United States, a high number of infections has prompted schools to close in some places and hospitals to institute visitation limits; so far, only Hawaii has not experienced a widespread number of flu cases.

The U.S. Centers for Disease Control and Prevention (CDC) reports that this year's flu vaccine has been effective in only 32 percent of the population. Additionally, the type of virus that is dominant in the United States this year, H3N2, typically causes more severe symptoms than other common strains. These factors together have caused mortality rates for this year's outbreak to reach epidemic levels throughout the country, according to the most recent CDC update. In response, the CDC recently changed the topic of its Jan. 16 meeting from nuclear war preparedness to the flu.

One hundred years removed from the global pandemic, there is still work to be done in the fight against the flu. While current vaccines typically target the parts of the flu virus that change year to year, firms such as the Alphabet Inc.-funded Vaccitech are working to develop a "holy grail" vaccine that targets the parts that do not easily mutate. Vaccitech hopes to have a universal vaccine, which would boost efficacy rates over current approaches, ready by 2025. In December, the National Institutes of Health (NIH) removed a three-year ban on funding for "gain of function" studies, in which researchers study mutations that change how viruses work, including those that cause Severe Acute Respiratory Syndrome (SARS), Ebola and influenza. Funding from an institution as large as the NIH is another major factor in helping scientists stay one step ahead of viruses, and it could eventually aid in the creation of flu vaccines or treatments for new strains.

New Rules for New Tools

Developments in technology  — particularly in the area of data science, which can allow researchers nonmedical avenues for tracking diseases and preventing their spread — are crucial in the ongoing fight against disease outbreaks. A recent paper in the Journal of the Royal Society Interface, for example, outlined how Facebook could be used to track and target human bridges of transmission. By identifying individuals who act as hubs for the spread of disease, medical professionals could more effectively and efficiently distribute limited vaccines in the event of a widespread outbreak. Other social media outlets all have the potential to play a similar role. Meanwhile, blockchain technology, which allows for the storage of massive amounts of personal data, also offers opportunities for tracking the spread and risk of diseases such as the flu. It would not only allow the efficient transmission and sharing of data — it would enable users to maintain privacy standards, a quality that will become increasingly valuable in the future.

The use of these and other technological advancements to help with disease control may face policy roadblocks, as data sharing and data privacy become key topics of political discussion. As the world becomes ever-more digital, and the amount of available data to analyze increases, governments will diligently focus on developing regulations for how that data is shared. Already, countries the world over are prioritizing intellectual property and digital rights in trade negotiations.

Data sharing and collection is vital for the understanding of disease; indeed, some experts attribute the severity of the SARS outbreak in 2003 to a lack of communication between Beijing and the rest of the world. But in the future, strict regulations developed by countries trying to protect their citizens' privacy may hamper communication efforts. In 2016, for example, the European Union instituted the General Data Protection Regulation, which gave its citizens greater control over how their personal data is shared and distributed. Perhaps more importantly, this new privacy law also permits countries to fine companies found in violation. Of course, the intent of such laws is not to prevent helpful medical communication, but rather to prevent the distribution of private information. But they could still delay the global implementation of these kind of technologies for epidemiological purposes, as governments try to sort out how and when to make exceptions for the medical community.

In the 100 years since the Spanish flu reached even the most remote corners of the globe, society has made countless improvements as it learns more about the science of disease. But though people are better equipped to treat victims and limit the spread of viruses with vaccines and other medicines, the risk of a global pandemic remains. Emerging technologies provide valuable tools for advancing disease control, but policy and regulation have the potential to limit or delay their impact. At the intersection of health, technology and geopolitics, the regulation of data policies have the ability to stir up storms that can spread far beyond Silicon Valley.
Title: Global Pandemic Will Happen
Post by: Crafty_Dog on January 30, 2018, 07:21:00 AM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on January 30, 2018, 04:05:32 PM


All day long I am seeing people with flu

It is amazing to me how many still do not get flu shots.  "I got sicker then I ever got when I got the shot 5 yrs ago and I will never do it again"
or "I don't believe in shots"  or this one is the best "I never got the flu before" 

People travel with the flu . They go on airplanes knowing they are sick .  Too hard to postpone a flight so they just expose another 100 to 200  or more people at airports.

Forget about the paper masks.

What exactly is the CDC supposed to do?
or the WHO ? 

They are working on vaccines but as far as I have heard not on antiviral medicines that are better than tamiflu.
you can put or the toilet washes you want around NYC like they did with the cameras and that ain't gonna stop it.

For God's sake we can't cure the common cold

You got aids - you live forever now.  You got hep c we can cure you.  You got a cold - tough shit.

Title: WSJ: New class of anti-biotics?
Post by: Crafty_Dog on February 12, 2018, 12:29:29 PM
y Robert Lee Hotz
Updated Feb. 12, 2018 11:14 a.m. ET

In a bag of backyard dirt, scientists have discovered a powerful new group of antibiotics they say can wipe out many infections in lab and animal tests, including some microbes that are resistant to most traditional antibiotics.

Researchers at Rockefeller University in New York reported the discovery of the new antibiotics, called malacidins, on Monday in the journal Nature Microbiology.

It is the latest in a series of promising antibiotics found through innovative genetic sequencing techniques that allow researchers to screen thousands of soil bacteria that previously could not be grown or studied in the laboratory. To identify the new compounds, the Rockefeller researchers sifted through genetic material culled from 1,500 soil samples.

“We extract DNA directly out of soil samples,” said biochemist Sean Brady at Rockefeller’s Laboratory for Genetically Encoded Small Molecules, a senior author on the new study. “We put it into a bug we can grow easily in the laboratory and see if it can make new molecules—the basis of new antibiotics.”

The new compounds appear to interfere with the ability of infectious bacteria to build cell walls—a function so basic to cellular life that it seems unlikely that the microbes could evolve a way to resist it. In lab tests, bacteria were exposed to the experimental antibiotics for 21 days without developing resistance, the scientists said.

So far, the new compounds also appear safe and effective in mice, but there are no plans yet to submit it for human testing. “It is early days for these compounds,” Dr. Brady said.

This image shows Enterobacteriaceae, a group of bacteria that includes common pathogens such as such as salmonella and shigella. Photo: U.S. Centers for Disease Control and Prevention

The discovery of antibiotics in the early 20th century transformed modern medicine, but many of them gradually became ineffective as bacteria evolved defenses, often by acquiring protective genes from other more-resistant micro-organisms.

In the U.S. alone, at least two million illnesses and 23,000 deaths can be attributed each year to antibiotic-resistant bacteria, according to the U.S. Centers for Disease Control and Prevention. World-wide, deaths due to untreatable infections are predicted to rise 10-fold by 2050.

About 48 experimental antibiotics are undergoing clinical trials. Few of them, though, are aimed at the most intractable drug-resistant infections and, if past history is any guide, most are unlikely to be approved for patient use, several public-health experts said.

“Only a fraction of those will make it,” said Kathy Talkington, director of the Antibiotic Resistance Project at the Pew Charitable Trusts in Washington, D.C. “Generating new antibiotics and new therapies will take a while.”

In the quest for new antibiotics, researchers like Dr. Brady and others are deploying advanced genomics, synthetic-biology tools, and a variety of other innovative ways to explore a vast natural reservoir of bacteria notoriously difficult to isolate and study—the so-called “dark matter” of microbiology.

In May, researchers led by chemist Dale Boger at the Scripps Research Institute in San Diego created a more-potent version of vancomycin—considered an antibiotic of last resort for the most intractable infections. In a soil sample from Italy, researchers at Rutgers University last June unearthed a powerful new antibiotic called pseudouridimycin. Neither, though, is ready for clinical trials.

At Northeastern University in Boston, microbiologist Slava Epstein and his colleagues have screened thousands of bacteria strains using a portable device he invented called the iChip that allows bio-prospectors to isolate and grow finicky micro-organisms.

Researchers created an online citizen science project called ‘Drugs from Dirt’ that solicits donations of dirt from volunteers around the world.

In 2016, they discovered an antibiotic called teixobactin. It too is years away from clinical trials.

“I did not understand how long it takes to develop an antibiotic, even when things go well,” he said.

To broaden their search for new therapeutic compounds, Dr. Brady and his Rockefeller colleagues set up an online citizen science project called “Drugs from Dirt” that solicits soil donations from around the world. The sandy soil that yielded the new malacidin antibiotics was shipped by relatives from the southwestern U.S.

“I think my parents sent it to me,” said Dr. Brady.

Write to Robert Lee Hotz at
Title: new class of antibiotics
Post by: ccp on February 12, 2018, 03:34:26 PM
Good article thanks - I hadn't seen this yet.  Do we have a company to invest in yet?   :wink:
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on February 15, 2018, 08:06:32 AM
If you find one/some please let us know here!
Title: Komodo Dragon Blood Peptide
Post by: Crafty_Dog on March 11, 2018, 11:00:09 AM
Title: 86% of TB cases are immigrants
Post by: Crafty_Dog on March 27, 2018, 09:58:50 PM
Title: Re: 86% of TB cases are immigrants
Post by: G M on March 28, 2018, 06:48:59 AM

Gee, that's strange. Legal immigrants have to be screened for TB. I wonder how these immigrants didn't get screened.
Title: POTH: Tick and Mosquito infections spreading rapidly
Post by: Crafty_Dog on May 01, 2018, 10:36:53 AM
Tick and Mosquito Infections Spreading Rapidly, C.D.C. Finds
More Americans are living in wooded suburbs near deer, which carry the ticks that spread Lyme disease, anaplasmosis, Rocky Mountain spotted fever, babesiosis, rabbit fever and Powassan virus.CreditScott Camazine/Science Source

By Donald G. McNeil Jr.
May 1, 2018

The number of people who get diseases transmitted by mosquito, tick and flea bites has more than tripled in the United States in recent years, federal health officials reported on Tuesday. Since 2004, at least nine such diseases have been newly discovered or introduced into the United States.

Warmer weather is an important cause of the surge in cases reported to the Centers for Disease Control and Prevention, according to the lead author of a study in the agency’s Morbidity and Mortality Weekly Report.

But the author, Dr. Lyle R. Petersen, the agency’s director of vector-borne diseases, repeatedly declined to connect the increase to the politically fraught issue of climate change, and the report does not mention either climate change or global warming.

Many other factors are at work, he emphasized, while noting that “the numbers on some of these diseases have gone to astronomical levels.”

C.D.C. officials called for more support for state and local health departments. Local agencies “are our first line of defense,” said Dr. Robert Redfield, the C.D.C.’s new director. “We must enhance our investment in their ability to fight these diseases.”

Although state and local health departments get brief infusions of cash during scares like the 2016 Zika epidemic, they are chronically underfunded. A recent survey of mosquito control agencies found that 84 percent needed help with basics like surveillance and pesticide-resistance testing, Dr. Petersen said.

While the C.D.C. did not suggest that Americans drop plans for playing outdoors or lying in hammocks this summer, Dr. Redfield emphasized that everyone — especially children — needed to protect themselves against tick and mosquito bites.

Between 2004 and 2016, about 643,000 cases of 16 insect-borne illnesses were reported to the C.D.C. — 27,000 a year in 2004, rising to 96,000 by 2016. (The year 2004 was chosen as a baseline because the agency began requiring more detailed reporting then.)

The real case numbers were undoubtedly far larger, Dr. Petersen said. For example, the C.D.C. estimates that about 300,000 Americans get Lyme disease each year, but only about 35,000 diagnoses are reported.

The study did not delve into the reasons for the increase, but Dr. Petersen said it was probably caused by many factors, including two related to weather: Ticks thriving in regions previously too cold for them, and hot spells triggering outbreaks of mosquito-borne diseases.

Other factors, he said, include expanded human travel, suburban reforestation and a dearth of new vaccines to stop outbreaks.

In an interview, Dr. Petersen said he was “not under any pressure to say anything or not say anything” about climate change and that he had not been asked to keep mentions of it out of the study.

More jet travel from the tropics means that previously obscure viruses like dengue and Zika are moving long distances rapidly in human blood. (By contrast, malaria and yellow fever are thought to have reached the Americas on slave ships three centuries ago.)

A good example, Dr. Petersen said, was chikungunya, which causes joint pain so severe that it is called “bending-up disease.”

In late 2013, a Southeast Asian strain arrived on the Dutch Caribbean island of St. Maarten, its first appearance in this hemisphere. Within one year, local transmission had occurred everywhere in the Americas except Canada, Chile, Peru and Bolivia.

Tickborne diseases, the report found, are rising steadily in the Northeast, the Upper Midwest and California. Ticks spread Lyme disease, anaplasmosis, babesiosis, Rocky Mountain spotted fever, rabbit fever, Powassan virus and other ills, some of them only recently discovered.

Ticks need deer or rodents as their main blood hosts, and those have increased as forests in suburbs have gotten thicker, deer hunting has waned, and rodent predators like foxes have disappeared.

(A century ago, the Northeast had fewer trees than it now does; forests made a comeback as farming shifted west and firewood for heating was replaced by coal, oil and gas.)

Most disease outbreaks related to mosquitoes since 2004 have been in Puerto Rico, the Virgin Islands and American Samoa. But West Nile virus, which arrived in 1999, now appears unpredictably across the country; Dallas, for example, saw a big outbreak in 2012.

For most of these diseases, there are no vaccines and no treatment, so the only way to stop outbreaks is through mosquito control, which is expensive and rarely stops outbreaks. Miami, for instance, was the only city in the Western Hemisphere to halt a Zika outbreak with pesticides.

The only flea-borne disease in the report is plague, the bacterium responsible for the medieval Black Death. It remains rare but persistent: Between two and 17 cases were reported from 2004 to 2016, mostly in the Southwest. The infection can be cured with antibiotics.

Dr. Nicholas Watts, a global health specialist at University College London and co-author of a major 2017 report on climate change and health, said warmer weather is spreading disease in many wealthy countries, not just the United States.

In Britain, he said, tick diseases are expanding as summers lengthen, and malaria is becoming more common in the northern reaches of Australia.

But Paul Reiter, a medical entomologist at the Pasteur Institute, has argued that some environmentalists exaggerate the disease threats posed by climate change.

The 2003-2014 period fell during what he described as “a pause” in global warming, although the notion of a long trend having pauses is disputed.

Also, disease-transmission dynamics are complicated, and driven by more than temperature. For example, transmission of West Nile virus requires that certain birds be present, too.

In the Dust Bowl years of the 1930s, St. Louis encephalitis, a related virus, surged, “and it looked like climate issues were involved,” Dr. Reiter said. But the surge turned out to depend more on varying hot-cold and wet-dry spells and the interplay of two different mosquito species. St. Louis encephalitis virtually disappeared, weather notwithstanding.

“It’s a complicated, multidimensional system,” he said.

A. Marm Kilpatrick, a disease ecologist at the University of California, Santa Cruz, said many factors beside hot weather were at work, including “a hump-shaped relationship between temperature and transmission potential.”

Warm weather helps mosquitoes and ticks breed and transmit disease faster, he explained. But after a certain point, the hotter and drier it gets, the more quickly the pests die. So disease transmission to humans peaks somewhere between mildly warm and hellishly hot weather.

Experts also pointed out that the increase in reports of spreading disease may have resulted partially from more testing.

Lyme disease made family doctors begin to suspect tick bites in patients with fevers and to blood more often. Laboratories began looking for different pathogens, especially in patients who did not have Lyme. That led to the discovery of previously unknown diseases.
Title: flu season has started
Post by: ccp on September 11, 2018, 08:33:57 AM
We are getting reports of flu in Texas and Florida so far

So all *patriots* and families may want to get their flu shots now,

I will not post this on Huff[com]post.

Title: Chicken poxed illegal aliens
Post by: Crafty_Dog on May 19, 2019, 08:43:36 PM
Title: Stratfor: Risks follow spread of new virus out of China
Post by: Crafty_Dog on January 22, 2020, 08:32:14 PM
Questions of Risk Follow the Spread of a New Virus out of China
Jan 23, 2020 | 00:41 GMT
Authorities in Wuhan, China, check the temperature of a passenger at a wharf on the Yangtze River on Jan. 22, 2020.
Security officials check the temperature of passengers at a wharf on the Yangtze River in Wuhan, China, on Jan. 22, 2020. The spread of an emerging coronavirus that has led to 17 deaths so far has prompted emergency health measures across China.

(Getty Images)


Compared with the outbreak of SARS in 2003, greater transparency on the part of the Chinese central government about the spread of a new coronavirus that recently surfaced in Wuhan has facilitated earlier responses and greater public awareness.

In the short term, the disease — and the emergency measures introduced in response — will lead to significant logistical disruptions and reduced travel in and out of Hubei province, which will have secondary impacts on China’s manufacturing and export economy.

Moving forward, information transparency, emergency responses at both the national and subnational levels and international coordination will be critical to the management of this emerging virus.

Over the past three days, the reported spread of a deadly strain of coronavirus first detected in Wuhan, China, both within and beyond Chinese borders has raised concerns of a wider outbreak that would increase the risks of significant economic and social impacts in China and the wider world. The coronavirus, which is the same type of virus that led to a disruptive global outbreak of Severe Acute Respiratory Syndrome (SARS) in 2002 and 2003, was first reported in Wuhan in November. Notably, however, compared with the apparent cover-up and scarcity of information released by Chinese officials during the first three months of the SARS outbreak, which first arose in Guangdong province, greater transparency about the current viral outbreak on the part of local and national officials has mobilized an earlier official response and raised public awareness, which could mitigate the extent of its spread.

Still, the exact source of the coronavirus at the heart of the current outbreak and its mutation methods remain unknown. And combined with the up to 14-day asymptomatic period at the early stages of infection and incubation, it's possible that the full extent of the outbreak within China has been underestimated and underreported. At a time of traditionally heavy travel associated with the Chinese New Year season, the disease could well inflict broader impacts on global travel and tourism. It will also test Chinese pandemic management strategies at both the national and subnational levels before the virus can be effectively contained.

The Big Picture

The quick spread of a deadly coronavirus apparently originating in the central Chinese city of Wuhan into other parts of the world has resurfaced memories of the detrimental effects caused by an outbreak of Severe Acute Respiratory Syndrome (SARS) 17 years ago.

At present, 543 confirmed cases of infection have been reported, covering almost all Chinese provinces, including major municipalities such as Beijing and Shanghai, and at least seven other countries, including the United States, Thailand and Japan. Of those confirmed cases, 80 percent have been centered in Hubei province, as well as all 17 of the reported deaths associated with the virus. Among those infected, the vast majority reported living in or traveling to Hubei's provincial capital, Wuhan, with an origination point believed to be a local seafood market.

But the virus has increasingly shown signs of human-to-human transmission. In at least one case, a single patient was found to have infected 14 health care workers. This raises the strong possibility that the new virus strain could easily spread among humans, differentiating it from the coronavirus behind the outbreak of Middle East respiratory syndrome (MERS), a type of bird flu first reported in 2012 in Saudi Arabia, which has a limited ability to spread through human contact. If the ease of human-to-human transmission of the new coronavirus strain is confirmed, it would make tracking, monitoring and effective containment substantially more difficult. This is especially true given Wuhan's status as a national transportation (rail and waterway) crossroads. The city also hosts the largest university cluster in Asia.

The Potential Effects

At this point, the new virus appears to be less deadly and less contagious than the one behind SARS. The death rate for the Wuhan virus appears to be at 3 to 4 percent of infections, versus 9 percent for SARS, and 35 percent for MERS. For comparison, the U.S. Centers for Disease Control and Prevention estimated that 6,600 people have died from the flu during the 2019-20 influenza season, with another 120,000 hospitalizations linked to this season's prevalent influenza strain. Still, much remains unknown about the emerging disease. For instance, the exact source of infection and primary means of transmission, factors that are critical in forecasting the disease's progression and associated socio-economic impacts, have yet to be determined. Likewise, the exact medical measures and antiviral drugs that can be used to control the disease in its early phase have yet to be determined. For perspective, it took about 270 days for the SARS outbreak to be controlled in 2003. But in the short term, a somewhat wider spread of the new virus appears unavoidable before it can be contained.

Given the speed of the spread and apparent relatively high death rate associated with the current outbreak, transparency will be critically important for effective disease management.

Critically, the lengthy incubation period for the new virus, considerably longer than MERS or SARS, means it takes much longer for those infected to show symptoms, thus making early detection and preparation difficult.
Considering the crush of domestic and international travel within and outside China during the Lunar New Year, the two-week incubation period and inconspicuous nature of those infected but not yet showing symptoms can result in significant underreporting or underestimation of the real scale of the virus. This would also delay the necessary response and protective measures that could have been used to prevent a further spread. (This factor can also skew fatality rates, especially if less severe cases are flying under the radar.) What's more, the spread of the disease is highest when symptoms aren't obvious — if that's when the virus is transmitted, as occurred during the SARS outbreak — and when no proper preventive measures are adopted.

A Question of Transparency

Given the speed of the spread and apparent relatively high death rate associated with the current outbreak, transparency will be critically important for effective disease management, including emergency response, mitigation and public awareness. For these reasons, the new disease has resurfaced questions about the credibility of Chinese authorities. During its early stages in 2003, ignorance, deliberate cover-ups and late responses contributed to the unrestrained spread of SARS and brought Beijing to the brink of political crisis. Compared with the four months of delayed reporting and passive responses to SARS, transparency and responsiveness during the current outbreak have increased.

It took 30 days for authorities to report the first case of coronavirus-related pneumonia to the World Health Organization, and about two weeks longer for direct central government intervention — a critical factor in curbing the tendency of local authorities to downplay bad news. Shortly thereafter, a nationwide emergency response, as well as related prevention and control methods, were put into place. Nonetheless, domestic public and international skepticism over a possible cover-up of the current outbreak remains strong. Suspicions were elevated by the fact that several cases of the disease were reported overseas, including in Thailand and Japan, before authorities acknowledged any other cases in China outside of Hubei province. If the transparency issue is not properly managed, the government's credibility could again come under question, possibly resulting in a wider social backlash.
Given that much about the virus remains unknown, the eventual socio-economic and international impacts of the current outbreak by the time it runs its course will be difficult to determine. To put it into perspective, the SARS epidemic in 2003 resulted in more than $40 billion in productivity losses, and the Ebola outbreak in 2014-2016 had an approximate impact of $53 billion. At the least, the current outbreak — and the responses to manage it — can be expected to affect China's logistics and travel sectors and reduce consumption. These effects will come on top of the inevitable disruptions posed by the Lunar New Year that annually weigh on the domestic economy.

What to Expect Next

Questions of Chinese response capacity: On Jan. 22, Wuhan authorities halted all road, waterway and expressway transit in and out of the city and suspended outbound travel by rail and air. This order followed on the heels of an official emergency quarantine by China's health authority affecting hospitals nationwide. In major cities, people have adopted preventive measures such as wearing protective masks. But given local capacity limitations and the limits of available resources, high-level national coordination or even tougher measures, such as employing security forces, may need to be introduced. Hubei province plans to seek national assistance to procure needed supplies, such as protective medical equipment.
Business disruptions: Hubei has the seventh-largest gross domestic product among China's provinces, totaling $541 billion in 2017, and a population of 59 million. Wuhan, meanwhile, is a major Chinese transportation hub as well as a center of scientific research, automobile manufacturing and heavy industry. The emergency measures will significantly disrupt traffic and input goods that rely on road, rail and maritime shipment through Hubei. Those disruptions, in turn, could have secondary effects on major ports — especially Shanghai, which is down the Yangtze River from Wuhan. But as with SARS, the business impact will likely be felt across the country, if not around the world, if the emergency measures remain in place for a considerable period, especially in an age of integrated national connectivity. Elsewhere, the international spread of the disease threatens to disrupt the movement of people and goods as East Asia enters the Lunar New Year holiday season.

International response: The new virus will test pandemic management systems in China and internationally. The CDC has introduced screening and quarantine measures at major U.S. airports that host flights from Wuhan. Countries that have reported cases of the coronavirus, such as South Korea, will be particularly mindful of the risks of human-to-human transmission, given the steep economic impacts of the 2015 MERS outbreak. A massive uptick in the flow of Chinese tourists throughout the Asia-Pacific region will inspire caution in Japan, Southeast Asia and even North Korea as well, although the ability of those countries to screen and manage cases vary widely. Additionally, the World Health Organization will decide on Jan. 23 if it will declare this a global emergency and what that means for funding and world attention.
Title: Re: new virus out of China
Post by: DougMacG on January 23, 2020, 06:05:57 PM

Quarantine a city the size of Wuhan?   How?

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on January 24, 2020, 05:42:12 AM
January 24, 2020   Open as PDF

    Chinese New Year 2020: The Year of the Coronavirus
By: Phillip Orchard

Grappling with internal political pressures, a slowing economy, an open rebellion in Hong Kong and an unresolved trade war with the U.S., Chinese leaders may have already been in a less-than-celebratory mood heading into this year’s Lunar New Year festivities, which begin Jan. 25. The last thing the government needed was an outbreak of infectious disease, particularly when hundreds of millions of people are expected to travel throughout the country and beyond. Not only is that exactly what happened, but the disease – a new type of coronavirus – is unknown to science.

The severity of the virus (known as nCoV or the Wuhan Virus) is uncertain, nor is it clear if it will mutate and spread. The World Health Organization has yet to label it a global health emergency. But it’s certainly not yet contained. As of Thursday, there were more than 653 confirmed cases across seven countries, including the United States, and 18 people had died. And despite repeated assurances that it had matters under control, the government on Wednesday began locking down Wuhan, the provincial capital of Hubei, where the outbreak started, and three nearby cities. Doctors in Wuhan are reportedly expecting the number of infections to exceed 6,000, and local authorities are planning to build a special hospital in just six days to handle the epidemic.

There’s reason to believe the disease isn’t nearly as big a threat to public health as the one posed by the SARS outbreak in 2003, which killed nearly 800 people. Inevitably, though, the biggest political and economic effects of pandemics come from public panic and panicked government responses, not the disease itself. And given Beijing’s checkered track record for managing these sorts of emergencies over the past two decades, the Communist Party of China’s very legitimacy might just prove to be on the line.

How Bad Is It?

Coronaviruses come in a variety of strains. Some, such as the one that’s one of the many causes of the common cold, are relatively harmless. Others, such as those responsible for SARS and MERS, are potentially lethal. The dangerous coronaviruses seem to be linked to animals. SARS may have originated in bats and then spread to humans via civets, which are eaten as a delicacy in China. MERS also came from bats but spread to humans via camels, once again, perhaps through consumption of raw camel milk or meat. It is therefore reasonable to suspect that the new coronavirus is linked to animals that are eaten. Indeed, the reason China is always likely to be ground zero for the next influenza pandemic is that millions of people regularly come into contact with livestock. As Smithsonian Magazine wrote, “Many Chinese people, even city dwellers, insist that freshly slaughtered poultry is tastier and more healthful than refrigerated or frozen meat.”

Whatever the source, it’s now been confirmed to be capable of being transmitted from one human to another. Even so, the new coronavirus will have a limited direct impact on public health. SARS appeared in 2002, spread quickly around the globe in 2003, infected 8,096 people and killed 774. Then, with the exception of a handful of cases, it mostly disappeared. MERS has infected 2,442 people and killed 842. It still lingers throughout much of the world, particularly in the Arabian Peninsula. And though the reported case-fatality rates for both seem high – 9.6 percent for SARS and 34.5 percent for MERS – bear in mind that many mild cases probably went unreported. The real case-fatality rate is likely lower.
(click to enlarge)

The damage inflicted directly by the disease is therefore highly unlikely to have much long-term impact. But, particularly in China, the potential economic and political implications can’t be dismissed.

Economic Impact

The problem with new outbreaks is that the public and public officials alike can’t exactly wait until all the facts become clear before taking preventative measures. And it doesn’t take much for fear of the unknown to grind public transportation systems to a halt, empty out shopping centers, movie theaters and restaurants, and, most important, persuade revelers to just stay put this year during the Lunar New Year rather than join the hundreds of millions of people who take part in the world’s largest annual human migration.

The costs add up quickly. The SARS outbreak in 2003, for example, dented Chinese gross domestic product by as much as $30 billion, reducing annual growth by between 1-2 percent. Globally, the bill for the pandemic ran up to as much as $100 billion.

Not all economic activity will be lost for good. Short-term hits to the sorts of sectors most exposed to the epidemic – mostly ones tied to consumer spending – often lead to supercharged recoveries. Chinese growth drivers where short-term disruption would have longer-lasting effects, such as manufacturing exports, industrial production and investment, stayed mostly intact in 2003. Indeed, while Chinese GDP growth dropped from 11.1 percent in the first quarter of 2003 to 9.1 percent in the second, it bounced all the way back to 11.6 percent a year later.

Still, even if nCoV proves more manageable than SARS, there are reasons to think the impact this year will be worse. For one, the SARS epidemic occurred on the heels of the dot com crash, when consumer spending across the region was already somewhat suppressed. (Incidentally, the resulting reduction of international travel may have helped contain the spread of the virus.) For another, locking down an urban area as large as Wuhan – a city at the center of one of China’s most important internal shipping routes along the Yangtze – will be immensely disruptive.
(click to enlarge)

Moreover, a substantial portion of the lost holiday spending will never be recovered. This is a problem for Asia Pacific nations that, unlike in 2003, are now highly dependent on Chinese tourists. All told, Chinese people took an estimated 130 million more trips abroad in 2018 compared to 2003, and before the outbreak, the China Outbound Tourism Research Institute predicted that more than 7 million Chinese people would head overseas during the Lunar New Year this year. In Thailand, which has already reported four cases of nCoV, foreign tourism accounts for as much as a fifth of economic growth. Around 57 percent of visitors to Thailand last year were Chinese, including more than 2 million in January and February alone. Japan, which hosts the 2020 Summer Olympics, is estimating an economic loss of nearly $25 billion if the virus spreads as widely as SARS.

The biggest difference for China this time around is that the economy can’t as easily shrug off a major shock. In the early 2000s, annual GDP growth was still climbing well above 10 percent. Today, with a long structural slowdown well underway, Beijing is running up staggering debts just to keep growth from swan-diving below 6 percent. Add to this an unresolved trade war with its largest export customer – along with its scramble to implement critical but growth-sapping measures to stave off a financial meltdown before the next global slowdown strikes – and the epidemic starts to look like the sort of thing that could derail Beijing’s best-laid plans for avoiding an economic reckoning.

Political Impact

The outbreak will also complicate a broader, existential challenge weighing on the CPC: preserving its very legitimacy with the public. Delivering steady gains in prosperity is, of course, at the center of this challenge. But breakneck economic growth has become impossible to sustain – and was never going to be sufficient, anyway. The wealthier a country becomes, the more its citizenry demands quality of life that can’t be sourced solely from rising GDP, things like clean air and water, medical services, social safety nets and responsive, corruption-free governance. This is why President Xi Jinping has encouraged the party to shift its focus to “high-quality growth,” and it’s why he’s put environmental and emergency management initiatives at the center of his sweeping reform agenda. No amount of propaganda or censorship can convince his people that a smog-choked sky is actually blue or make devastation from an earthquake disappear.

The 2003 SARS outbreak laid bare the political risks of mismanaging a public health emergency. The government came under withering public criticism for covering up the scale of the epidemic (inadvertently worsening panic), impeding the World Health Organization’s investigation, and moving slowly to contain the outbreak. Bungled government responses to a number of other crises, such as the 2008 Sichuan earthquake, a high-speed rail accident in 2011, and a string of scandals involving tainted milk, tainted vaccines and fiery industrial accidents likewise prompted fierce public outcry. Beijing received higher marks in subsequent health scares, particularly the H171 bird flu outbreak in 2013. And this time around, initially at least, it received international praise for its improved transparency and swiftness in moving to contain the virus. Chinese authorities had isolated and published the nCoV genome by the second week in January, allowing foreign governments to develop critical testing procedures for the virus. Xi addressed the emergency personally last week, ordering “all-out prevention and control efforts.” China’s top political body responsible for law and order said officials who withheld information would be “nailed on the pillar of shame for eternity.”

But facts on the ground are once again giving the public reason to doubt its government’s candor and capability. Authorities have been claiming for more than a month that the virus is “preventable and controllable.” Now, they’re taking extreme measures like locking down the Wuhan metro area, home to some 19 million people, and making belated mea culpas. The government has also struggled to abandon its practice of reflexively cracking down on independent sources of information, despite commands to do so from on high. This has led to contradictory messaging and suppressed information that might have helped contain the virus. Chinese censors initially ordered local media outlets to stick to reprinting official reports, according to the Financial Times, effectively silencing independent reporting. And in early January, eight people were reportedly detained for posting information about the outbreak on social media. As also happened in the SARS outbreak, moreover, the government’s rigidly enforced top-down decision-making structure has once again worsened matters by incentivizing, for example, hospitals to under-report cases and local authorities to go forward with high-profile public gatherings deemed politically important.

For all the criticism they are receiving, authorities in Beijing are trying to address a problem that would bedevil any government. China is very large and very dense. As happened with SARS, panic would almost certainly do more damage than the disease itself. And Beijing may reasonably conclude that resorting to drastic measures may truly be in the public interest, even if they’re at odds with public sentiment. Perhaps more than any government, Beijing has given itself the power to surveil its citizenry, to shut down cities, to silence unfounded rumors on social media – all without permission. Such powers certainly could come in handy in this sort of crisis.

But by hoarding authority – by insisting on the right to micromanage the country – the CPC has raised the bar for what the public expects in response when the country is under attack, whether from foreign powers, economic forces or viral mutations. This is a problem when tight centralization has also, paradoxically, created a rigid top-down institutional culture that’s ill-suited to respond nimbly to public demand. When faced with a crisis, the machinery of the state is programmed to default to the tools it knows best. Censorship, disinformation and problem-solving by brute force are hardwired into the Chinese system, often making it at once flat-footed and prone to overcorrection. Yet, the more pressure intensifies, the more Beijing is doubling down on this model. And the stakes riding on its bet are getting higher.   

Title: China virus
Post by: Crafty_Dog on January 24, 2020, 05:43:54 AM
second post
Title: Michael Yon comments on Chinese Virus
Post by: Crafty_Dog on January 24, 2020, 06:38:57 AM
Third post

Xi’s Disease Spreading: After this hits the global streets—and it has already—efforts at containment are something akin to containing a global wildfire.

Political and other dimensions are mind-boggling and beyond reach. Epidemiologists and other experts constantly talk about the cruciality of early detection and jumping right on it RIGHT NOW, but if this turns out to be very serious, right now was already yesterday, and listening to the experts we all have to focus on slowing spread by wearing masks and so forth.

There always are cultural aspects, too, such as the habit of mainlander Chinese sneezing everywhere with no attempt cover their faces. They will sneeze in elevators— yes, they do— restaurants, airplanes, more. They ain’t Japanese who will self-quarantine.

To be clear, I am not talking about “Chinese” (difficult to define), but some cultures in Mainland China. Many in Taiwan or Hong Kong and other places are super-civilized, but many of the mainlanders are like something from another time and planet.

The Thai and China governments jointly published a book years ago showing traveling mainlanders how to behave civilized, such as not spitting on restaurant floors, or defecating in department store changing rooms. This drives Thais crazy. Not to mention everyone else.

This is the sort of barbarian invaders that Hong Kongers, Taiwanese, and the rest of us who see, are very concerned about.

They will not hesitate even as known-virus carriers to sneeze on airplanes without covering their faces. Why would they cover their face and soil their hand or whatever when they can just let it fly? They do this constantly.

The virus is doing what viruses do. It bought tickets and flew to Korea, Hong Kong, Japan, USA, more.

Wait ‘till it hits the great incubators of India and Africa. Hopefully it is not that serious but hope is not a plan, or a vaccine.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on January 24, 2020, 11:08:52 AM
Wuhan crisis not in check. The novel coronavirus is continuing to spread, and China is moving into full crisis mode. At least 869 people have been infected in China, and at least 26 people have died. There was also a fifth confirmed case in Thailand and a second confirmed case in the United States. A number of epidemiology models are now predicting that there will eventually be several thousand infections. In response, at least 10 Chinese cities – with a combined population of more than 40 million – have effectively been placed in quarantine. Beijing has also ordered travel agencies to suspend sales of domestic and international tours. The Coalition for Epidemic Preparedness Innovations, an alliance of public and private medical entities, announced a multinational effort to develop a vaccine for the new virus, but it won’t be ready for months, if ever. (There is still no MERS vaccine.) As we’ve noted, the biggest and longest-lasting impacts will come from the reaction to the virus, not the virus itself.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on January 24, 2020, 05:27:06 PM
fourth post
Title: Laowhy86 on China's reaction to the virus
Post by: G M on January 24, 2020, 06:55:13 PM

He knows what he is talking about.
Title: Being ready for next time
Post by: Crafty_Dog on January 25, 2020, 08:13:59 AM
Title: Is this a Chinese bioweapon?
Post by: G M on January 25, 2020, 09:35:19 PM

Title: Re: Is this a Chinese bioweapon?
Post by: G M on January 25, 2020, 09:41:28 PM
Title: Re: Is this a Chinese bioweapon?
Post by: G M on January 25, 2020, 11:24:06 PM

But worries surround the Chinese lab, too. The SARS virus has escaped from high-level containment facilities in Beijing multiple times, notes Richard Ebright, a molecular biologist at Rutgers University in Piscataway, New Jersey. Tim Trevan, founder of CHROME Biosafety and Biosecurity Consulting in Damascus, Maryland, says that an open culture is important to keeping BSL-4 labs safe, and he questions how easy this will be in China, where society emphasizes hierarchy. “Diversity of viewpoint, flat structures where everyone feels free to speak up and openness of information are important,” he says.
Title: Wuhan Viral spread map
Post by: G M on January 26, 2020, 04:34:32 PM
Title: Re: new virus out of China
Post by: G M on January 26, 2020, 07:44:42 PM

Quarantine a city the size of Wuhan?   How?

The ugly truth is you can't really.

Title: Is the Market underestimating the Coronavirus impact?
Post by: G M on January 27, 2020, 04:05:31 PM
Title: NorKs and Mongolia close border with China
Post by: G M on January 27, 2020, 09:17:24 PM
Title: GPF
Post by: Crafty_Dog on January 28, 2020, 10:40:39 AM
    Daily Memo: China's Coronavirus Strategy, the UK's Huawei Policy
By: GPF Staff
Xi responds to the coronavirus. Chinese President Xi Jinping on Monday charged Premier Li Keqiang with the job of heading government efforts to deal with the coronavirus, after infections doubled over the span of just 24 hours. During a visit to Wuhan, Li pledged greater government support and resources for treating the sick and containing the virus's spread. Criticism over how the Chinese government has responded to the health crisis has been circulating on social media. There are also reports of vigilante groups blocking transit and regulating foot traffic to protect their communities. Yesterday, the city's mayor once again offered to resign, taking part of the blame for the local government’s response but also making the case that China’s sclerotic top-down decision-making structure impeded the Wuhan government’s response. Xi needs someone in the government to assume responsibility over the virus, thereby distancing himself from any cries of government mismanagement. Li has often been tasked with being the public face of the government’s response to crises, in part because he’s considered an effective administrator with a relatively positive reputation among foreign governments (a useful trait at a time when doubt over Beijing’s transparency is growing). But it’s also because he doesn’t hail from Xi’s political network and has been given relatively minimal power by Xi over routine matters, making him an ideal fall guy if the crisis response falls short. The move also shows that Xi appreciates the need to prevent the disease from destabilizing the country and impinging on his hold on power.
Title: Thailand unable to stop Coronavirus
Post by: G M on January 29, 2020, 08:25:11 PM

This is looking very, very bad.
Title: Corona Kung Flu
Post by: Crafty_Dog on January 30, 2020, 07:48:34 AM

The New Coronavirus Could Leave Global Tourism and Trade Ailing

Countries around the world are facing major fallout from the new coronavirus. Cases of the virus originating in Wuhan have cropped up worldwide, forcing governments to roll out measures to screen travelers or even restrict arrivals in hopes of preventing outbreaks in their own countries. As of Jan. 29, 16 countries besides China have reported cases of the virus. Nearly all of the affected patients contracted the virus in China, but cases of human-to-human transmission have occurred several times outside of China. And while many countries are equipped to prevent the spread of an outbreak on their soil, the complex nature of disease control means that each new case presents risks of an outbreak outside China.

The Big Picture
The new coronavirus has yet to prove particularly deadly, but authorities in China have so far failed to halt its spread — both within the country and abroad. And the longer the outbreak continues, the longer the disruption to international trade and tourism will be.
The Geopolitics of Disease

The effects, of course, are not just limited to public health. Inside China, the virus has already caused massive disruption by dampening consumption during Lunar New Year celebrations — the busiest shopping time in the country — and forcing lockdowns of key supply chain nodes. Moreover, any dip in Chinese economic growth and outbound tourism will have ripple effects in countries that rely on trade with China. The existing global economic slowdown prior to the outbreak has already done a number on the likes of export-oriented economies worldwide, but the possibility of a drop in Chinese tourist numbers or a blow to Chinese economic growth could sap tourist revenue around the world, particularly in East and Southeast Asia.
The next phase of the outbreak will be critical to determining the success of interventions to stop the spread of the virus and limit its impacts outside China. But even in an optimistic scenario, the effects of the virus will last for weeks, raising the possibility of sustained, monthslong disruptions to growth in countries linked to the Chinese economy.

Here is how the new coronavirus could impact economies around the world.

South Korea and Japan

Although well-equipped to screen for and stem the spread of the virus, South Korea and Japan will experience some economic difficulties due to declines in tourism, as well as disruptions to Chinese imports and supply chains. South Korea, however, will be more vulnerable than Japan because its economy has already suffered amid the preexisting global trade slowdown.
Already, the outbreak in China has disrupted the flow of travelers, as Beijing has banned Chinese tourists from conducting overseas group tours, which account for 44 percent of the country's outbound tourism. A sustained outbreak could further stanch flows of Chinese travelers to South Korea and Japan, while the spread of the virus inside either country would naturally have a chilling effect on tourism overall.
South Korea and Japan boast widely diversified economies, yet a drop in tourism revenues from China (or overall) would deal both a blow in certain areas. In 2019, 7.4 million Chinese tourists visited Japan, while a further 5.5 million went to South Korea. In Japan as a whole, Chinese tourists accounted for 30.3 percent of the total, spending $16.2 billion in 2019, or 37 percent of what all tourists to the country spent combined. Japan's Nomura Research Institute estimates that a dropoff on par with the 2002-2003 outbreak of severe acquired respiratory syndrome (SARS) could cost the country's economy $7.1 billion. What's more, Chinese tourism growth in 2019 was key in helping rural, tourism-dependent and economically smaller Japanese areas offset a South Korean boycott stemming from Seoul and Tokyo's trade standoff.

South Korea's tourism sector, too, has enjoyed a greater influx of Chinese tourists, who contributed 34 percent of the total in
2019 and who accounted for a substantial portion of the estimated $21.6 billion in 2019 total tourism receipts — revenue that is doubly important for an export-reliant South Korean economy flagging in the face of global trade headwinds. As it is, Seoul knows all too well what a drop in Chinese tourist arrivals can mean for the economy: In 2017-2018, Beijing banned Chinese citizens from traveling to South Korea on group tours in retaliation for Seoul's deployment of a U.S. missile-defense system, costing Seoul around $6.82 billion in revenue. Beyond Chinese tourists, South Korea is particularly worried about the risk of the new coronavirus spreading inside the country given its experience with Middle East respiratory syndrome (MERS) in 2015. That outbreak in South Korea scared away tourists, ultimately costing the country's economy $3.6 billion in losses, or 0.2 percent of gross domestic product.

Any drawdowns in tourism revenue would come at a particularly fraught time for South Korea's economy, which is reeling due to drops in worldwide demand and trade tensions with Japan. (Over 44 percent of South Korea's GDP comes from exports as compared to just 18.5 percent for Japan.) More troubling for Seoul, however, is that South Korean exporters are vulnerable to the economic ripples of an extended outbreak in China. Already, South Korean markets have taken a hit on fears that the new coronavirus could dampen Chinese consumption and roil supply chains. China accounts for nearly 24 percent of South Korea's total trade, including 36 percent of electronics exports, 28 percent of machinery exports and over half of organic chemical exports. A virus-related Chinese slowdown would especially hit South Korean chipmakers and display manufacturers hooked into Chinese production chains, as well as South Korean retailers that sell to the Chinese market. With South Korea's economy already suffering in a tough global environment, that would be particularly troubling.

Southeast Asia

Southeast Asia is equally vulnerable to the health and economic effect of the virus given the large numbers of Chinese tourists who visit the region, as well as the area's deep links to the Chinese economy. The uneven levels of health care, monitoring and screening capacity among these countries make the situation even riskier. Thailand, Cambodia, Singapore, Malaysia and Vietnam have all confirmed cases of new coronavirus, and while Myanmar and Laos have yet to report cases, their high Chinese tourism flows — and porous, poorly controlled borders with China — put them at risk of undetected infections.
In the region, Thailand stands to fare the worst. Over 21 percent of Thailand's GDP comes from tourism and related spending, while its cities are also key destinations for Chinese travelers. As of Jan. 28, Thailand had 14 reported cases of the virus — the highest number outside China. Furthermore, fear of the virus could deter vital tourism from all countries to Thailand. Most immediately, however, the country could suffer from a long-lasting drop in Chinese arrivals, who accounted for 10.5 million arrivals in 2019 and $17 billion in spending. According to the Tourism Authority of Thailand's estimates, the virus could lead to a drop of 2 million Chinese tourists in 2020 — a big blow that comes on top of the problems stemming from a strengthening baht, competition with Vietnam for tourists and a series of high-profile ferry accidents that discouraged Chinese visitors. The outbreak further jeopardizes this revenue stream at a worrying time for Bangkok, which is trying to prop up growth amid political fragility, weak global demand for its electronics and automotive sector, as well as dampened domestic consumption.
Vietnam, too, relies on China for a substantial number of tourists — one-third of its total. Its economy, however, is not overdependent on tourism, as it has been a key beneficiary of manufacturers fleeing China due to the U.S.-China trade war. But as with most Southeast Asian countries, Vietnam's deep reliance on Chinese supply chains puts it at risk of economic fallout if a sustained outbreak saps China's economic growth.

Africa and the Middle East

While Africa is far from the Chinese center of the outbreak, the increased flow of Chinese nationals to the continent in recent years puts it at risk. Any disruptions in African economies, however, would stem less from a sharp dropoff in Chinese arrivals or a slowdown in the Chinese economy than outbreaks in the countries themselves, particularly as many nations lack decent health care infrastructure or robust screening procedures. On Jan. 28, Ethiopia reported that it had quarantined four students who recently returned from Wuhan exhibiting symptoms of the virus. Ethiopia is comparatively well-positioned to control any outbreak, but others with significant links to China are not. The virus, for instance, could spread much more quickly in a country like Zimbabwe, which is currently facing a severe economic and food crisis. At the same time, many of Africa's major cities, especially Addis Ababa, Cairo, Johannesburg and Casablanca, are all destinations for Chinese travelers, students and businesspeople.

If China's domestic response nips the virus in the bud, the number of cases could peak in the coming weeks, resulting in a relaxing of restrictions within the next two months.

Europe and the Americas

In the Americas, Canada and the United States are the only countries that have reported cases to date, and both are well-equipped to monitor and deal with the threat. Fewer Chinese travelers visit Latin America, which is also at lower risk because many flights from China to the region first go through the United States or Canada, which could prevent the onward travel of anyone suffering from the virus. During the 2002-2003 SARS outbreak, for instance, the virus spread at a significantly lower rate in Latin America than elsewhere: Brazil and Colombia each registered just one confirmed case, in contrast to 250 in Canada and 75 in the United States. (The latter, meanwhile, was the only country in the Americas to confirm an outbreak of MERS.) Disruptions to China's economy, however, would still have knock-on effects for Latin American countries, which conducted $307.4 billion in bilateral trade with China in 2019. A long-lasting outbreak would jeopardize agricultural and natural resource exports, especially Chile, which sends over half of its vital copper exports to China, and Brazil, which relies on agricultural exports to China.

Elsewhere in Asia

China's numerous land borders in Northeast and Central Asia also put other countries at risk of the virus, leading Mongolia and Kazakhstan to implement severe restrictions on movement from China. However, most countries have to balance the need to protect their populations against the economic and political ramifications of severing links with China. Particularly worried is North Korea, which has banned Chinese tourist arrivals and set up quarantine zone at its borders. While North Korea's tight, authoritarian system appeared to help it weather both the 2002-2003 SARS outbreak and the 2015 MERS outbreak, the new coronavirus presents the country with more of a dilemma, as Chinese tourists (350,000 visited last year alone) have become a critical source of revenue for the country's economy as it struggles under the weight of sanctions. Another source of danger for Pyongyang are the estimated 50,000 North Korean workers in China. The laborers were supposed to return to North Korea by late last month in accordance with U.N. sanctions, but many reportedly did not due to the haphazard implementation of the measures. Since then, however, some may have returned home before Pyongyang implemented quarantine measures, particularly in the run-up to the Lunar New Year.

The Upshot

China's coronavirus outbreak is a fluid, rapidly evolving situation. What happens now is highly uncertain — and even more so for countries that are trying to contain the spread of the virus within their own borders. If China's domestic response nips the virus in the bud, the number of cases could peak in the coming weeks, resulting in a relaxing of restrictions within the next two months. But if the measures prove ineffective and the virus spreads further — or becomes more fatal — the long period of incubation and contagiousness could mean cases continue to crop up internationally for some time to come. In such a scenario, authorities in China and farther afield won't be lifting restrictions anytime soon, which would herald a difficult year ahead for the global tourism industry.
Title: China underreporting true scale of coronavirus
Post by: G M on January 30, 2020, 06:48:31 PM

Title: We live in historic times
Post by: G M on January 31, 2020, 07:07:00 PM

Plan accordingly.
Title: Coronavirus infections predicted to grow exponentially; first death outside Chin
Post by: G M on February 02, 2020, 09:57:54 AM
Coronavirus infections predicted to grow exponentially; first death outside China; outbreak becomes political
Major airlines stop flying to China as coronavirus spreads
The United States has issued a “Level 4” travel advisory for China, its highest level of caution, over the rapidly spreading outbreak. (The Washington Post)
Anna Fifield and
Alex Horton
The Philippines and New Zealand have joined the list of countries that have sharply restricted entry to people traveling from or through China, as the number of cases confirmed outside the mainland continues to grow. Meanwhile, inside China, the number of reported cases has grown rapidly, and scientists predict that exponentially more have been infected. Here is what we know:

● There are nearly 14,500 confirmed cases of coronavirus in China, including 10 on the self-governing island of Taiwan, with more than 300 dead. A new study says that as many as 75,815 people in Wuhan may have been infected.

● The World Health Organization has reported roughly 130 confirmed cases of the virus in more than 20 countries outside China and Taiwan. The Philippines reported the first death attributable to the virus outside China. New cases have been confirmed in South Korea and India.

● Doctors say the virus can be spread by fecal matter, as well as droplets from the mouth and nose.

● Chinese financial regulators have prepared a $173 billion support package for when markets reopen Monday.

● Are you in isolation or quarantine because of the coronavirus? We want to hear your story.

First person-to-person case reported in the U.S. | Mapping the spread

BEIJING — The Philippines has blocked entry to travelers from China, including from Hong Kong and Macao, after a man from Wuhan died in Manila of the coronavirus, the first person outside China to succumb to the pneumonia-like respiratory illness.

With the coronavirus continuing to spread beyond China’s borders, more countries are moving to close their doors to foreign nationals who have visited there. New Zealand, Iraq and Indonesia joined the Philippines on Sunday in imposing new restrictions on people coming from or through China.

The virus has been detected in small numbers in some 20 other countries — from the United States and France to Thailand and Australia — while the number of infections in China has surged to nearly 14,500, according to the latest National Health Commission figures.

The number of deaths has risen to 304, although anecdotal reports suggest the true number could be much higher.

A 44-year-old Wuhan man died in a Manila hospital Sunday, after arriving, via Hong Kong, on Jan. 21. He was admitted to a hospital with pneumonia four days later and his 38-year-old companion remains hospitalized, but there was no evidence of local transmission, the country’s Department of Health said.

Early missteps and state secrecy in China probably allowed the coronavirus to spread farther and faster

Even before the man’s death, President Rodrigo Duterte had decided to expand the Philippines’ travel restrictions from those traveling from Hubei province, the epicenter of the outbreak, to the rest of mainland China, as well as its special administrative regions, Macao and Hong Kong.

Members of the People’s Liberation Army arrive Sunday in Wuhan with medical staff members and supplies to fight the coronavirus outbreak. (China Daily/Reuters)
Members of the People’s Liberation Army arrive Sunday in Wuhan with medical staff members and supplies to fight the coronavirus outbreak. (China Daily/Reuters)
“I wish to emphasize that we are not singling out Chinese nationals,” Sen. Christopher “Bong” Go, a close aide to Duterte, said in an interview with DZBB radio station on Sunday, after meeting with the president on Saturday night. “It covers all travelers from China to the Philippines regardless of nationality.”

New Zealand’s government announced that starting Monday, it would deny entry to foreign travelers arriving from China and order returning New Zealanders to isolate themselves for 14 days.

Indonesia said it would immediately bar visitors who have been in China for 14 days, the maximum incubation period, from entering or transiting. Iraq’s Interior Ministry said it would ban all foreign nationals coming from China.

These three countries have not reported a case of coronavirus on their shores.

They, however, join countries including the United States, Australia and Singapore in imposing travel restrictions on visitors from China. Japan and South Korea have imposed looser rules on people from the Hubei province, although the subtropical South Korean island of Jeju, where 98 percent of foreign tourists are Chinese, said Sunday that it would rescind visa-free entry for them.

South Korea on Sunday reported three more cases of infection, taking the total to 15, while India confirmed its second case. The United States now has eight infections.

But even as countries around the world impose restrictions on travel from China, the Foreign Ministry’s combative spokeswoman, Hua Chunying, has sought to frame the coronavirus outbreak as part of a bigger, existential battle between the United States and China.

After U.S. Commerce Secretary Wilbur Ross said the coronavirus could “help” to bring jobs to the United States as companies moved operations away from China, Hua said these “unfriendly U.S. comments” were “certainly not a gesture of goodwill.”

A worker disinfects an area in Jincheon, South Korea, on Sunday. (Yonhap/EPA-EFE/Shutterstock)
A worker disinfects an area in Jincheon, South Korea, on Sunday. (Yonhap/EPA-EFE/Shutterstock)
“Many countries have offered China support in various means,” she said. “In sharp contrast, certain U.S. officials’ words and actions are neither factual nor appropriate.”

Over the weekend, she singled out the United States for going against the World Health Organization’s advice that travel limitations were not necessary, even though a raft of other countries have also imposed restrictions.

A “certain country has turned a blind eye to WHO recommendations and imposed sweeping travel restrictions against China,” Hua tweeted Saturday. “This kind of overreaction could only make things even worse. It’s not the right way to deal with the pandemic.”

Reality check: The flu is a much bigger threat than coronavirus, for now

China is still struggling to contain the spread of the virus, which began in December in a market in the Hubei provincial capital of Wuhan, where exotic animals including bats, civets and snakes were sold for consumption. Bats and the catlike civets have been linked to previous mutations in viruses that have jumped from animals to humans, including severe acute respiratory syndrome (SARS), which began in southern China in 2002.

With authorities slow to recognize this latest outbreak as a new virus and even slower to warn people of it, the number of infections has continued to rise rapidly, passing the total infected by SARS.

The number of confirmed cases rose by almost 2,000 between Saturday and Sunday, despite stringent restrictions placed on movement of some 50 million people from Hubei province.

The People’s Liberation Army sent 1,400 medical staff members from the armed forces to Wuhan on Sunday to treat patients at the new 1,000-bed Huoshenshan Hospital, which was built in just 10 days and is due to start operation on Monday.

“This is the latest development in the Chinese people’s critical battle against the novel coronavirus outbreak,” the official Xinhua News Agency said in an article that presented leader President Xi Jinping as “commanding this fight” against the coronavirus outbreak.

In trying to contain the outbreak, Hubei officials continue to speak in terms of an epic battle against what Xi has called a “devil” virus.

“Cadres at all levels should truly show a wartime spirit,” the Hubei state newspaper exhorted Sunday after a meeting at the provincial pneumonia prevention headquarters.

A leukemia patient waits for permission to cross a checkpoint in Jiujiang, China, on Saturday. (Thomas Peter/Reuters)
A leukemia patient waits for permission to cross a checkpoint in Jiujiang, China, on Saturday. (Thomas Peter/Reuters)
Scientists around the world have raced to consolidate and share what they’ve learned since the outbreak.

Virologists at Italy’s National Institute for Infectious Diseases announced on Sunday they isolated the virus for research, uploading its partial sequence in the GenBank database — a first in Europe. “In the next few days the whole virus will be made available to the international scientific community,” said Salvatore Curiale, a spokesperson for the institute. “This is a fundamental step for perfecting diagnosis [and] developing treatments and a vaccine.”

China’s stock markets will reopen Monday after the Lunar New Year holiday, the first trading day since the extent of the outbreak became clear.

Anticipating a sharp sell-off, China’s central bank and other financial regulators said Sunday that they had prepared an emergency package totaling an astronomical $173 billion to support companies and markets during the coronavirus crisis.

This news came as a new study by University of Hong Kong scientists, published in the Lancet, said the outbreak could be even worse than it appears and could get dramatically worse over the next week or two.

They found that as many as 75,815 people in Wuhan had been infected with the coronavirus by Jan. 25, based on an assumption that each infected person could have passed the virus to 2.68 others. It also said the epidemic was doubling every 6.4 days.

If the virus was spreading at a similar level around the country, “we inferred that epidemics are already growing exponentially in multiple major cities of China with a lag time behind the Wuhan outbreak of about 1-2 weeks,” the scientists wrote.

In coronavirus outbreak, China’s leaders scramble to avert a Chernobyl moment

Medical advice over the past two weeks has emphasized the need to wear masks to stop transmission through respiratory droplets from the mouth and nose. But Chinese authorities are now saying that the virus can be passed from fecal matter.

Researchers from the Renmin Hospital of Wuhan University and the Wuhan Institute of Virology of the Chinese Academy of Sciences reported this weekend that there had been fecal-oral transmission. It warned medical workers to “protect themselves against vomit and feces of patients.”

In Shenzhen, on China’s southern border with Hong Kong, scientists at the Third People’s Hospital said the stool samples of infected people had tested positive for the virus, further suggesting that it could be transmitted through feces in addition to through respiratory droplets.

Health officials urged good personal hygiene, and especially washing hands well and often.

“When mildly ill patients are isolated in their homes, they and their family members should pay special attention to hygiene, and they should avoid sharing bathrooms with family members as much as possible,” officials said, according to the China News Network.

Hubei Vice Gov. Xiao Juhua acknowledged in a news conference Sunday the province’s medical resources were relatively week amid the “severe and complicated” outbreak, Reuters reported, though officials described optimism that test kits for the virus have improved in speed and accuracy.

People in Hong Kong protest on Sunday government plans to convert a heritage site into a quarantine camp. (Philip Fong/AFP/Getty Images)
People in Hong Kong protest on Sunday government plans to convert a heritage site into a quarantine camp. (Philip Fong/AFP/Getty Images)
As the virus continues to spread and new cases continue to emerge, anger is mounting about the lack of access to protective equipment, especially the face masks that authorities are urging to be worn in public places.

With stores and online shopping sites sold out of masks, many cities across the country have launched an online booking system or lottery system for masks.

In Guangzhou in the south, each person can reserve up to five masks a day, although those in the Zhejiang province’s Shaoxing are allowed only one. In the southeastern seaboard city of Xiamen, authorities have launched a lottery system for residents.

Masks and other basic protective equipment like goggles and gloves are in such short supply that Hubei hospitals have been openly appealing for donations on social media.

U.S. seeks to send expert team to China to combat coronavirus outbreak; Xi defends response

There is growing criticism about the shortage of masks and particularly about the distribution of the masks after a video emerged of a man taking a box of masks apparently donated to the Red Cross Society in Wuhan. Rumors spread that the man was diverting the masks for local leaders, rather than for their intended recipients, prompting state news outlets to claim that he was simply delivering them to their rightful place.

A list of the materials donated to the Red Cross Society branch in Hubei showed that 36,000 masks had been given to two private hospitals in Wuhan, while the public Wuhan Union Hospital, whose doctors have been working at the front line in fighting the coronavirus, had only received 3,000.

One Wuhan doctor said that his hospital had not received a single mask from the Red Cross, one of the few officially recognized organizations permitted to handle civic donations.

In a post on social media, since deleted by censors, the doctor said his hospital had only 300 N95 masks left, barely enough for a day. “Fortunately we got a batch of donations from America, 500 U.S. FDA standard N95 masks. It made us so happy because we could last one more day!”

One netizen even called the Wuhan Charity Federation and other such groups “pixiu,” a mythical winged animal that eats but never defecates, accusing them of receiving more than $80 million in donations but spending none of that amount on the public. That post has also been deleted by China’s zealous Internet police, which tries to swiftly stamp out any criticism of the ruling Communist Party.

In apparent recognition of this growing discontent, Premier Li Keqiang, who is leading the party’s efforts to prevent and control the coronavirus outbreak, went to the national hub for medical supplies in Beijing over the weekend.

Kimchi, cow poop and other spurious coronavirus remedies

Li “called for all-out efforts to ensure the provision of key medical supplies and create necessary conditions to win the battle against the outbreak,” the Foreign Ministry said Sunday in a statement about his visit. He also urged “further refinement” of the ways equipment was allocated, noting that “the priority is to meet the needs of medical workers selflessly saving lives on the front lines.”

Echoing the military language of the state media, Li said medical supply manufacturers were “like military contractors producing for the ‘arsenal’ in this battle against the epidemic.”

Liu Yang in Beijing contributed to this report.
Title: GPF The geopolitics of Corona Kung Flu
Post by: Crafty_Dog on February 04, 2020, 05:41:40 AM

February 4, 2020   View On Website
Open as PDF

    The Geopolitics of the Novel Coronavirus
By: George Friedman

Geopolitics is a fairly slow-moving process that unfolds in predictable ways. This is usually the case. There are then moments when a wild card enters the system from the outside, unpredictable yet significant. At the moment, we can’t tell if the new coronavirus is such an event. We don’t know exactly how it is transmitted, how lethal it is, whether it causes long-term illness and so on. We know it has broken out in a Chinese city, Wuhan; that the Chinese government regards it as serious enough to impose significant controls on movement in and out of Wuhan; and that a small number of cases in China, relative to the population, and a smaller number of cases outside of China have been reported. For this we depend on media reports, since our own knowledge of viral medicine is limited.

Geopolitically, communicable disease ranges from the common cold to the Black Death. The former is ever-present but of little consequence; the latter massively disrupted European society and, in some cases, shifted the regional balance of power. There is a trigger point between these two diseases where the political system erects disruptions in everyday life and commerce designed to limit the effect of the disease. To some extent these actions are effective, and to some extent they can be sufficiently disruptive to cause economic problems. We are at the moment teetering between these points, with the consequence of the disease and the consequence of protecting against the disease uncertain.

The major threat would appear to be travelers carrying the virus. The United States has banned travel to the U.S. for foreigners who have traveled to infected regions, while U.S. citizens may return but are quarantined for two weeks. Major U.S. airlines are starting the process of suspending all flights to and from China, but Chinese airlines and U.S. cargo carriers are still flying to the U.S. Other countries like Russia have also imposed travel bans. The U.S. government has imposed very limited barriers, through which the disease is likely to pass. Most important, maritime shipments to and from China have not been significantly disrupted. This is vital, because if they were to be suspended, the situation would transform from a problem to a crisis.

China is dependent on exports to maintain its economy. About 20 percent of its gross domestic product derives from exports, and its single largest customer is the United States, despite the trade dispute. Assume for the moment that the new coronavirus were closer to the bubonic plague than the common cold, or assume that the panic that arises from the fear of the unknown compelled the governments of multiple advanced countries to place China under quarantine. It is an unlikely but far from impossible outcome.

The Chinese government has been under intense pressure in three ways. First, the crackdown on Xinjiang province generated a massive negative response from Europe and the United States. Alongside that, the United States imposed significant tariffs on China. The contraction in exports hit a financial system that the Beijing government was already struggling to stabilize. This led to fear among Chinese authorities of unrest over economic and financial issues. The result was increasing security, from recognition technology to intrusion into the internet and periodic arrests of those considered dissidents. Economic insecurity led to increased security. This in turn led to Hong Kong. The Hong Kong riots were triggered by a bill that authorized China to extradite Hong Kong residents. This was a desire Beijing did not have before. But as the situation intensified, the desire to assure stability in Hong Kong increased. With the bill, some in Hong Kong recognized that extradition could be carried out for things legal in Hong Kong and could lead to extreme sentences. It represented an existential threat to many in Hong Kong, and the results were transmitted around the world.

A chief responsibility of the Chinese president is to manage relations with its most important customer, the United States. China has deflected American demands to open its markets and not manipulate its currency since the George W. Bush administration. It was expected that President Xi Jinping could continue this process. He failed to manage U.S. President Donald Trump, and the result was that an exporting nation faced a challenge from a consuming nation. To put it more simply, there is a rule in business that you should never have a fight with your best customer. Xi violated this rule by winding up in a tariff fight with the United States.

There is no evidence – but then, there wouldn’t be – of a fight in the Central Committee of the Chinese Communist Party over Xi’s stewardship. The Central Committee is packed with Xi supporters, of course, but a situation like what has developed must cause concern and generate ambitions. The idea that the Central Committee was content with the financial situation, trade war, Hong Kong and Xinjiang is to me the least likely situation.

Now, to the coronavirus. Assume that the fears that are being expressed do not turn out to be exaggerated. Assume that in response to this, massive trade restrictions and embargoes were imposed on China and that freighters were not permitted to dock in Long Beach or Rotterdam, nor would they be permitted in Shanghai. With the Russians already screening China’s northern border, China would be isolated.

China is a nation whose core dynamic is based on international trade. Under pressure from the United States, a dangerous virus would inevitably cripple that trade at best. At this point, the Chinese government, like any government, would be blamed for what went wrong, and it would be blamed for mismanaging the virus and failing to understand the economic consequences. From here you can play out the game.

The reason for this exercise is to point out that the coronavirus is neither a geopolitical nor a political event. Diseases emerge with some frequency. But given the Chinese dynamic and China's current condition, the virus could readily evolve into a geopolitical and political event, in which tension within China might explode, with the coronavirus the last straw and China’s international position transformed.

To emphasize, I have no idea what “2019-nCoV” is or what it will do, but judging from what is being said about it and the level of anxiety, I will assume for the sake of argument that it is more dangerous than not. Then, given the evolution of the past year or two, and given the fear that always follows new, deadly diseases, we could see a fundamental transformation of the international system.

Not all events are geopolitical. They do not arise out of relations between nations. But events that are unconnected to geopolitics can connect themselves to the system and disrupt it. This is meant as an exercise in geopolitical theory. It is not insignificant in the case of China, which has had a difficult period and doesn’t need to be quarantined by the world.   

Title: Is Coronavirus a pandemic?
Post by: G M on February 04, 2020, 05:10:37 PM

I am going with a yes.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on February 07, 2020, 01:31:49 PM
Beijing's coronavirus mismanagement. We noted Thursday that a 34-year-old doctor in Wuhan who had been detained in early January for sounding the alarm about the appearance of a mysterious new coronavirus, Dr. Li Wenliang, had become one of the 638 people who have succumbed to the disease – and that it was exactly the sort of development that Beijing feared could crystallize rising public anger at the government’s mismanagement of the pandemic. Sure enough, news of the death of the doctor sparked a torrent of outrage on Chinese social media platforms like Weibo and WeChat. Posts praising whistleblowers and calling for free speech received millions of views over the course of a couple hours before censors caught up. Making matters worse for itself, the government also appeared to spike several stories in state media announcing the death after they had already been published and gone viral on social media, effectively pouring gas on what was already a bonfire of public anger over the heavy hand of censorship.

China’s much-feared anti-graft agency, the CCDI, announced it would launch a probe into the death of the doctor, and a prominent official or two may have to take the fall, raising the risk of a destabilizing power struggle in Beijing. One other takeaway from the incident: State media and the government's censorship apparatus are enormously powerful tools for shaping public opinion, but Beijing’s control over information is hardly airtight, particularly in a crisis, when it has the potential to do more harm than good to the party’s legitimacy.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: G M on February 07, 2020, 09:32:19 PM
The PTB in Beijing are already blaming city level officials for everything.

Beijing's coronavirus mismanagement. We noted Thursday that a 34-year-old doctor in Wuhan who had been detained in early January for sounding the alarm about the appearance of a mysterious new coronavirus, Dr. Li Wenliang, had become one of the 638 people who have succumbed to the disease – and that it was exactly the sort of development that Beijing feared could crystallize rising public anger at the government’s mismanagement of the pandemic. Sure enough, news of the death of the doctor sparked a torrent of outrage on Chinese social media platforms like Weibo and WeChat. Posts praising whistleblowers and calling for free speech received millions of views over the course of a couple hours before censors caught up. Making matters worse for itself, the government also appeared to spike several stories in state media announcing the death after they had already been published and gone viral on social media, effectively pouring gas on what was already a bonfire of public anger over the heavy hand of censorship.

China’s much-feared anti-graft agency, the CCDI, announced it would launch a probe into the death of the doctor, and a prominent official or two may have to take the fall, raising the risk of a destabilizing power struggle in Beijing. One other takeaway from the incident: State media and the government's censorship apparatus are enormously powerful tools for shaping public opinion, but Beijing’s control over information is hardly airtight, particularly in a crisis, when it has the potential to do more harm than good to the party’s legitimacy.
Title: Coronavirus and the global depression
Post by: G M on February 08, 2020, 07:31:43 PM
Title: no freedom of press or speech hard to know what the truth is
Post by: ccp on February 09, 2020, 04:38:02 PM

China likely is putting the whole world at risk by covering up the true scope of the outbreak

Who can believe anything the Chicoms say ?

There should be world outrage

Title: Re: no freedom of press or speech hard to know what the truth is
Post by: DougMacG on February 10, 2020, 06:55:44 AM

China likely is putting the whole world at risk by covering up the true scope of the outbreak

Who can believe anything the Chicoms say ?

There should be world outrage

China's Ambassador to the US came on Face the Nation yesterday, to reassure us of ... something.  Should be a friendly forum for him.  He said the million plus Muslims being held in concentration camps in China "are happy".  And liberals here aren't outraged?!

No, we can't believe anything they say.

Two weeks ago it was 1000 infected.  Now it is 40,000.  Neither number is accurate.  How do we do the math or know the danger level?
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on February 10, 2020, 05:25:53 PM
Title: What happens when the global supply chain grinds to a stop?
Post by: G M on February 10, 2020, 06:04:39 PM
Title: Re: What happens when the global supply chain grinds to a stop?
Post by: G M on February 10, 2020, 06:15:51 PM

Title: Coronavirus analysis
Post by: G M on February 12, 2020, 10:56:54 PM

Title: Re: Coronavirus analysis
Post by: G M on February 12, 2020, 11:01:21 PM
Title: US mil prepping for coronavirus pandemic
Post by: G M on February 12, 2020, 11:25:07 PM
Title: China promises it didn't leak a bioweapon in Wuhan
Post by: G M on February 13, 2020, 06:00:14 PM

And promises to never do it again!
Title: Who needs China's medical supplies?
Post by: G M on February 15, 2020, 09:15:19 PM

We do.
Title: Steve Bannon and Guest on Pandemic
Post by: Crafty_Dog on February 17, 2020, 01:37:18 PM
This episode is strongly recommended by Michael Yon:
Title: GPF: How dangerous is Kung Flu?
Post by: Crafty_Dog on February 17, 2020, 02:22:51 PM

February 17, 2020   View On Website
Open as PDF

    How Dangerous Is the Wuhan Coronavirus?
By: Ryan Bridges

The political and economic effects of the new coronavirus – both in China and across the globe – hinge overwhelmingly on just how successful efforts to stop its spread are likely to be. Forecasting these, therefore, requires us to take a closer look at the mechanics of both contagion and containment.

When determining how dangerous an infectious disease can be, microbiologists and epidemiologists need to know two numbers: R0 (called R-naught) and the case-fatality rate (which is actually a ratio, not a rate). The former estimates how infectious the disease is, while the latter provides an insight on its virulence.

R0 is an attempt to calculate how many people will catch a disease from an infected person. An R0 of 2, for instance, means that an infected person will spread the disease to two other people. But this is not an easy number to calculate. A paper published in the scientific journal PLOS One describes two methods for finding R0. One involves hunting down every contact of several infected people to determine how many get sick and averaging the results; the second involves calculating an estimate by plugging cumulative data into equations that serve as infectious disease models.

But, as an article in The Atlantic explains, R0 is even trickier than that. It can change depending on external circumstances. A public health campaign or an effective quarantine could lower R0, while the virus’ spreading to a region with poor health care could increase R0. Perhaps the most salient point is that an R0 greater than 1 suggests that the infection will spread, while an R0 less than 1 suggests it will fizzle out.

As its name implies, the case-fatality rate estimates the percentage of deaths that occur among infected people. The Wuhan coronavirus has an estimated case-fatality rate of about 2 percent, meaning that there are two fatalities for every 100 cases of the disease. Science News reports that “the [World Health Organization] says less than 2 percent of patients who have fallen ill with 2019-nCoV have died, most often from multi-organ failure in older people and those with underlying health conditions.”

But just like R0, this number can be tricky to calculate and interpret. First, the true number of cases is hard to know for sure, since people who contract a mild version of the disease don’t go to the hospital, don’t get tested, and don’t become tallied in the official statistics. Second, the case-fatality rate will vary inversely with the quality of a health care system. Wuhan was so overwhelmed by the coronavirus that hospitals were turning away patients. It is quite likely that some people who died could have been saved had they received treatment. Combined, these facts would suggest that the case-fatality rate for the Wuhan coronavirus is lower than 2 percent, especially if an infected person is treated in an advanced nation with a good health care system. Indeed, an article in Reuters concluded that infections have been underreported. As of publication, data from Johns Hopkins show that of the more than 1,000 deaths, only two have occurred outside mainland China (in the Philippines and Hong Kong).

Despite the difficulty in calculating R0 and the case-fatality rate, these numbers are worth estimating because they help place a new disease in the context of what is known about other diseases. The R0 of measles could be as high as 18, while the case-fatality rate of seasonal influenza is approximately 0.1 percent. Thus, preliminary numbers suggest the Wuhan coronavirus is less infectious than measles but deadlier than seasonal flu. But, because of the sheer number of cases of seasonal flu (which number in the millions), the global death toll from influenza is far greater, estimated to be approximately 300,000 to 500,000 deaths annually.

Containing the Coronavirus

The global economy surely will take a substantial hit from the coronavirus. This will be the result of China’s massive, citywide quarantines, a decrease in industrial output, and travel restrictions and supply chain disruptions. Many such efforts to contain the coronavirus are disproportionate to the threat.

China’s massive quarantines will probably work to an extent – after all, preventing people from traveling within and between
cities will help curb transmission of the virus – but this measure cannot be implemented in free societies. In non-authoritarian countries, only individuals can be quarantined, and this has been adequate to prevent the spread of disease. (When Ebola came to the United States, it didn’t spread far thanks to effective treatment and isolation procedures.) Citywide quarantines also aren’t necessary because the best way for uninfected people to remain that way is to wash their hands frequently and to avoid touching their face while in public. It’s difficult to say whether wearing a mask accomplishes anything. On the one hand, masks catch respiratory droplets, which is why sick people and those with whom they are in close contact absolutely should wear them. On the other hand, viruses are so tiny, they can pass right through masks. To the extent that a mask prevents a person from touching his or her face, then a mask may provide some protection. However, the Centers for Disease Control and Prevention does not recommend that healthy people wear a mask in public.

While coronaviruses can spread via frequently touched fomites (objects, such as doorknobs, that can transmit an infection indirectly to another person), it is not known how long they can survive outside the body on surfaces. While some scientists believe that coronaviruses can last only a few hours, a newly published literature review in the Journal of Hospital Infection concludes that they “can persist on inanimate surfaces like metal, glass or plastic for up to 9 days, but can be efficiently inactivated by surface disinfection procedures… within 1 minute.” Because exports from China take 30 to 40 days to arrive in the United States (if shipped via ocean freight), there is virtually no chance that exported products could infect Americans – unless the export is an infected human, animal or animal product.

When Overreactions Are Rational

The most serious threat to the global economy is not from the virus itself but from overreaction. Chinese manufacturing plants sit idle due to sick or quarantined workers. Travel into and out of China has been reduced. These overreactions are understandable, however, because scientists and public health officials have expressed a lot of uncertainty about the virus. When faced with uncertainty – particularly when that uncertainty potentially involves death – people (especially politicians) behave cautiously. (From the American perspective, restricting travel to China has the side benefit of squeezing that nation’s economy even further.)

The general public hates uncertainty. But scientists live in a world of probability and are very comfortable dealing with uncertainty. This is also why scientists rarely use words like "never" and "always." (We know better from experience. At one time, we thought all swans were white, until we went to Australia and found black swans.) This difference between the public and scientific community on the relationship to risk creates a communication gap that further feeds the uncertainty.

Ultimately, the future of the Wuhan coronavirus is not knowable. Like the other major coronavirus epidemics that preceded it, the Wuhan virus is thought to have jumped from animals to humans. SARS terrified the world, but then quickly vanished. MERS, on the other hand, is now endemic, meaning there are a few cases that occur all the time. The Wuhan virus could follow either path or some other path entirely.

Just like an economic recession, an infectious disease outbreak provokes strong psychological responses. Life will return to normal when enough people believe that it’s okay to return to normal.   

Title: Re: Steve Bannon and Guest on Pandemic
Post by: G M on February 17, 2020, 02:45:42 PM
This episode is strongly recommended by Michael Yon:

Worth the time to listen to.
Title: Yon recommends this on Japan
Post by: Crafty_Dog on February 19, 2020, 10:34:27 AM
Title: China deploys 40 industrial incinerators to Wuhan
Post by: G M on February 19, 2020, 02:12:59 PM

Hopefully, their definition of medical waste doesn't include the possibly infected or political dissidents.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on February 19, 2020, 06:47:18 PM
Title: Corona with a slice of recession
Post by: G M on February 19, 2020, 08:41:09 PM
Title: Not looking good...
Post by: G M on February 22, 2020, 07:42:39 PM
Title: Coronavirus-plan accordingly
Post by: G M on February 24, 2020, 08:21:23 PM
Title: What Next? (Coronavirus)
Post by: G M on February 26, 2020, 08:37:25 AM

What Next?

If you missed it, read yesterday's post of CDC warnings.

If there are mass quarantines in effect at some point, you're going to need some things.
Some of them you know, and some of them you probably haven't made provision for.

1) Water
One gal/person/day, minimum.
If you're planning on city water continuing to flow, of luck there.
Hope ain't a plan.
Three days without water, and your kidneys will begin to shut down.

2) Food
Figure out a menu for a month. Focus on variety, and calories, ideally of easy-to-prepare food.
Now get to where you have six to twelve months' worth on hand.
If you're planning on the .Gov handing out MREs, of luck there.
Hope ain't a plan.

3) Rx and OTC meds.
Your pharmacy probably won't be open, and you may need to care for yourself and/or family members.
For any conditions you already have, and possibly also Kung Flu.

4) Lights and Heat/AC
If water stops, what makes you think power, gas, etc. will still continue?

5) Banking and cash reserves
Your landlord or bank is still going to expect you to make rent/mortgage payments.
Ditto for property taxes. Trash or utility bills. Any other regular payments.
Whether banks are still operational is an open question. Options, and a cash reserve float, would be prudent. Doubly so if this becomes you not going to work for an extended period, non-voluntarily.

6) Your home version of 9-1-1.
Protection from stupid people, because you've got something they didn't plan to have.
I don't care if, for you, that's a big dog, a baseball bat, a loaded .45, or prayer beads.
People are stupid now, pre-panic.
Think hurricane, that lasts months, here.
Imagine your stupidest near-neighbor, two months into being hungry every day.

Hopefully, nothing gets this bad, or lasts for very long.
But it might. And stay-at-home quarantines are what CDC is talking about when they talk about "community mitigation measures" and "tele-schooling, and tele-working".
And yet again, hope ain't a plan.

Notice I said nothing about isolation gear.
That's because
a) you won't have enough, ever
b) playing outside in a pandemic is about as bright as playing on the highway
c) the results are likely to be rather similar
Stay inside means stay inside.
Going out and about is simply rolling the dice with catching something you didn't have, until you got stupid.
Don't do that.

Someone really smart would start doing an inventory, and see where they're short, then start backfilling those holes in their abilities. That way you're the solution, and not part of the problem, if/when this becomes a thing.

And if it never does, nothing on this list goes bad overnight, and solves 99% of your problems in every other disaster/problem you're likely to face.

It's also too late to shop when they announce things are shutting down now, like they will, with barricades and check points already up.

So decide whether you'd rather be a month early, or five minutes too late.
You only get one chance to make that choice, and it's now.
Title: coronavirus
Post by: ccp on February 26, 2020, 05:39:25 PM
I dunno
we don't quarantine for flu
every yr
this sounds similar
to me

many likely to get, few to die
in US
will be worse in the 3rd world tho

I doubt I will lock myself up for 30 days ........
the world will not end.

if one wants to avoid move the N Pole.
and no visitors for a yr.
Title: OZ pulls the trigger on Pandemic plan
Post by: G M on February 26, 2020, 09:13:45 PM
Title: Taiwan vs. China on the Kung Flu
Post by: Crafty_Dog on February 27, 2020, 01:27:27 AM
Title: "WHO official" criticizes Trump speech
Post by: ccp on February 27, 2020, 07:20:06 AM

guess who the WHO official is:

One guess related to Rahm. 

I posted some yrs back I saw him and med conference in NJ some yrs ago about different topics .


not sure why we are urged to get 30 days of water.
is there a concern someone will sneeze into the water supplies?
is there a concern I won't be able to turn the faucet?

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on February 27, 2020, 09:44:38 AM
Not willing to sign on for the cookies to get that article.

Tucker had something about the head of the WHO being an corrupt east African quasi-jihadi type or something like that.
Title: Re: "WHO official" criticizes Trump speech
Post by: G M on February 27, 2020, 09:45:02 AM

guess who the WHO official is:

One guess related to Rahm. 

I posted some yrs back I saw him and med conference in NJ some yrs ago about different topics .


not sure why we are urged to get 30 days of water.
is there a concern someone will sneeze into the water supplies?
is there a concern I won't be able to turn the faucet?

If the trucks stop running, your local grocery store runs out in 72 hours or less. If the trucks aren’t bringing water purification chems to the local water facility, you will need to purify it yourself. If your water system isn’t gravity fed and the electric grid is down, no water from faucet.
Title: Saudi shut down pilgrimage
Post by: Crafty_Dog on February 27, 2020, 09:52:05 AM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: G M on February 27, 2020, 10:00:20 AM

Pretty big deal for them to do that.

Title: Trump fired pandemic team?
Post by: Crafty_Dog on February 27, 2020, 10:51:47 AM
Title: Trump and the pandemic team
Post by: ccp on February 27, 2020, 03:38:04 PM

Breitbart sites AP for this response:
Title: New whistle suckers and their Dem Party lawyers
Post by: ccp on February 27, 2020, 04:12:59 PM

New grounds to impeach.  :roll:
Title: Re: New whistle suckers and their Dem Party lawyers
Post by: G M on February 27, 2020, 05:13:32 PM

New grounds to impeach.  :roll:

These are our top people who should tell us how to live.
Title: Japan: Patient infected a second time?!?
Post by: Crafty_Dog on February 27, 2020, 06:11:00 PM
Title: Think hard about how to proceed
Post by: G M on February 27, 2020, 09:53:59 PM

Getting very real.
Title: Noonan
Post by: Crafty_Dog on February 28, 2020, 01:38:20 AM

By Peggy Noonan
Feb. 27, 2020 6:52 pm ET

President Trump holds a news conference on the coronavirus in Washington, Feb. 26.
Punditry 101: It’s bad when you don’t write about what you’re thinking about. All week I was taking notes knowing I’d be looking at South Carolina, Super Tuesday and this week’s debate. I was thinking about polls and Rep. Jim Clyburn’s beautiful remarks in support of Joe Biden. They were beautiful because they were highly personal without being manipulative, which is now something unusual in American politics. But my mind kept tugging in another direction. So I’ll write what I’m thinking, and it may be ragged but here goes.

I’ve got a feeling the coronavirus is going to be bad, that it will have a big impact on America, more than we imagine, and therefore on its politics. As this is written the virus is reported in 48 nations. We’ve had a first case with no known source, in California, and the state is monitoring some 8,400 others for possible infection. Canada has 13 cases. There have been outbreaks in Iran and Italy; in Rome, there are worries because Pope Francis had to cancel a Lenten Mass due to what the Vatican called a “slight indisposition.”

There’s a lot we don’t know but much we do. We know coronavirus is highly communicable, that person-to-person transmission is easy and quick. Most who get it won’t even know they’re sick—it feels like a cold and passes. But about 20% will get really sick. Among them, mortality rates are low but higher than for the flu, and higher still among those who are older or impaired.

So it’s serious: A lot of people will be exposed and a significant number will be endangered. And of course there’s no vaccine.

We live in a global world. Everybody’s going everyplace all the time. Nothing is contained in the ways it used to be. It seems to me impossible that there are not people walking along the streets in the U.S. who have it, don’t know it and are spreading it.

Americans are focusing. If you go to you famously find that the best face masks are no longer available, but check out the prices of hand sanitizers. They appear to be going up rather sharply! (Note to Jeff Bezos: if this turns bad and people start making accusations about price gouging and profiteers, public sentiment won’t just be hard on manufacturers, they’ll blame you too. Whatever downward pressure can be applied, do it now, not later.)

If you limit your focus to politics, to 2020 election outcomes, you find yourself thinking this: Maybe it’s all being decided not in the next few weeks of primaries but in the next few weeks of the virus, how much it spreads, and how it’s handled.

If coronavirus becomes a formally recognized world-wide pandemic, and if it hits America hard, it is going to change a lot—the national mood, our cultural habits, the economy.

The president has been buoyed the past few years by a kind of inflatable raft of good economic news and strengths. The Dow Jones Industrial Average gained 8,581 points from the day he took office to the beginning of 2020. Unemployment is down so far it feels like full employment. Minority employment is up, incomes are up. He’s running for re-election based on these things.

But the stock market is being hit hard by virus-driven concerns. If those fears continue—and there’s no reason to believe they won’t—the gains the president has enjoyed could be wiped out.

As for unemployment, if the virus spreads people will begin to self-distance. If they shop less, if they stay home more and eat out less, and begin to cancel personal gatherings—if big professional events and annual meetings are also canceled—it will carry a whole world of bad implications.

What I notice as a traveler in America is the number of people who make a traveler’s life easier, and whose jobs depend on heavy travel—all the people in the airport shops and concessions, and those who work in hotels. There’s the woman whose small flower shop makes the arrangements for the donor reception at the community forum, and the floor managers, waiters and waitresses at the charity fundraising dinner. Local contractors, drivers, the sound man who wires the dinner speaker. Many are part of the gig economy, operating without the protections of contracts and unions. If the virus spreads and events are canceled, they will be out of jobs. And that’s just one sliver of American life.

In a public-health crisis the role of government is key. The question will be—the question is—are the president and his administration up to it?

Our scientists and health professionals are. (I think people see Tony Fauci of the National Institutes of Health as the de facto president on this.) Is Donald Trump? Or has he finally met a problem he can’t talk his way out of? I have written in the past questioning whether he can lead and reassure the nation in a time of crisis. We are about to find out.

Leaders in crises function as many things. They are primary givers of information, so they have to know the facts. They have to be serious: They must master the data. Are they managerially competent? Most of all, are they trustworthy and credible?

Or do people get the sense they’re spinning, finagling, covering up failures and shading the facts?

It is in crisis that you see the difference between showmanship and leadership.

Early signs are not encouraging. The messaging early this week was childish—everything’s under control, everything’s fine. The president’s news conference Wednesday night was not reassuring. Stock market down? “I think the financial markets are very upset when they look at the Democratic candidates standing on that stage making fools out of themselves.” “The risk to the American people remains very low.” “Whatever happens we’re totally prepared.” “There’s no reason to panic, because we have done so good.”

It was inadequate to the task.

I wonder if the president understands what jeopardy he’s in, how delicate even strong economies are, and how provisional good fortune is.

If you want to talk about what could make a progressive win the presidency it couldn’t be a better constellation than this: an epidemic, an economic downturn, a broad sense of public anxiety, and an incumbent looking small. Especially if the progressive says he stands for one big thing, health care for everyone.

The only candidate to bring up the threat of coronavirus at the Democratic debate the other night was Mike Bloomberg. This is how you’ll know the fact of the virus has hit the political class: Politicians will stop doing what they’ve done for more than two centuries. They’ll stop shaking hands. It will be a new world of waving, nodding emphatically, and patting your chest with your hand.

Some kinda world, when the pols can’t even gladhand.

It would be extremely reassuring if a temporary armistice were called in the cold war between the White House and congressional Democrats. If the virus is as serious as I think it is, no one will look back kindly on anyone who acted small.
Title: death rate
Post by: ccp on February 28, 2020, 04:52:22 AM

I suspect the actual numbers here will be much less but. who really knows.
University of Nebraska ID expert on yesterday saying he suspects it will be less than 1%.

The total world wide death rate in the 1918 epidemic was estimated at 30,000 for decades though for some inexplicable reason the numbers seem to get higher as we get further from the disease -  50 mill even 100 mill.

If I recall the death rate was about 5% at that time.
Title: Lowry WH should not down play virus
Post by: ccp on February 28, 2020, 06:35:52 AM

in New Jersey the politicians have become our nannies.
Everytime there is a thunder shower I get some sort of warning on my phone
before it rains .

If we have one inch of snow we are hearing warnings about a storm schools are closing
and we advised only go out if absolutely needed

Like every time I get into my car I get a warning about driving and using the radio. and the radio WILL NOT turn on till I am forced to see this
someone is always "covering their ass" at my inconvenience .

the Pols feel if they don't put the warning out they could be criticized if a few people slip in rain or ice.

I just want the information from the CDC and not endless nanny warnings making hysteria worse.

Title: How Iran fuct up
Post by: Crafty_Dog on February 28, 2020, 01:24:43 PM

Title: D1 freaks out
Post by: Crafty_Dog on February 28, 2020, 02:25:14 PM
second post
Title: Impact on IRan
Post by: Crafty_Dog on February 28, 2020, 02:38:15 PM
third post

February 28, 2020   View On Website
Open as PDF

    The Coronavirus Outbreak: Impact on Iran
By: Caroline D. Rose

Over the past two weeks, Iran has been dealing with an outbreak of coronavirus that has so far led to 388 infections and 34 deaths in the country. The government has struggled to contain the virus, and in barely more than one week, there have already been riots over its mismanagement of the outbreak. The virus has not only had political consequences but also economic ramifications, especially stemming from the closure of border crossings with some of its most critical trade partners. The dissatisfaction with the government’s handling of the outbreak comes at an especially vulnerable time for the regime. Over the past two years, the United States has applied a maximum pressure campaign on Iran that it hoped would squeeze the country’s finances, instigate social unrest and curtail Iranian influence in the Middle East. It has done so mainly through sanctions, which have crippled Iran’s economy and caused some degree of unrest but failed to weaken the regime to the point of collapse. The coronavirus outbreak, however, has the potential to undermine the regime in ways that U.S. sanctions never could.

Still, we don’t expect the government to completely crack under the pressure; Tehran will manage by implementing curfews, quarantines and other measures to crack down on anti-government sentiment. But coronavirus is yet another issue that will cause the public’s frustration with the government to rise. It highlights the growing distrust of the regime, as well as the government’s own resilience in the face of adversity.

Economic Implications

Many have highlighted the potential implications of the outbreak for Iran’s economy, particularly the effects on trade and Iran’s currency. But the country’s formal economy won’t take as big a hit as other affected countries like China and Italy. Sanctions have already crippled Iran’s economy, forcing the country to reduce its dependence on exports and rely increasingly on illicit trade. While the outbreak will certainly further discourage other countries from trading with Iran and affect its access to foreign currency, the list of willing buyers for Iranian exports is already limited, and the value of the rial has already declined substantially.

Instead, the outbreak’s largest economic impact will be felt in the shadow economy, which has been Iran’s greatest weapon against sanctions. Iran’s gross domestic product dropped by 4.8 percent in 2018 and an additional 9.5 percent in 2019, and its unemployment level rose to 16.8 percent last year. Import shortages, high living costs, drained foreign currency reserves, a strained pension system, and skyrocketing prices for bread, beef, sugar and milk have also contributed to the country’s deep recession. Iranians have therefore increasingly resorted to the informal market as a means of survival. In 2017, Iran’s informal economy was estimated to account for about 36 to 38 percent (worth $12.3 billion) of economic activity in the country. Experts estimated that $10 billion to $15 billion worth of products were smuggled across Iran’s borders annually. By contrast, non-oil exports traded through official channels were worth about $650 million in 2019. At a time of extreme economic hardship, therefore, smuggling has provided a source of income for thousands of otherwise unemployed Iranians.

The informal economy has also enabled Iran’s oil export market to survive. This is because U.S. sanctions only target trade of Iranian goods in the formal market. In May 2019, the U.S. announced a fresh round of sanctions with the intention of slowing Iranian crude production to zero. The campaign has been fairly successful: Iranian exports have fallen 87 percent from 2016 levels, and oil output decreased to 2.1 million barrels per day last October from 3.8 million bpd in 2018. Tehran has therefore been forced to turn to other means, including smuggling, to sell its most profitable export.

In 2018, experts estimated that between 5.3 million to 10.6 million gallons of crude were smuggled out of Iran daily – though this number has undoubtedly declined as production has fallen. Proxy networks and Iraqi Shiite militias loyal to Tehran have served as dependable intermediaries in Iranian smuggling networks. Militias within Iraq’s Popular Mobilization Forces, which the Iraqi government has entrusted with guarding certain border checkpoints, patrolling highways and protecting oil fields, have been particularly helpful. Iraqi Shiite groups and Iran’s Islamic Revolutionary Guard Corps have also helped smuggle Iranian crude into Syria, now the largest customer for Iranian oil. Crude is typically smuggled across the border using trucks and vans through unofficial or militia-guarded checkpoints, particularly along challenging terrain such the marshlands in the Maysan province. It is often offloaded between Iraqi Shiite groups with limited Iranian logistical supervision and transported along the al-Boukamal-al-Qaim highway at the Iraq-Syria border. Though trucks, which can carry only about 120 barrels of oil, and vans, which can carry only 12 barrels, are not as efficient as oil tankers, Iran’s wide network of proxies in Iraq has turned cross-border smuggling into one of the most reliable methods of distributing Iranian oil to external markets.

But this method will be jeopardized if Iraq closes its border over coronavirus fears. Iraq has already closed some crossings for several days to stop the virus from spreading. The economic impact will depend on how strictly Baghdad enforces the border closures and prohibition on travel to and from Iran. Smuggling won’t end entirely, as poorly defended border crossings will continue to enable illicit trade. But the element of fear will certainly have an impact on Iran’s informal economy. All of the reported infections in Iraq and Lebanon have been linked to Iran. People involved in the trafficking of goods will be increasingly hesitant to deal with Iranians, particularly as cases in the region continue to rise in countries that lack protective gear, medical services and well-staffed hospitals. Even if the Iraqi government does not enforce the border closure as strictly as it says it will, the virus could take a toll on Iran’s informal economy.

Political Unrest

Most importantly, the virus comes to Iran at a politically inopportune time. In its first two weeks of the outbreak in Iran, the government has already shown signs of unpreparedness. Sanctions and the recession have stripped Iran’s health care system down to its bones, depriving it of critical medical equipment, personnel and expertise. As of 2019, the World Health Organization recorded the country had only 10 doctors per 10,000 people. (For comparison, in the U.S. there are 45 doctors per 10,000 – and the Association of American Medical Colleges considers even this a shortage.) Reports have poured in from Iran about the lack of protective masks, hand sanitizer and adequate medical equipment in both rural and urban environments. And the government’s track record of reporting infections has upset opposition lawmakers and citizens alike. Tehran announced the two cases that hit Qom on Feb. 19, two days before elections to the country’s parliament, or Majlis, and withheld information about an additional 18 cases and two deaths (translating to a higher mortality rate than the global rate of a little over 3 percent) two days later.
(click to enlarge)

But the government had a powerful interest in underselling the scale of the outbreak, less than two months after it sparked protests when it accidentally shot down a Ukrainian passenger airplane during a missile barrage targeting U.S. forces in Iraq, and ahead of an election that was already fated to be controversial. In January, the Guardian Council barred 6,850 reformist candidates from the ballot, causing widespread outcry over a lack of democratic representation and leading to calls, particularly in urban areas, to boycott the vote. The last thing the government needed, then, was a mass viral outbreak that would further damage the credibility of itself and the election. In the end, the election’s outcome was favorable for Supreme Leader Ayatollah Ali Khamenei, with 30 conservative hardliners gaining seats in the Majlis. Just 42.57 percent of Iranians voted, the lowest participation rate since the 1979 Islamic Revolution and down nearly 20 percentage points from the previous election in 2016. Fear of infection certainly played a role in keeping Iranians from the ballot box, and the government didn’t shy away from accusing its “enemies” of sensationalizing the outbreak to influence its internal affairs – even if, in the end, the low turnout probably worked to the government’s advantage.

In the wake of the election, as the extent of the outbreak has become clear, there have been riots over the government’s mishandling of the virus. In Talesh, a city in Iran’s northern Gilan province, people protested the government’s secrecy and mysterious quarantines outside a hospital on Feb. 23 until security forces dispersed them with tear gas. In Isfahan, medical students protested in front of the University of Medical Sciences over the lack of protective gear and supplies, while in Rasht, protesters started fires in the streets to oppose unexplained street closures, where they were met with crackdowns from security forces. And in Najaf, protesters upset with the government’s refusal to close the city’s international airport attempted to block travelers’ access.

In the face of rising unrest, Tehran has tried to nip political threats in the bud. On Feb. 26, Iran’s cyberpolice unit arrested 24 people accused of spreading rumors about the virus, and warned news outlets and social media users against reporting cases that contradicted official reports. The government is gradually shutting down social gatherings, religious sites, schools and sports matches in affected provinces as well as the cities of Isfahan, Mashhad, Tabriz, Shiraz and Tehran, which will soon turn into full-fledged quarantines and curfews. Under such restrictions, large anti-government gatherings will be difficult to coordinate. But that doesn’t mean political resentment toward the regime won’t continue to fester.

In unstable countries such as Iran, the coronavirus outbreak is not only a health crisis but also a political and economic threat to the regime. In the face of a crushing sanctions campaign, the government has been struggling to keep the lights on, keep protesters off the streets and keep up its campaign to spread its influence in the region. The hospitals are lacking proper medical kits and virus protection to treat patients. Panic risks crippling its illicit economy, which has struggled to make up for its teetering formal economy. With such political and economic uncertainty, Iran’s government cannot finance this outbreak and come out unscathed. However, after everything the regime has endured in recent years, it will likely take much more than the coronavirus to force regime change.   

Title: FDA reports first drug shortage
Post by: Crafty_Dog on February 28, 2020, 05:25:02 PM
fourth post
Title: Newt G: Asking the right questions
Post by: Crafty_Dog on February 28, 2020, 09:16:53 PM
Fifth post
Title: Re: FDA reports first drug shortage
Post by: G M on February 28, 2020, 09:24:32 PM
fourth post

I expect that the drug/medical supply shortages to kill more people in the US than the virus.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on February 28, 2020, 09:27:03 PM

A point that caught my attention today was the danger of secondary respiratory infections going uncured as we run out of antibiotics due to supply chain issues with China.

In the meantime, the Jews are on it:
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on February 29, 2020, 09:58:09 AM
if I recall the 1918 -19 pandemic lasted ~ 14 mo .
and traversed the globe twice

Title: Buy while you can
Post by: G M on February 29, 2020, 11:59:37 AM
Title: Things that make you go "Hmmmm . . ."
Post by: Crafty_Dog on February 29, 2020, 12:12:41 PM
Title: Re: Things that make you go "Hmmmm . . ."
Post by: G M on February 29, 2020, 12:26:16 PM

I don't doubt the left is hoping for the virus to derail Trump's chances for re-election. That doesn't negate the very real impact it will have on us all.
Title: Don't test, don't tell
Post by: G M on February 29, 2020, 04:55:03 PM

I was wondering how Vegas didn't have any cases.
Title: 4 cases in Coahuila, Mexico
Post by: Crafty_Dog on February 29, 2020, 09:39:19 PM
Well, apparently they are testing in Coahuila
Title: Re: 4 cases in Coahuila, Mexico
Post by: G M on February 29, 2020, 09:59:50 PM
Well, apparently they are testing in Coahuila

Good thing we have a secure border to keep the infected in Mexico from flooding into the US for medical treatment!
Title: It's just like the flu!
Post by: G M on March 02, 2020, 08:47:53 AM

Go back to sleep. Everything is fine.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: DougMacG on March 02, 2020, 06:19:59 PM
Coronavirus: China stabilises with lowest new cases since epidemic began
Expert team and supplies arrive in Tehran to help worst-hit country outside China cope with epidemic while Chinese officials report record low of 125 new cases.
7 minutes ago

Dow up today.  When is the big scare over?
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: G M on March 02, 2020, 06:26:17 PM

Greta be praised!

Coronavirus: China stabilises with lowest new cases since epidemic began
Expert team and supplies arrive in Tehran to help worst-hit country outside China cope with epidemic while Chinese officials report record low of 125 new cases.
7 minutes ago

Dow up today.  When is the big scare over?
Title: George Friedman on Corona
Post by: Crafty_Dog on March 03, 2020, 04:23:14 AM
George Friedman is the founder of Stratfor, and then of Geopolitical Futures.

March 3, 2020 View On Website
Open as PDF

Thoughts on the Coronavirus
By: George Friedman

I have presented geopolitics to be like economics, a science that predicts and summarizes the impersonal forces that drive a system so vast as to be beyond the control of individuals. Each is controlled by forces so powerful that kings and peasants alike must align with them or fall victim to them. Kings ultimately do not decide the global business cycle, nor do they control the relations between nations. Kings must align with the overwhelming forces that are at work.

To some extent, individuals are helpless in the face of massive forces. In a world of seven billion people and endless variables, humans make history by aligning with it. This is difficult, since thinking that we are caught in a storm in which we may choose to get wet or to make and sell umbrellas collides with the idea that we are all masters of our fate. We are masters of our fate in making certain we understand the forces that compel and constrain us. We are masters of our fate in choosing how we align with the broad reality. But when markets decline, we can claim to have willed them to do so, but the markets consist of billions of people making billions of decisions, so the best we can do is try to anticipate the decisions that are going to be made.

There is something preposterous in all this. We all know that politicians do make decisions and that these decisions matter. It is the wisdom and goodwill of the leader, and sometimes the lack of both, that make history. The idea of history being out of control – the idea that depressions and war are ultimately beyond the control of the leaders whom we hold responsible for all things, good and bad, and can at best anticipate what is coming and mitigate it – is terrifying. Far better to imbue them in our minds with powers they don’t have, to praise or execute them for things over which they are as helpless as we are.

I bring this up in light of the coronavirus, which exists outside the purview of world leaders. It is dreadful because it will do what it will do. It is even more dreadful because it is a virus, something without consciousness that cannot be reasoned with or bribed. We are merely observers of it, waiting for it to show whether it is as powerful as we fear, and waiting with even more dread to see whether we or those we love will fall victim to its terrible power or be saved with the discovery that its power will be meager. We search for a way to align ourselves with the disease, but like history, it flows on.

We live in the age of technology that has achieved remarkable things, from antibiotics to microchips to visions of the universe. We take pride in what has been wrought. But each of these things has come from understanding the nature we have been given, aligning with its forces, and crafting engines that conform with nature, not changing it. And when our power grows enough that we delude ourselves to be nature’s master, something arises to remind us of our limits. In due course, it will learn more about the coronavirus, including ways we can fight it, but for now our fears take counsel of themselves.

The threat of the virus is not only that we may die, but that the fear of death will cause the world to heave up out of control. The virus first emerged with authority in China, a country dominated by the idea that the state’s power governs all things. This belief holds a fractious nation together in pride at how the state had made China great. The coronavirus showed the limits of human power, even in China. Beijing insists that it will deal with the virus and that its edicts will stop its spread, but the reality is that China is being overwhelmed, both by the disease and by the fear of the disease.

Two great forces are being hurled against each other. On the one side is a tiny bag of molecules that aligns with the vulnerabilities of the human body. On the other side is science, desperately trying to find its footing, justifying itself by asserting the limits of its knowledge and the promise that it will know more later. The virus is what it is, science is what it is, and so are the rulers, whose opinions on what the virus is and what ought to be done are of value to the extent that they conform to the reality. Our local supermarket has announced that it is rationing the number of sanitizing wipes that can be bought because of high demand, while the latest word from experts is that the virus is spread by human liquids. No matter, where there is no solution, we invent solutions. They give us comfort that we are fighting back.

In truth, we don’t know how deadly the virus is. It may kill no more than the flu. It may turn out to be much worse. We don’t know. And therefore the global economy is in disarray. China’s economy seems shattered. The price of oil is plunging. And fear of Turkey releasing Syrian refugees on Europe is now compounded by fear that they carry this disease among others.

We speak of black swans, unpredictable events that wreck economic and geopolitical expectations. This is surely a black swan, even if humanity has been periodically hit by unexpected diseases for time immemorial. We know there are black swans swimming about, and that one or two will occasionally come to shore. It is the time they decide to leave the lake, and the reasons that they have chosen this particular time, that startles us and drives us to search for explanations and solutions.

Not understanding why they chose this moment or what their intent is, we search for explanations. Since we no longer believe that they are here as God’s punishment for our sins, they must have been caused by biological warfare units, or have spread because of the incompetence of scientists and politicians. Where priests used to comfort us, now leaders do, and now we hold the leader responsible not for causing the virus, but for not acting quickly enough to protect us.

Coronavirus does not seem to be like the Black Death that wiped out half of Europe. It seems more like a nasty flu. But then that is just one guess in a world full of guesses. It has been elevated to a global menace because living in Texas, I am aware of what is going on in Wuhan. Listening to scientists, I am told that this is a new virus. Being American, I am presented with a problem and expect someone to solve it quickly. It is what I know that concerns me: The virus is global, it kills people, it has wreaked havoc in China and some other countries, and therefore I should be and am afraid. It is not the unknown but the poorly understood that is frightening, as well as the inability of very smart people charged with protecting me from all things natural and dangerous to do so.

Our expectations are what frighten us. The coronavirus does not seem especially dangerous to our species. But we have come to expect to be protected and when we are not our imaginations turn to the apocalypse. The successes of science and the claims of politicians have led us to believe in human invincibility so that the arrival of the virus is a violation of the social contract between the state, science and us. There are limits to power, and that, above all else, frightens us.
Title: Compare and contrast
Post by: G M on March 03, 2020, 10:39:08 AM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 03, 2020, 11:46:55 AM
Daily Memo: China Recovers From Coronavirus, Others Descend

Chinese imports. Chinese authorities reported 125 new coronavirus infections on Tuesday. A twist: At least 19 patients had contracted the virus from elsewhere, particularly Italy, prompting Beijing to issue a slew of warnings against travel abroad and urging Chinese citizens currently abroad to stay put. Stories (MARC: Chinese lie?) such as this enable Chinese propaganda chiefs to shift the narrative toward the complexities of epidemiology or the relative inefficiency of democracies’ efforts to mobilize against the outbreak. The problem for China (among many others) is the global spread will only compound its economic crisis. The issue now for China isn’t just the herculean task of getting people back to work and its factories up and humming (without refueling the outbreak), but also the risk that, if much of Europe, Japan and the U.S. go into lockdown – and if the resulting panic triggers a global recession – the loss of external demand for Chinese goods could torpedo the “V-shaped recovery” that would normally follow a public health crisis.

In the U.S., the virus has now been detected from the West Coast to the East Coast, and as of publication, six people have died in the United States, all in Washington state. There is, however, a possible silver lining. Based on a genetic analysis, scientists believe that the coronavirus has been circulating in the Seattle area for about six weeks. If that’s really the case, then it is almost certainly true that hundreds if not thousands of people in Greater Seattle alone already have been exposed to and infected by the virus. That only six people have died is further evidence, then, that the case fatality rate is far below the widely cited 2 percent estimate, which has likely been inflated because of the concentration of deaths in Hubei province. Some 4.2 percent of patients have died in the province, where hospitals are overwhelmed, compared to just around 0.8 percent elsewhere in mainland China. In South Korea, the rate is just above 0.53 percent, while in Italy it’s about 2.5 percent. Iran’s case fatality rate has started to normalize now that Tehran is acknowledging the scale of its outbreak (835 new confirmed cases on Tuesday alone). A lower case fatality rate would suggest the virus is more akin to a severe cold or seasonal flu than the more dire comparisons that have been made.
Title: DIY Hand Sanitizer
Post by: G M on March 03, 2020, 02:06:36 PM
Title: Chinese discharge criteria
Post by: Crafty_Dog on March 03, 2020, 11:07:23 PM
Title: F35 factory shut down in Japan
Post by: Crafty_Dog on March 04, 2020, 08:40:17 AM
Title: Brace for impact
Post by: G M on March 04, 2020, 06:56:43 PM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 04, 2020, 08:33:46 PM
Well, that was cheery , , ,
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 04, 2020, 08:54:05 PM
Title: Re: China deploys 40 industrial incinerators to Wuhan
Post by: G M on March 05, 2020, 09:18:20 PM

Hopefully, their definition of medical waste doesn't include the possibly infected or political dissidents.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 06, 2020, 07:28:15 AM
Plausible, but so far uncorroborated , , ,
Title: We are not ready for this
Post by: G M on March 06, 2020, 05:13:11 PM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 06, 2020, 07:56:18 PM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 07, 2020, 07:58:23 AM
Title: Dr. Paul Offit
Post by: Crafty_Dog on March 07, 2020, 08:11:30 AM
second post
Title: This doesn't sound good
Post by: G M on March 07, 2020, 02:48:35 PM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 07, 2020, 03:57:13 PM

At this point reading mostly the same stuff everyone else reads
I agree with the virologist

this is similar to flu. which has been "grandfathered " in.

However older people and those with chronic lung or heart issues like copd heart failure significan liver or kidney should be concerned and very cautious

the risk to nursing homes etc is alarming.

Problem is we don't yet have wide testing available so the extent is unknown
My best guess is there are 50 to 100 K people walking around now with it we don't see.
I see 25 to 40 patients a day all day long with respiratory illness some of which may well be covid 19.

As result all we hear are the announcements of the deaths the case reports in states making headlines

increasing the panic

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: G M on March 07, 2020, 06:39:15 PM
Sure. China welds people into buildings and shuts down it's economy to the point where the CCP is facing violent revolution because of bad flu.

At this point reading mostly the same stuff everyone else reads
I agree with the virologist

this is similar to flu. which has been "grandfathered " in.

However older people and those with chronic lung or heart issues like copd heart failure significan liver or kidney should be concerned and very cautious

the risk to nursing homes etc is alarming.

Problem is we don't yet have wide testing available so the extent is unknown
My best guess is there are 50 to 100 K people walking around now with it we don't see.
I see 25 to 40 patients a day all day long with respiratory illness some of which may well be covid 19.

As result all we hear are the announcements of the deaths the case reports in states making headlines

increasing the panic
Title: Millions of hospitalizations
Post by: G M on March 07, 2020, 09:04:20 PM
Title: Tariffs lifted on face masks and med supplies
Post by: Crafty_Dog on March 07, 2020, 10:56:34 PM
Title: multiple theories on where covid 19 began
Post by: ccp on March 08, 2020, 05:03:21 AM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 09, 2020, 12:02:31 PM
The Most Important Coronavirus Question
By: Alex Berezow

The first person to die from coronavirus on American soil passed away on Feb. 29 at a Seattle area hospital – incidentally, the same hospital where my daughter was born just ten and a half months ago.

For epidemiologists, the most important unanswered question about the Wuhan coronavirus, or COVID-19, is the case-fatality rate. But for the general public, the question is much more personal: “Might I – or anyone I love – get sick and die?” When faced with uncertainty, people make decisions cautiously, and they base them on emotion and personal experience instead of statistics. If enough people answer “Yes,” there could be major repercussions as panic sets in around the world. Small behavioral modifications, such as telecommuting or reducing factory activity to avoid spreading the disease, made by millions of people can have a large impact. The United Nations already estimated $50 billion worth of exports worldwide will be affected, excluding non-trade economic activities such as travel tourism, as manufacturing slows and governments impose measures like port restrictions. This is why it is necessary to develop a “risk of death” profile for COVID-19.

The first substantial effort to do just that was published by the Chinese Center for Disease Control and Prevention. Though these numbers should be thought of as preliminary (and perhaps specific to only China), they allow us to begin to comprehend the risk that our global society is facing. After analyzing 44,672 confirmed cases, Chinese health officials estimated the case-fatality rates by age group:
(click to enlarge)

Of the 416 children aged 0 to 9 who contracted COVID-19, precisely zero died. This is unusual for most infectious diseases, but not for coronaviruses; the SARS coronavirus outbreak also had minimal impact on children. For patients aged 10 to 39, the case-fatality rate is 0.2 percent. The case-fatality rate doubles for people in their 40s, then triples again for people in their 50s, and nearly triples yet again for people in their 60s. A person who contracts COVID-19 in their 70s has an 8 percent chance of dying, and a person in their 80s a nearly 15 percent chance of dying.

The virus can be lethal in a variety of ways. Viral infections in the lungs can trigger an immune response so strong that it fatally damages the lungs. In others, a systemic immune response, called a “cytokine storm,” can cause multiple organ failure. This could explain why some young, healthy people are killed by the virus, such as Dr. Li Wenliang, the 34-year-old doctor who died shortly after alerting the world to this new strain of coronavirus. An older person’s immune system may not be able to fight a respiratory virus. Underlying conditions such as high blood pressure or diabetes can worsen outcomes.

The above statistics are no doubt frightening numbers. But there are at least three major mitigating factors. First, the number of mild or asymptomatic cases is unknown and probably substantial. Second, China is still a poor country with low-quality health care and, at the epicenter of the outbreak in Hubei province, was overwhelmed by the virus. (The case-fatality rate in Chinese provinces outside Hubei, where hospitals aren’t overloaded, is much lower.) Third, smoking is much more prevalent in China than America, especially among men (52 percent in China versus 16 percent in the U.S.), and smoking is a risk factor for poor responses to respiratory infections. Together, this means the case-fatality rate is likely inflated, and it would be a mistake to apply these figures to the United States or other advanced nations.

The real question, then, is how inflated the case-fatality rates are. At this point, it’s impossible to determine because scientists are still collecting data on how widespread the virus is. But to get a sense of how exaggerated these numbers might be, it is useful to examine the case-fatality rate for seasonal influenza. For the 2018-19 influenza season, the U.S. Center for Disease Control and Prevention provides estimates for the number of cases (defined here as “symptomatic illnesses”) and deaths. From these, we can derive case-fatality rate estimates by age group.
(click to enlarge)

If COVID-19 ends up being similar to seasonal influenza, then the case-fatality rates for COVID-19 are inflated by a factor of 20 to 100. Dr. Anthony Fauci, head of the U.S. NIAID, co-authored an editorial for the New England Journal of Medicine in which he wrote:

“If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively [emphasis added].”

We have reason to believe this view is closest to reality. In South Korea, public health officials screened about 100,000 people and detected over 7,300 cases. So far, the death toll is 50, which translates to a case-fatality rate of 0.7 percent. That’s still seven times worse than seasonal flu, but it’s far lower than the initial reports from China.
(click to enlarge)

The Future of COVID-19

Stat News describes two possible scenarios that epidemiologists envision for the future of COVID-19. In the first, COVID-19 becomes just another cold virus, and possibly evolves to become less lethal as well. What we call the “common cold” is actually caused by roughly 200 different viruses. Each year, about 25 percent of common colds are due to four coronaviruses, and some scientists think COVID-19 could eventually join this group as its fifth member. In the second scenario, COVID-19 behaves more like a severe seasonal flu, vanishing in the summer and returning to hit us hard in the winter.

In neither scenario does COVID-19 resemble the Spanish flu of 1918, which disproportionately killed young people. In neither scenario does the virus mutate to become more lethal. Most likely, the opposite will be true. There is an inverse relationship between lethality and contagiousness; that is, the most contagious viruses tend to be less lethal. Evolutionary pressures – namely, the biological imperative to reproduce as far and wide as possible (which means not killing people) – may push COVID-19 down this path.

For now, influenza remains the far bigger global public health threat. Each year, about 1 billion people become infected with seasonal flu, killing some 300,000 to 500,000. This season alone (2019-20), about 20,000 Americans have died from flu, including 136 children. Yet, very few people fear the flu. Society has accepted it as part of reality, and people carry about their daily lives without excessive concern over influenza. This is the likely future for COVID-19.

Until then, perhaps the last word should be given to virologist Dr. Lisa Gralinski, who told The Scientist, “If you’re over fifty or sixty and you have some other health issues and if you’re unlucky enough to be exposed to this virus, it could be very bad.” While everyone else should remain vigilant and take proper precautions (e.g., washing hands and avoiding crowds) until more data comes in, from a scientific perspective the public alarm is disproportionate to the risk.   

Title: It's just the flu, bro!
Post by: G M on March 09, 2020, 01:21:06 PM
Title: coronavirus: We must ‘brace for a three-month problem
Post by: DougMacG on March 10, 2020, 07:07:51 AM

coronavirus: We must ‘brace for a three-month problem
Title: Fukk!!!
Post by: Crafty_Dog on March 11, 2020, 07:44:07 AM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 11, 2020, 09:14:26 AM

I have been working telemedicine for over 4 yrs now
and the calls coming in for evaluations for covid 19
are rising

especially with VP Pence mentioning telemedicine yesterday at WH with the health care CEOs

I expect we will be swamped soon
we are being asked to do extra hours shifts etc

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 11, 2020, 09:20:41 AM
Keep us posted!




Signs of a rebound in China. Chinese President Xi Jinping on Tuesday visited Wuhan, the epicenter of the coronavirus outbreak, for the first time since the epidemic began. This is one of a handful of developments we’ve been watching for from Beijing that would signal it truly thinks it has the outbreak under control – even if Xi didn’t explicitly say as much during his trip. The data coming out of China on the spread of the virus, assuming authorities aren’t somehow hiding legions of unreported cases, gives Beijing ample reason to feel confident that touting its success won’t come back to haunt it. Nearly all the new cases reported outside of Hubei province over the past few days were from people who had contracted the virus while abroad. In Hubei, meanwhile, the drop in new cases has enabled authorities to begin closing down makeshift hospitals and reportedly start considering lifting some restrictions on travel from the province. The data on the Chinese economy will stay extremely ugly for a while to come, especially as the global spread dampens consumption of Chinese exports. But it’ll be much easier to rebound with the virus broadly contained at least at home.

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: G M on March 11, 2020, 09:27:06 AM
Keep us posted!




Signs of a rebound in China. Chinese President Xi Jinping on Tuesday visited Wuhan, the epicenter of the coronavirus outbreak, for the first time since the epidemic began. This is one of a handful of developments we’ve been watching for from Beijing that would signal it truly thinks it has the outbreak under control – even if Xi didn’t explicitly say as much during his trip. The data coming out of China on the spread of the virus, assuming authorities aren’t somehow hiding legions of unreported cases, gives Beijing ample reason to feel confident that touting its success won’t come back to haunt it. Nearly all the new cases reported outside of Hubei province over the past few days were from people who had contracted the virus while abroad. In Hubei, meanwhile, the drop in new cases has enabled authorities to begin closing down makeshift hospitals and reportedly start considering lifting some restrictions on travel from the province. The data on the Chinese economy will stay extremely ugly for a while to come, especially as the global spread dampens consumption of Chinese exports. But it’ll be much easier to rebound with the virus broadly contained at least at home.

Believe nothing from China.
Title: Re: Fukk!!!
Post by: G M on March 11, 2020, 09:49:13 AM

Second and third order effects are the biggest killer.
Title: We don't need to blow this off
Post by: ccp on March 11, 2020, 04:23:54 PM
but we don't want panic either:

stimulate what ?  A dead horse?

pumping like mad
interest rates near zero

enough .

what is going to happen is going to happen
contain the virus
the best we can

many will get ill
few of those will die but will be large number since so many will likely be infected in total

this is playing out like the flu 1918- 19 epidemic

panic closing of everything people walking around with masks
hospitals overwhelmed

and few yrs later we had the roaring twenties.

damn if only I sold out to buy back later
Doug would have told me when to buy back in.
Title: Re: We don't need to blow this off
Post by: G M on March 11, 2020, 07:45:05 PM

but we don't want panic either:

stimulate what ?  A dead horse?

pumping like mad
interest rates near zero

enough .

what is going to happen is going to happen
contain the virus
the best we can

many will get ill
few of those will die but will be large number since so many will likely be infected in total

this is playing out like the flu 1918- 19 epidemic

panic closing of everything people walking around with masks
hospitals overwhelmed

and few yrs later we had the roaring twenties.

damn if only I sold out to buy back later
Doug would have told me when to buy back in.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 11, 2020, 09:25:19 PM
Title: Maybe true, but these are Obama boys
Post by: ccp on March 12, 2020, 05:01:12 AM
making the claims and fast with the criticism

watching this guy on CNN MSLSD every day bashing Trump.  Just a "non partisan career official":

“They’ve simply lost time they can’t make up. You can’t get back six weeks of blindness,” said Jeremy Konyndyk, who oversaw the international response to Ebola during the Obama administration and is a senior policy fellow at the Center for Global Development. “To the extent that there’s someone to blame here, the blame is on poor, chaotic management from the White House and failure to acknowledge the big picture.”
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 12, 2020, 08:44:32 AM
Yeah, I saw that-- but the rest of the article for me simply was a chronicling of how humans organized in government bureaucracies act and interact.  I'm of the impression that our CDC and the related agencies compare quite favorably to elsewhere in the world.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: G M on March 12, 2020, 08:49:23 AM
Yeah, I saw that-- but the rest of the article for me simply was a chronicling of how humans organized in government bureaucracies act and interact.  I'm of the impression that our CDC and the related agencies compare quite favorably to elsewhere in the world.

Our inept government drones are number one!
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 12, 2020, 09:11:08 AM
What say we?

Congress Can Take the Economic Edge off Covid-19
Give cash assistance to low-income Americans so they don’t feel compelled to go to work sick.
By Michael R. Strain and Scott Gottlieb
March 11, 2020 2:02 pm ET

Covid-19 will soon be an epidemic in the U.S. Large cities need to take emergency measures to protect their residents, especially those who are at greatest risk for hospitalization or death. Congress has an important role to play in supporting states and cities.

President Trump’s announcement on Monday that he would work with legislators on a package to help workers is a step in the right direction. As negotiations begin, what economic policies can Congress pass to help limit the virus’s spread and reduce some of its damage?

The Coronavirus Roils Markets and Washington

A top priority: shielding the poor from economic distress. Congress should make direct cash payments—mailed checks or direct deposits—to low-income households in places with severe outbreaks. Hourly wage workers should not feel compelled to show up to work sick because they need to pay bills. Congress can help these Americans recover and keep other people healthy by financing their time away from work.

In states experiencing severe outbreaks, Congress should waive the requirement that people receiving unemployment insurance payments look for work. Better that such unemployed workers receive financial assistance for rent, mortgages and groceries than to risk spreading the virus by applying and interviewing for jobs. Congress should also waive work requirements in the food-stamp program.

Children in low-income families will miss subsidized meals if schools are closed. Federal subsidies to those households should be increased to account for lost breakfasts and lunches. This might help relieve some of the pressure on low-income parents, who might otherwise feel the need to go to work even if ill.

Cash-strapped states may be reluctant to divert spending from other priorities toward health care, especially as more people use services. States that experience outbreaks may also lose tax revenue. Congress should increase the share of Medicaid spending financed by the federal government to alleviate the budget pressure.

Last week Mr. Trump signed an $8.3 billion emergency spending bill that will fund the public-health response to this outbreak, including research and development for drugs, vaccines and diagnostic tests to treat the coronavirus and stop its spread. The legislation also includes resources for state and local preparedness and response. This is a welcome development and a substantial amount of money. But if the virus continues to spread, more funding may be needed to expand hospital capacity and help local health departments enforce “social distancing” measures.

This coronavirus may be a once-in-a-generation pathogen that combines lethality with easy transmission. It is deadlier than the seasonal flu, and as contagious if not more so. Many will suffer and die if it is allowed to spread unchecked. Italy’s health-care system is on the brink of collapse. In China, fatalities in Wuhan increased as hospitals were overwhelmed. The U.S. must try to slow the spread so that health resources can be spent on those who most need care.

The bump in federal spending should be temporary and only for states experiencing severe outbreaks. Amid trillion-dollar deficits, the federal government shouldn’t spend more money unless necessary. But the risk to public health from overreacting is much smaller than the risk from an inadequate response. The country is better off spending the money to prevent deaths than spending the money to deal with the aftermath of a lethal epidemic.

More to the point, a severe outbreak could push the economic growth rate close to or below zero. In that event, additional spending to stimulate and support the overall economy—and not only areas experiencing severe outbreaks—may be necessary.

Congress should not wait until the crisis intensifies to enact these measures. These changes should be signed into law immediately, with clear triggers for additional funding. This would allow the changes to be executed before a regional outbreak spirals out of control. States will be in a much better position to plan and to address any outbreak if they know these measures will automatically kick in.

States and localities are the tip of the spear in the fight against coronavirus. Congress can—and should—give them weapons to battle the disease.

Mr. Strain is director of economic policy studies at the American Enterprise Institute, Dr. Gottlieb is a resident fellow at AEI and a partner at New Enterprise Associates. He was commissioner of the Food and Drug Administration, 2017-19.


Dodd-Frank Worsens Covid’s Risk
The Fed, FDIC and Treasury need the same powers they wielded against the 2008 crisis.
By Hal Scott
March 11, 2020 7:01 pm ET

Coronavirus is contagious. So is financial panic.

The spread of the novel coronavirus could cause a run on the financial system leading to a deep recession. Severe stock-market drops and increased demand for liquidity are warning signals. Bank equity capital has increased by $750 billion to $2.1 trillion since 2007, but a panic could still overwhelm well-capitalized banks. We need to restore the weapons to fight contagion that Congress took away during the last financial crisis. Strong pre-emptive action would greatly diminish the risk of a panic.

The previous systemic threat to the financial system was spurred by the failure of Lehman Brothers in 2008. That threat came from within the banking system in the form of bad housing loans. This time is different. Wall Street risk-taking isn’t to blame for the coronavirus.

The Coronavirus Roils Markets and Washington

In 2008 the Fed supplied needed liquidity to the banking and nonbanking financial sector, the latter through its authority under Section 13(3) of the Federal Reserve Act. Meanwhile, the Federal Deposit Insurance Corp. expanded the limits of deposit insurance, among other things providing unlimited protection for transaction accounts. The Treasury Department offered guarantees to money-market funds.

Once the crisis abated, however, there was growing public concern about “moral hazard”—that government backstops and guarantees created incentives for risky behavior. In response, the Dodd-Frank Act of 2010 limited the Fed’s lender-of-last-resort powers for nonbanks, an increasingly important part of the financial system. Fed loans to nonbanks can now be made only with the approval of the Treasury secretary. They must be done through a broad program, unlike the one-off rescue of AIG, and must meet heightened collateral requirements. Loans to nonbanks must be disclosed to congressional leaders within seven days and to the public within one year. Loans to banks must be disclosed within two years. While disclosure is usually desirable, in this situation it creates the specter of future stigma that deters financial institutions from seeking even badly needed Fed funding. Even before the current crisis, banks’ use of the discount window had dropped to record lows.

Dodd-Frank also prevents the FDIC from expanding guarantees to bank depositors without congressional approval, as it did in the credit crisis. And the Treasury is now prohibited from guaranteeing money-market funds. These legislative changes make it difficult for the Fed and other regulators to deal effectively with a financial panic.

Government agencies have compounded the problem of their own weakness with regulations that make it harder for financial firms to lend to each other. The liquidity coverage ratio, the Fed liquidity stress tests, and the “living wills” process require the largest banks to meet stiff liquidity requirements that can result in liquidity hoarding.

Even before the coronavirus sent markets tumbling, the scarcity of liquidity was a big problem. The 9% spike of overnight repurchase agreement, or repo, rates last September caused the Fed to supply as much as $75 billion a day to the repo market. Although the demand for such support had fallen to about $26 billion by the end of February, it rose to $100 billion on March 4. The Fed responded Monday by raising the minimum support offered to $150 from $100 billion. While this change is welcome, it falls short.

Here’s what should be done immediately: First, the Fed should reactivate all the facilities it created in the crisis and any additional ones it believes necessary, so it is ready to be the strongest possible lender of last resort—to do whatever it takes, consistent with its present legal authority. This includes making U.S. dollars available to other major central banks through currency swaps. And the Treasury secretary should announce his approval of these efforts, consistent with the requirements of Section 13(3). Second, financial regulators should modify their rules and supervision to stimulate liquidity in the interbank and repo markets. Third, Congress should restore all the powers it took away from the Fed, FDIC and Treasury during the crisis. Fourth, international coordination through the Group of 20 must be accelerated. This is a global problem.

China, Europe and Japan already have many of these powers. Policy makers in the U.S. need them too. Bold action can prevent a panic before it starts. The public knows the situation is serious and wants the government to act.

Mr. Scott is an emeritus professor at Harvard Law School and the director of the Committee on Capital Markets Regulation.

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: G M on March 12, 2020, 09:13:53 AM
Sure, why not? It totally won't be abused!

What say we?

Congress Can Take the Economic Edge off Covid-19
Give cash assistance to low-income Americans so they don’t feel compelled to go to work sick.
By Michael R. Strain and Scott Gottlieb
March 11, 2020 2:02 pm ET

A sign calling for affordable Covid-19 drugs in Washington, March 5.
Covid-19 will soon be an epidemic in the U.S. Large cities need to take emergency measures to protect their residents, especially those who are at greatest risk for hospitalization or death. Congress has an important role to play in supporting states and cities.

President Trump’s announcement on Monday that he would work with legislators on a package to help workers is a step in the right direction. As negotiations begin, what economic policies can Congress pass to help limit the virus’s spread and reduce some of its damage?

The Coronavirus Roils Markets and Washington

A top priority: shielding the poor from economic distress. Congress should make direct cash payments—mailed checks or direct deposits—to low-income households in places with severe outbreaks. Hourly wage workers should not feel compelled to show up to work sick because they need to pay bills. Congress can help these Americans recover and keep other people healthy by financing their time away from work.

In states experiencing severe outbreaks, Congress should waive the requirement that people receiving unemployment insurance payments look for work. Better that such unemployed workers receive financial assistance for rent, mortgages and groceries than to risk spreading the virus by applying and interviewing for jobs. Congress should also waive work requirements in the food-stamp program.

Children in low-income families will miss subsidized meals if schools are closed. Federal subsidies to those households should be increased to account for lost breakfasts and lunches. This might help relieve some of the pressure on low-income parents, who might otherwise feel the need to go to work even if ill.

Cash-strapped states may be reluctant to divert spending from other priorities toward health care, especially as more people use services. States that experience outbreaks may also lose tax revenue. Congress should increase the share of Medicaid spending financed by the federal government to alleviate the budget pressure.

Last week Mr. Trump signed an $8.3 billion emergency spending bill that will fund the public-health response to this outbreak, including research and development for drugs, vaccines and diagnostic tests to treat the coronavirus and stop its spread. The legislation also includes resources for state and local preparedness and response. This is a welcome development and a substantial amount of money. But if the virus continues to spread, more funding may be needed to expand hospital capacity and help local health departments enforce “social distancing” measures.

This coronavirus may be a once-in-a-generation pathogen that combines lethality with easy transmission. It is deadlier than the seasonal flu, and as contagious if not more so. Many will suffer and die if it is allowed to spread unchecked. Italy’s health-care system is on the brink of collapse. In China, fatalities in Wuhan increased as hospitals were overwhelmed. The U.S. must try to slow the spread so that health resources can be spent on those who most need care.

The bump in federal spending should be temporary and only for states experiencing severe outbreaks. Amid trillion-dollar deficits, the federal government shouldn’t spend more money unless necessary. But the risk to public health from overreacting is much smaller than the risk from an inadequate response. The country is better off spending the money to prevent deaths than spending the money to deal with the aftermath of a lethal epidemic.

More to the point, a severe outbreak could push the economic growth rate close to or below zero. In that event, additional spending to stimulate and support the overall economy—and not only areas experiencing severe outbreaks—may be necessary.

Congress should not wait until the crisis intensifies to enact these measures. These changes should be signed into law immediately, with clear triggers for additional funding. This would allow the changes to be executed before a regional outbreak spirals out of control. States will be in a much better position to plan and to address any outbreak if they know these measures will automatically kick in.

States and localities are the tip of the spear in the fight against coronavirus. Congress can—and should—give them weapons to battle the disease.

Mr. Strain is director of economic policy studies at the American Enterprise Institute, Dr. Gottlieb is a resident fellow at AEI and a partner at New Enterprise Associates. He was commissioner of the Food and Drug Administration, 2017-19.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 12, 2020, 09:51:34 AM
"Like the common flu, except the death rate from the virus may be ten times higher. Like the common flu, except the U.S. population has no built-up immunity, so the virus left unchecked could infect a significantly higher share of the population at a faster rate, overwhelming the medical system."

The Virus and Leadership
Trump’s main opponent isn’t Joe Biden. It’s the coronavirus.
By The Editorial Board
March 11, 2020 7:27 pm ET

When President Trump sees a political threat, his instinct is to deny, double down and hit back. That has often been politically effective, but in the case of the novel coronavirus it has undermined his ability to lead.

It’s not accurate, as the press reported last week, that the President called the virus a “hoax.” He said the criticisms of his Administration were a hoax. Yet his public remarks too often continue to give the impression that he views the virus more as another chance for political combat than as a serious public-health problem.

White House advisers last week said the virus is being “contained” despite contrary evidence. On Monday, after suggesting “fake news” was driving the stock-market rout, the President tweeted: “So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!”

Like the common flu, except the death rate from the virus may be ten times higher. Like the common flu, except the U.S. population has no built-up immunity, so the virus left unchecked could infect a significantly higher share of the population at a faster rate, overwhelming the medical system.

We hope the dire coronavirus prognostications turn out not to pass, and no one knows how the coming months will play out. Yet with stock markets falling, schools canceling classes, companies emptying their offices, and nations locking down borders and some cities, Americans want steady leadership.

The biggest failure so far has been on testing when the Centers for Disease Control and Prevention produced contaminated test kits and the Food and Drug Administration was slow to approve private alternatives. The best response to that is to acknowledge the delay, explain what happened, and relate when and how the problem will be addressed. The mistake is to claim there was no problem.

Mr. Trump is right that his opponents, in politics and the media, want to turn the virus into his Hurricane Katrina. That is inevitable and he shouldn’t take their bait. The best defense isn’t to strike back as if the virus is Adam Schiff. It can’t be mocked with a nickname or dismissed with over-optimistic assertions that risk being run over by reality in a week or a month. On Wednesday Mr. Trump punched back at an article in Vanity Fair by tweeting: “Our team is doing a great job with CoronaVirus!” Who cares about Vanity Fair?

The best reply is cool and realistic leadership that marshals the strengths of the government a President leads. This means letting the experts speak, not putting himself in the front of every briefing and speculating about things he doesn’t know much about. It means showing personal support, ideally at some point in person, for virus patients and their front-line caregivers.

Leadership means putting together a response to economic weakness and what can be done to help those who lose their jobs, not promising something he can’t deliver on Capitol Hill or blasting the Federal Reserve for the 100th time. Above all, leadership in a crisis means telling the public the truth, lest people begin to tune him out or, worse, make him a figure of mockery.

Disasters and crises can make or break presidencies—not from the event itself but from how the public judges a President’s response. In the last week the Administration’s performance has improved, and his speech to the nation Wednesday night was at least a step toward more realism. But the pandemic continues to build and he still understated the scope of the health risk. Travel bans are less important than mitigation efforts at home with thousands of likely cases already here. Comparing the U.S. favorably to Europe won’t reassure anyone if the U.S. catches up.

Mr. Trump did seem to recognize that the threat to public health is a chance to rise above narrow partisanship and speak for the whole country. His main opponent for re-election now isn’t Joe Biden. It’s the coronavirus.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 12, 2020, 09:56:55 AM
Virus Relief, Good and Bad
The goal is to relieve hardship, not expand the welfare state.
By The Editorial Board
Updated March 11, 2020 10:16 pm ET
The coronavirus has had the bad judgment to arrive in an election year, so Congress will inevitably respond with what it does best—spend money. As the ideas spill out, it’s worth laying out some principles to sort the good from the bad and the ugly.
• Target the real hardship. Americans who need the most help will be those who lose their jobs because they or their family members are sick, especially low-income workers who are paid hourly rather than by salary. Federal grants could help make up for lost wages, sick leave, or special health-care costs.
The precedents here are unemployment insurance and disaster relief. The former is targeted at individuals who had been working and lose their jobs, and both programs are limited. Jobless benefits expire after a time, with a goal of encouraging recipients to get back into the job market when the economy improves.
Disaster relief addresses the immediate harm to personal property and businesses, and recipients have to meet certain criteria to qualify. Relief can be in the form of grants or loans, especially to small business. Congress recently passed $1 billion in small-business loan subsidies as part of its $8.3 billion virus relief package, and on Wednesday night President Trump asked for another $50 billion more that we hope has virus-damage requirements attached.
• Make the relief immediate. People who lose their jobs or are sick need the money now, not months down the road. One problem, among many, with the Obama 2009 stimulus program is that its spending was spread over years. So-called shovel-ready projects weren’t close to ready. The worst idea we’ve heard in response to the coronavirus is for a big new public-works bill. In other words, to address an epidemic today, the solution is to build more roads in 2021 and 2022.
• Target individuals, not bureaucracies. The further away from people the money goes, the less good it will do. Senate Democrats on Wednesday floated a kitchen-sink virus bill loaded with money for every pet program going back to the Great Society. One chestnut is “supplemental financial assistance directly to housing authorities”—that is, the folks at the New York City Housing Authority who spend $1,973 per apartment to install new lighting. Their tenants may need a check if they lose their job, but why reward the housing bureaucrats?
• Avoid new mandates on business. Progressives will try to use this crisis to require employers to provide mandatory paid sick leave to all employees. The idea will be to start at seven days, and claim it’s temporary, but once in place the mandate will never go away. Soon it will be 90 days, raising the cost of hiring. If Democrats want to pay for virus sick leave, have Uncle Sam write the checks.
• Beware new or expanded entitlements disguised as emergency relief. Senate Democrats want to expand “benefit levels” for food stamps, as you’d expect. But they also want “new pandemic SNAP authority” to provide additional food assistance for public-health emergencies. This looks suspiciously like an increase in food-stamp eligibility that wouldn’t go away when the health-crisis does.
Congress may also try to expand eligibility for Medicaid, or increase the federal share of payments in the state-federal program. But the heavy federal share, which can be as high as 90% for some recipients, already increases the incentive for states to enroll more able-bodied adults at the expense of the needy. If the states need money for virus-related health relief, write them a check based on the number of state cases and let them decide how to spend it.
We’ll have more to say in the future about tax cuts and proposals to bail out industries. Our larger point today is that government’s role in this crisis should be to address a genuine short-term hardship, not to permanently expand the size of government and the burden on taxpayers. These spending ideas won’t provide much of an economic stimulus, though they might help consumer confidence. They should end when the virus threat does.
Title: Italy
Post by: Crafty_Dog on March 12, 2020, 11:16:08 AM
Title: not good
Post by: ccp on March 12, 2020, 03:12:30 PM
Title: Re: not good
Post by: G M on March 12, 2020, 03:46:56 PM


Next time at the hospital, figure out how much of your disposable medical equipment is made in China, and how much resupply is readily available. Expect you are 2 to 4 weeks away from where Italy is now.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 12, 2020, 04:26:02 PM
Next time at the hospital, figure out how much of your disposable medical equipment is made in China, and how much resupply is readily available. Expect you are 2 to 4 weeks away from where Italy is now."

but Bloomberg and the rest of the globalists have told us this was all good.

tariffs to try to bring manufacturing home are all bad........

Let me get this straight.  our American generic pharm send the manufacturing overseas so the drugs are made as cheap as possible then sent back here we get billed the highest in the world for same drugs. ...........

Title: drive thru testing beginning
Post by: ccp on March 12, 2020, 06:19:33 PM
Denver with first drive through testing site

need doctor's note

we just got the notes ready to get to patients who after assessment qualify

NYC (Mario's kid running for 2024)  is planning on doing same
hopefully other locations will have
and this will sure make my job easier.

Title: If it is on the internet, it has to be true!
Post by: G M on March 12, 2020, 08:33:44 PM

Still, something to consider as we only have X number of shopping days until TEOTWAWKI.
Title: Protective gear running low
Post by: G M on March 12, 2020, 09:50:48 PM
Title: CDC FDA response ?
Post by: ccp on March 13, 2020, 05:11:27 AM
This twit at the NYT of course describing the CDC sarcastically as storied and of course laying the blame on Trump in effort to get senile corrupt Joe elected :

politics aside
the testing was the biggest issue
Look at all the times CDC did protect us from all the past threats
   We did not appreciate all they did for us.

Question :  should we be manufacturing test kits every time there is outbreak around the. world
by the millions when indeed most of the time they won't be needed?

MAybe FDA restrictions too stringent?
DOn't know.

OTOH do we really want the schysters who sell unneeded vitamins on the radio and everywhere else getting into the testing business?

Title: Gov. Newsome in CA
Post by: Crafty_Dog on March 13, 2020, 07:38:02 AM
Title: Newsom
Post by: ccp on March 13, 2020, 07:59:59 AM
I see casinos exempt.

no risk there.

Gee how did that happen?
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 13, 2020, 08:10:11 AM
This doesn't sound good, but I am paywalled from seeing it.  Could someone paste it please?
Title: Re: Newsom
Post by: G M on March 13, 2020, 08:10:53 AM
I see casinos exempt.

no risk there.

Gee how did that happen?

Casinos are sterile environments! Just ask the Las Vegas Mayor.
Title: Brazilian President test positve
Post by: ccp on March 13, 2020, 08:26:59 AM
Based on this President Trump should be quarantined for 14 d post exposure

and if gets symptoms THEN get tested

like all the other celebrities he will be tested right away

of course he should be very closely tested etc
but Charlie Barkley?

Just saw patient from Florida who was at rally in Miami for Bolsonaro and gave him a hug
I advised she must remain quarantined since one of his ministers was positive

until the President and the 3 ministers , whose status was unknown as of yesterday test negative

just called pt back - she was aware of this headline and is staying in - advice is to get tested if becomes symptoms

does not really make sense to test now as positive test will not change her quarantine status

and may be a false negative

either way if she gets symptoms she will then need to go in for health evaluation or if severe go to the ER calling ahead
to let them know of her coming in and wear a face mask

Title: Jail as a petri dish
Post by: Crafty_Dog on March 13, 2020, 08:57:56 AM
Title: Re: Jail as a petri dish
Post by: G M on March 13, 2020, 09:00:50 AM

Yes they are.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 13, 2020, 09:06:29 AM
military barracks traditionally also .

though I would think military would have more options.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: DougMacG on March 13, 2020, 09:07:02 AM
This doesn't sound good, but I am paywalled from seeing it.  Could someone paste it please?

L.A. Unified will close effective Monday due to coronavirus concerns

Trump administration blocks states from using Medicaid to respond to coronavirus crisis
Donald Trump, Seema Verma
Seema Verma, head of the government’s Centers for Medicare and Medicaid Services, in a meeting with President Trump in 2017.(Evan Vucci / Associated Press)
MARCH 13, 2020
6:30 AM

WASHINGTON —  Despite mounting pleas from California and other states, the Trump administration isn’t allowing states to use Medicaid more freely to respond to the coronavirus crisis by expanding medical services.
In previous emergencies, including the 9/11 terrorist attacks, Hurricane Katrina and the H1N1 flu outbreak, both Republican and Democratic administrations loosened Medicaid rules to empower states to meet surging needs.

But months into the current global disease outbreak, the White House and senior federal health officials haven’t taken the necessary steps to give states simple pathways to fully leverage the mammoth safety net program to prevent a wider epidemic.

That’s making it harder for states to quickly sign up poor patients for coverage so they can get necessary testing or treatment if they are exposed to coronavirus.

And it threatens to slow efforts by states to bring on new medical providers, set up emergency clinics or begin quarantining and caring for homeless Americans at high risk from the virus.

“If they wanted to do it, they could do it,” said Cindy Mann, who oversaw the Medicaid program in the Obama administration and worked with states to help respond to the H1N1 crisis in 2009.

One reason federal health officials have not acted appears to be President Trump’s reluctance to declare a national emergency. That’s a key step that would clear the way for states to get Medicaid waivers to more nimbly tackle coronavirus, but it would conflict with Trump’s repeated efforts to downplay the seriousness of the epidemic.

Qiagen Markets QIAstat-Dx For Coronavirus Testing
Problems mount with coronavirus testing, limiting access and sowing confusion
March 12, 2020
Another element may be ideological: The administration official who oversees Medicaid, Seema Verma, head of the government’s Centers for Medicare and Medicaid Services, has been a champion of efforts by conservative states to trim the number of people enrolled in Medicaid.

The steps that California, Washington and other states hit hard by the epidemic want to take would likely increase the number of people enrolled in the program.

“Medicaid could be the nation’s biggest public health responder, but it’s such an object of ire in this administration,” said Sara Rosenbaum, a Medicaid expert at George Washington University. “Their ideology is clouding their response to a crisis.”

In response to questions about how her agency, known as CMS, is handling state concerns, Verma’s office noted that the agency is trying to assist states, providing answers to frequently asked questions and hosting nationwide calls with state health officials. The agency noted that some waivers are not possible because Trump hasn’t declared a national emergency.

“Waivers cannot be invoked until and unless there is a Presidential Stafford Act declaration,” the agency noted, saying that it was “prepared to exercise that authority should it become available.”

Medicaid, the half-century-old government safety net program, and the related Children’s Health Insurance Program provide health insurance to more than 70 million low-income Americans, many of whom gained coverage through the 2010 Affordable Care Act.

To control fraud, the program has extensive rules dictating who is eligible and what kinds of medical services can be covered; federal officials can penalize states that don’t scrutinize who receives benefits.

During major disasters, CMS has traditionally loosened these rules.

In 2005, for example, two weeks after Hurricane Katrina struck New Orleans, the administration of President George W. Bush told states that it would grant waivers so they could rapidly enroll people into Medicaid who had been displaced by the storm.

This meant simplified applications for enrollees and no requirement that states verify applicants’ income or other information to grant coverage.

Similarly, in 2009, after President Obama declared a national emergency in response to H1N1, Secretary of Health and Human Services Kathleen Sebelius invited states to seek waivers from Medicaid rules to make it easier for medical providers to quickly treat patients without worrying about their eligibility for government assistance.

States need similar flexibility now, said Jacey Cooper, who directs Medi-Cal, as California’s mammoth Medicaid program is called.

“Getting an emergency declaration would really help us get services to people who need it,” said Cooper. Medi-Cal currently covers about 13 million low-income Californians.

Among other things, Cooper said the state wants to shorten lengthy verification procedures to quickly enroll people. Public health experts fear that gaps in insurance coverage make controlling coronavirus more difficult because patients who don’t have insurance won’t seek medical attention and testing they fear they can’t afford.

California and other states also want to ensure that mobile clinics and other temporary facilities set up to handle a crush of patients can bill Medicaid, which also would require a waiver.

And a number of states with large homeless populations — including California, Washington and New York — are interested in potentially using Medicaid funding to help homeless victims of coronavirus who need not only medical care but also housing and other services.

The easiest way to speed Medicaid waivers is a declaration from the president of a national emergency. Obama issued such a declaration in 2009 during the H1N1 outbreak.

On Thursday, the American Medical Assn., the American Hospital Assn. and the American Nurses Assn. sent a joint letter to Vice President Mike Pence calling for the president to issue a declaration.

But the White House hasn’t indicated whether Trump will make such a move.

State leaders are wary of criticizing the president directly, fearing that he may attack them personally or retaliate against their states.

Last week, Trump called Washington Gov. Jay Inslee a “snake” after the governor, a Democrat, criticized the administration’s slow coronavirus response.

That’s left states with a more limited set of Medicaid options that CMS outlined Thursday afternoon. These include small steps such as allowing hospitals to more easily enroll patients in Medicaid.

In California, Cooper said CMS officials have been helping the state develop a plan. But she noted California needs significantly more flexibility.

For example, state health officials do not want to have to send people to hospitals to get rapidly enrolled in Medi-Cal, potentially exposing them to the virus.

“We need help sooner rather than later,” Cooper said.

Noam N. Levey writes about national healthcare policy out of Washington, D.C., for the Los Angeles Times. He covered passage of the 2010 Affordable Care Act and has written extensively about the landmark law and reported on its implementation from around the country. A former investigative and political reporter, he is a Boston native and a graduate of Princeton University. He joined the newspaper in 2003 and has reported from Washington since 2006
Subscribe for unlimited access
Copyright © 2020, Los Angeles Times
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 13, 2020, 11:29:11 AM
Title: WH press conference
Post by: ccp on March 13, 2020, 02:31:50 PM
For me DJT was at his finest!

It was a great sight to see America stepping up to the plate!

Of course Pelooooosi had to have her own speech

      in which she is saving "the families".

(wait, since when have the crats been for families ....... they have destroyed them )

Title: Reasons to be positive
Post by: Crafty_Dog on March 13, 2020, 04:22:36 PM
Reasons to Be Positive About the US Coronavirus Fight

Less than a month ago markets were at a record high, as healthy data on the US economy signaled continued growth on the horizon. Then, as Coronavirus made its way to continental Europe and the United States, markets went into a tailspin, suffering one of the fastest declines on record. The last several weeks have been characterized by extreme volatility as investors try to make heads or tails of the situation. Coverage around the virus has been almost exclusively negative, as experts extrapolate worst case scenarios to spur action. It should come as little surprise then, that fear of a recession has moved to the forefront of many minds. At times like these, we think it's crucial to look at the data and note some positive developments that aren't getting as much media coverage.

Testing Capacity is About to Rise Substantially: The initial government response to Coronavirus has been extremely disappointing. The first round of test kits sent out by the CDC were faulty, requiring a recall and costing precious time in the fight to find/quarantine those infected. Further slowing action, only the CDC was allowed to do tests at its own facilities, limiting testing capacity. Now, things are beginning to change. Many private labs have now been approved to conduct tests, and the FDA has announced that not only will high-volume testing be allowed, but that emergency approval has been given for an automated Coronavirus test that is estimated to speed up the testing process 10-fold. So not only are tests becoming more available, results will come quicker as well. Identify and contain, the proven method to-date, can be rolled out at the national level.

A Wave of Recoveries on the Horizon: The number of official infections in the United States has continued to rise at an accelerated pace over recent weeks. Meanwhile, our preferred measure of active cases (total cases minus deaths and recoveries, which gives a better picture of the number of people who are able to spread the virus further) has continued to rise consistently as well. As so often occurs during virus outbreaks, fears arise that the early pace of spread will continue, unabated, at an exponential rate. History – including the experiences of both China and South Korea with Coronavirus – shows identification and treatment leads to a slowdown in the pace of new cases, and a pickup in recoveries. Typically, it takes roughly two weeks for otherwise healthy individuals who test positive to get better and be officially moved from the "active" to the "recovered" counts. Now that we are about two weeks out from the initial surge in US cases, recoveries should begin to rise consistently. The world recovery rate currently sits at 93% right now, while in the US it is only 43%. We expect the US to move toward and then exceed the world recovery rate in the weeks ahead.

The Private US Healthcare Industry is the Best in the World: One of the biggest things overlooked (and underappreciated) in the fallout from the Coronavirus is just how fast the private US healthcare industry has responded. Moderna has already begun testing a vaccine, and many other companies have followed suit with their own treatments. Meanwhile, doctors have begun using the experimental anti-viral drug Remdesivir to treat US Coronavirus patients, with positive results. The speed with which these discoveries have been made is absolutely breathtaking, imagine how long it would take to develop effective treatments for a never-before-seen illness 50 years ago! Meanwhile, a 2013 study by the Department of Health and Human Services determined that the US has the most Intensive Care Unit beds per capita of any country at 20-32 per 100,000 people. This is far higher than China where there are only 2.8-4.6, demonstrating why they needed to build hospitals overnight. Likewise, the US far outdoes countries with socialized medical systems like Canada (13.5), Sweden (5.8-8.7), or the UK (3.5-7.4). This means the US is better suited to deal with the healthcare capacity issues that could arise with a Pandemic than virtually any other country in the world.

Put it all together, and the US is well poised to not only win its own fight against the Coronavirus, but also to export treatments that should help the rest of the world. The coming weeks will be critical as tests go out en masse and we learn more about the fight we are up against, but we are up to the task. Panic is never permanent, and as the virus response ramps up, sentiment will turn higher as well. Every day we learn more. Every day we make progress. This too shall pass.

Brian S. Wesbury - Chief Economist
Robert Stein, CFA – Deputy Chief Economist                                                                                                                   
Title: Worst case scenario
Post by: Crafty_Dog on March 14, 2020, 06:33:51 AM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 14, 2020, 06:49:43 AM
Title: outbreak may have leaked from a Chinese virology lab
Post by: DougMacG on March 14, 2020, 09:08:05 AM
Title: Chinese virology lab just happens to be Wuhan
Post by: ccp on March 14, 2020, 11:00:35 AM
definite amazing coincidence.

of course the Left is only concerned about xenophobia

perhaps we call the Left something like "identity politics phobics"

EVERYTHING is seen placed in category of identity politics to stir up their me too crowds
Title: China 2017
Post by: Crafty_Dog on March 14, 2020, 11:02:51 AM
Title: Hollywood bail out?
Post by: ccp on March 14, 2020, 11:29:26 AM

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 14, 2020, 01:38:19 PM

see my reply #250
of course that was last week....
but glad to see experts at Johns Hopkins are reading this threat on Dog Brothers
Title: Re: outbreak may have leaked from a Chinese virology lab
Post by: G M on March 14, 2020, 04:57:22 PM

Is this a Chinese bioweapon?
« Reply #162 on: January 25, 2020, 09:35:19 PM »

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 15, 2020, 09:18:13 AM
Seems a tad tin foil GM.  I'm not saying it can't be-- indeed given how vulnerable we have been revealed to be to Chinese antibiotic based extortion by all this, if it didn't occur to them before it surely is occurring to them now-- but that article seems really thinly sourced and highly speculative.

Anyway, here is this:
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: G M on March 15, 2020, 10:38:48 AM
Nothing definite, but it sure is an interesting coincidence that China's only BSL-4 lab is located in Wuhan, a short distance from that alleged wet market source of the virus.

Seems a tad tin foil GM.  I'm not saying it can't be-- indeed given how vulnerable we have been revealed to be to Chinese antibiotic based extortion by all this, if it didn't occur to them before it surely is occurring to them now-- but that article seems really thinly sourced and highly speculative.

Anyway, here is this:
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 15, 2020, 12:05:09 PM

Title: Anti-inflamatories and infections
Post by: Crafty_Dog on March 15, 2020, 07:27:11 PM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 16, 2020, 05:43:27 AM
Just one thing about the youtube video

Wuhan virus CAN start with cold like symptoms
Title: infected monkeys become immune
Post by: DougMacG on March 16, 2020, 07:28:17 AM
Hopes for coronavirus vaccine rise after infected monkeys become immune
Primates found to have developed antibodies after being infected with Covid-19 – a discovery that suggests the immune system will fight back against the disease
Scientists have been puzzled by case of patients apparently being reinfected with the disease, but this study suggests that may not be the case
Title: US: As The Number Of Cases Has Expanded, The Mortality Rate Has Declined
Post by: DougMacG on March 16, 2020, 07:37:31 AM
US #CoronaVirusDeathRate by date:

4.06% March 8 (22 deaths of 541 cases)

3.69% March 9 (26 of 704)

3.01% March 10 (30 of 994)

2.95% March 11 (38 of 1,295)

2.52% March 12 (42 of 1,695)

2.27% March 13 (49 of 2,247)

1.93% March 14 (57 of 2,954)

1.84% March 15 (68 of 3,680)
As the number of cases has expanded, the mortality rate has declined. It will likely decline even further if and when those without symptoms can be diagnosed and counted.
Title: we are almost overwhelmed with calls
Post by: ccp on March 16, 2020, 08:02:49 AM
hiring more doctors

wait times up at times
overtime encouraged with bonuses

businesses calling our company

one call after another

As in Doug's post as we are able to test more then deaths rates will continue to come down
My armchair guestimate this could peak in 2.5 to 3.5 months.
if we are able to contain likely sooner

Wish I had more cash

Of course the dirty libs making this another " never waste a crises " moment for their darn programs

My favorite part of last night 's debate betwee Jewish Trotsky and Senile Old Joe
was when Bernie calls wuhan virus "ebolat"
 and a minute later senile Joe calls it "Sars"

what a laugh

I noticed Jake Tapper ran to get slow Joe out of trouble when he started rambling garbled crap at one point.
Title: GM for CDC director
Post by: ccp on March 16, 2020, 08:05:04 AM
I nominate our own GM for director of CDC who called this months ago.

leave it to a prepper !  :))
Title: Re: GM for CDC director
Post by: G M on March 16, 2020, 08:14:08 AM
I nominate our own GM for director of CDC who called this months ago.

leave it to a prepper !  :))

Well, I couldn't do a worse job...
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 16, 2020, 08:29:00 AM
One would think we doctors would get the most up to date
information learned from Italy or China etc

but it is hard for even me to find

CDC which has been a gem in past is not

posting anything for us that one can't find on CNN or the website that goes to everyone.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: G M on March 16, 2020, 08:37:40 AM

Pournelle's Iron Law of Bureaucracy states that in any bureaucratic organization there will be two kinds of people":

 First, there will be those who are devoted to the goals of the organization. Examples are dedicated classroom teachers in an educational bureaucracy, many of the engineers and launch technicians and scientists at NASA, even some agricultural scientists and advisors in the former Soviet Union collective farming administration.

Secondly, there will be those dedicated to the organization itself. Examples are many of the administrators in the education system, many professors of education, many teachers union officials, much of the NASA headquarters staff, etc.

The Iron Law states that in every case the second group will gain and keep control of the organization. It will write the rules, and control promotions within the organization.

One would think we doctors would get the most up to date
information learned from Italy or China etc

but it is hard for even me to find

CDC which has been a gem in past is not

posting anything for us that one can't find on CNN or the website that goes to everyone.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 16, 2020, 08:37:55 AM
I second the nomination!!!
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: DougMacG on March 16, 2020, 10:57:40 AM
I second the nomination!!!

GM has been right on this so far.  Not many saw this leading to almost total lockdown.  People should have been prepared BEFORE they heard of any of this.  I have many more questions on preparedness for other kinds of crises and much can be learned from this one.
I am still of the view that this will pass in a relatively short order but I am short on the details or vision of how that will happen.  ccp:  "My armchair guestimate this could peak in 2.5 to 3.5 months.
if we are able to contain likely sooner".  Yes, it could be worse but that gives me something to work with on a recovery scenario.

In preparedness we need to look at multiple scenarios and look at it from multiple dimensions.  Personal health, public health, economic, financial, political, geo-political.

In the doom scenario that this just covers the globe, some things get better in the aftermath.  Not for those who die of it or suffer permanent health damage from it.
On the source of it, was it a Chinese bio-weapon leak?  Crafty: "Seems a tad tin foil GM.  I'm not saying it can't be-- indeed given how vulnerable we have been revealed to be to Chinese antibiotic based extortion by all this, if it didn't occur to them before it surely is occurring to them now-- but that article seems really thinly sourced and highly speculative."

   - Yes, there is no evidence, no proof, no real sourcing.  It is only speculative, just the most plausible explanation out there at this time.  What we do know is that China hid this, lied about it, allowed it to become what it is now.  What was their motive to hide it, just habit possibly.  I would add my question to the conspiracy question, what is the other tie to Iran and the Chinese center of bio-weapons?  Were the Islamists having a cultural exchange with the Chinese communists right while China imprisons a million Muslims?  I can't think of an innocent explanation.

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 16, 2020, 12:13:57 PM
I have seen pieces by scientists-doctors saying that study of the virus itself show that is was not man created. 
Title: Coronavirus video
Post by: DougMacG on March 16, 2020, 12:50:06 PM
1 minute Cheers bar episode.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: DougMacG on March 16, 2020, 01:19:07 PM
I have seen pieces by scientists-doctors saying that study of the virus itself show that is was not man created.

Interesting point to know.  Assuming not manmade, does that mean no connection to this Chinese facility?  If it jumped from animal to human, it could have happened there or had some connection.  This outbreak is tied to their deceit and incompetence.  I think we know the outbreak was not deliberate or they wouldn't have tried to kill and contain it.  If it did leak or escape from such a facility, it means it was related to something they were contemplating, not intending in the immediate sense.

What is the Iran China connection?  Let's assume it was an innocent belt-road-train planning meeting.  Then which Chinese official(s) had it?  When did it spread?  Who else was exposed?  We are researching a pandemic killing people on 6 continents that originated in Wuhan China (coincidentally near a bio-weapons facility) and what they do in place of cooperate is hide facts, blame us and tell lies.  It makes full study difficult (understatement).
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: G M on March 16, 2020, 02:54:27 PM

I have seen pieces by scientists-doctors saying that study of the virus itself show that is was not man created.

Interesting point to know.  Assuming not manmade, does that mean no connection to this Chinese facility?  If it jumped from animal to human, it could have happened there or had some connection.  This outbreak is tied to their deceit and incompetence.  I think we know the outbreak was not deliberate or they wouldn't have tried to kill and contain it.  If it did leak or escape from such a facility, it means it was related to something they were contemplating, not intending in the immediate sense.

What is the Iran China connection?  Let's assume it was an innocent belt-road-train planning meeting.  Then which Chinese official(s) had it?  When did it spread?  Who else was exposed?  We are researching a pandemic killing people on 6 continents that originated in Wuhan China (coincidentally near a bio-weapons facility) and what they do in place of cooperate is hide facts, blame us and tell lies.  It makes full study difficult (understatement).
Title: I dunno : I just don't see this.
Post by: ccp on March 16, 2020, 06:14:18 PM

When this blows over people will once again start flying cruising again

This is a very rare event.

Title: Re: I dunno : I just don't see this.
Post by: G M on March 16, 2020, 06:31:18 PM

When this blows over people will once again start flying cruising again

This is a very rare event.

What time frame do you foresee for this to blow over?
Title: Changing business model
Post by: G M on March 16, 2020, 06:36:19 PM
Title: Re: Epidemics: Dr. Michael Lin
Post by: DougMacG on March 16, 2020, 07:35:15 PM
Title: Why China?
Post by: Crafty_Dog on March 16, 2020, 11:57:21 PM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: DougMacG on March 17, 2020, 07:49:56 AM
G M, from another thread:  "I expect multiple waves".

Yes.  If this current round of closures curtails it, there will still be multiple waves.  People can't stay home and do nothing forever.

They closed my ski areas.  They closed my hockey arena.  I had 12 top players in our age group confirmed for tennis and they closed our indoor club (even though one of our guys runs the club and has the keys).

Instead we played winter, outdoor platform tennis last night, aka 'paddle', '(not quite) 'stick fighting with social distancing'. It goes something like this:
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 17, 2020, 08:42:03 AM
It goes something like this:

wow great form; good action
could send to ESPN .  They need more sports now .

Isn't it hard to go from tennis to paddle ball.
In college playing tennis then going to racketball was hard because racquets different lengths.

Title: Re: Epidemic: odds
Post by: DougMacG on March 17, 2020, 08:53:27 AM
COV 19 Wuhan Virus dashboard, cases by country:

If you lived on planet earth during this crisis so far, the odds you contracted a known case of this virus are:  .000000023

Significantly lower in the US.

When that number doubles or goes up 10 or 100-fold, it still rounds to zero.
Title: Re: Epidemic: odds
Post by: G M on March 17, 2020, 08:57:12 AM
COV 19 Wuhan Virus dashboard, cases by country:

If you lived on planet earth during this crisis so far, the odds you contracted a known case of this virus are:  .000000023

Significantly lower in the US.

When that number doubles or goes up 10 or 100-fold, it still rounds to zero.

Subject to rapid change.
Title: still waiting for ubiquitous testing
Post by: ccp on March 17, 2020, 09:56:15 AM
I am telling most people who call in sick to quarantine themselves for 2 weeks
unless it is near certain it is not corona
unfortunately most of the time we can't tell

so i wind up having to tell people to stay home

 a lot of people calling with subjective shortness of breath

I can't tell if anxiety or real


employers also calling anyone who travelled or with a cough or sniffle to call us and get a release

Are not the posters here all over 60?

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: DougMacG on March 17, 2020, 10:08:01 AM
[Odds of contracting virus] "Subject to rapid change."

Yes.  And the odds that your finances, work and day to day activities are affected by it are now 100%.
[Exercise/recreation during the crisis]
ccp:  "Isn't it hard to go from tennis to paddle ball.
In college playing tennis then going to racketball was hard because racquets different lengths."

The mind/body is amazing in its ability to adapt.  At a competitive level you wouldn't want to mix the sports too much.  For me, the limiting factor is physical / mobility, so any exercise and movement in one is helpful in the others.  Racquetball is wristier than tennis so the stroke has to be different.  Hockey for me has the hardest hand to eye, to pick a puck out of the air with the blade of the stick so far from the eye, it's hit and miss.  Baseball even harder, round bat to hit a round moving ball at just the right angle.  Even Ty Cobb only batted .366    Given that, golf should be easy.  The ball is just sitting there!  In golf, the clubs in the bag are all different lengths intentionally.  That isn't what makes it hard...
Title: Re: still waiting for ubiquitous testing
Post by: G M on March 17, 2020, 10:28:44 AM
I am telling most people who call in sick to quarantine themselves for 2 weeks
unless it is near certain it is not corona
unfortunately most of the time we can't tell

so i wind up having to tell people to stay home

 a lot of people calling with subjective shortness of breath

I can't tell if anxiety or real


employers also calling anyone who travelled or with a cough or sniffle to call us and get a release

Are not the posters here all over 60?


I am not yet 50.
Title: TRump mad at Jrod
Post by: ccp on March 17, 2020, 04:17:36 PM

my question is why was he listening to him to start with?
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 17, 2020, 05:09:53 PM

"I am not yet 50."

GM you may have to carry on the forum for us ........ :|
Title: The virus discriminates
Post by: DougMacG on March 18, 2020, 06:03:21 AM
Gunnison County bans restaurants, bars from serving people 60 and older to slow coronavirus spread
Dr. ccp:  "Are not the posters here all over 60?"

63, young and healthy from my perspective.  Just realized my daughter is being so careful around me because she thinks I'm elderly, at risk.
Title: Corona Is Slowing Down, Humanity Will Survive, Nobel laureate,Stanford professor
Post by: DougMacG on March 18, 2020, 07:04:39 AM
Corona Is Slowing Down, Humanity Will Survive, Says Biophysicist Michael Levitt
Nobel laureate and Stanford professor Michael Levitt unexpectedly became a reassuring figure in China at the peak of the coronavirus pandemic. Now he assures Israelis: statistics show the virus is on a downturn,7340,L-3800632,00.html
Title: rambling thoughts
Post by: ccp on March 18, 2020, 08:25:36 AM
Thanks Doug

for the post

if one reads drudge the world will end soon
we will all be on streets killing each other for the right to eat the remaining cats rabbits and possums

Trump vs the Dems
can't stop falling all over themselves to spend more than the other to show that they are doing more than the other side

yes  I get it for the people out of work it sucks big time
and I do fear for elderly (I am 62 and not as trim the past yr as the jocks on this site)
  and those with serious chronic conditions

This is the first real test of the nation in my life time
 I did not live through WW 1. the 1918 to 1919 flu pandemic or WW 2
I did not live in Europe during the Iron Curtain etc

We kind of did during the cold war but that was not ever the same during my life
maybe it was in the later 40 s or early 50 s though  with nuclear testing going off all over

Hopefully this will re awaken the American spirit and not the Left ist spirit

we will see.....

Title: Ventilators
Post by: Crafty_Dog on March 18, 2020, 10:35:16 AM
Title: Re: Ventilators
Post by: G M on March 18, 2020, 11:17:30 AM

How fast can you ramp up production of the trained medical personnel to run them?
Title: SCary new model
Post by: Crafty_Dog on March 18, 2020, 11:36:35 AM
Without them we will never find out.


Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 18, 2020, 12:18:47 PM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 18, 2020, 12:55:49 PM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 18, 2020, 01:05:56 PM[pull]=omeda|2450A5959134B2V&oly_enc_id=2450A5959134B2V
Title: Perfidious China
Post by: Crafty_Dog on March 18, 2020, 03:09:46 PM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: DougMacG on March 18, 2020, 07:16:38 PM
The exponential growth curve of the virus is theoretical.  It assumes people make no changes to their behavior, to anything, which of course is not possible is this more interconnected than ever before world.  In fact the curves are already flattening in every country:

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: G M on March 18, 2020, 08:12:02 PM
All information from China should be discarded. Italy's is still skyrocketing in deaths. It's very premature to assume anything.

The exponential growth curve of the virus is theoretical.  It assumes people make no changes to their behavior, to anything, which of course is not possible is this more interconnected than ever before world.  In fact the curves are already flattening in every country:

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: DougMacG on March 19, 2020, 08:43:55 AM
All information from [the regime of] China should be discarded.  But there are other data points.

"Italy's is still skyrocketing in deaths."  - Good point, but the curve is bending.  In Italy, young people have contact with their elders.  Not so much here.
99% of Those Who Died From Virus Had Other Illness, Italy Says

As MIT Prof Jonathon Gruber might coldly observe, this is lowering our health care costs.

"It's very premature to assume anything."    - Absolutely!

Also look at South Korea and Singapore.  They took extreme measures and are getting good results.

There will be more and better testing soon.  Someday hand sanitizers (and toilet paper) will return to the shelves. 

Imagine (to the tune of John Lennon) wand washing stations at the front of the restaurants.  Tongs in the buffet lines that aren't touched by every finger licking dirty hand and then dropped in the food.  Imagine subsidies for private automobiles equal to those for mass transit.   Imagine all the people ... practicing basic, first-world hygiene. 
Here's a thought:

If you were the enemy or an alien force and wanted to weaken or destroy the human species, you would kill off the youngest and strongest, not the oldest and weakest.

War can kill off the youngest and strongest - and we come back from it.  Traffic deaths hit every category and perhaps the young and healthy worst and we don't blink unless it's someone we know.  This, except for all the carnage and grieving, makes us stronger.
Title: WuFlu in Europe
Post by: Crafty_Dog on March 19, 2020, 08:55:12 AM
Title: Not for the hoi polloi
Post by: Crafty_Dog on March 19, 2020, 12:44:07 PM
Title: Research on Wuhan Coronavirus
Post by: DougMacG on March 20, 2020, 09:22:25 AM
Too bad this chart doesn't start at or before Nov 17, the first known outbreak of the crisis:

Title: Fear
Post by: ccp on March 20, 2020, 11:36:53 AM
Is going up with the worsening news every day

people calling with panic attacks, any little sore throat sniffle
discomfort in the chest

people with colds flu
  crying they have this disease and might die.
loved ones all fearful for their older relatives

I am almost crying feeling bad for them

most are low risk
have not anyone to hospital but am quarantining most people
Title: Las Vegas continues to be Vegas during a pandemic
Post by: G M on March 20, 2020, 07:05:25 PM

It may be the cleanest place in the city.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 21, 2020, 11:18:17 AM
Title: More math
Post by: G M on March 21, 2020, 11:37:35 AM

Title: Rumor
Post by: Crafty_Dog on March 21, 2020, 09:30:55 PM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 22, 2020, 12:55:17 AM
Title: Over 60s in Italy are fuct
Post by: Crafty_Dog on March 22, 2020, 02:46:49 PM
Title: China starting up again, blames foreigners
Post by: Crafty_Dog on March 23, 2020, 10:17:05 AM
Title: Re: China starting up again, blames foreigners
Post by: G M on March 23, 2020, 11:22:50 AM


Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 23, 2020, 12:15:21 PM
Corrected!  Thank you!
Title: NJ releasing felons
Post by: Crafty_Dog on March 23, 2020, 02:57:57 PM
Title: NJ releasing prisoners
Post by: ccp on March 23, 2020, 03:40:01 PM
The American Civil Liberties Union of New Jersey, which called for the action along with the Public Defender’s Office, praised the move in a statement, calling it a “landmark agreement” that embodies the principles of “compassion” and “looking out for all people’s well-being.”

“Unprecedented times call for rethinking the normal way of doing things, and in this case it means releasing people who pose little risk to their communities for the sake of public health and the dignity of people who are incarcerated,” ACLU New Jersey Executive Director Amol Singha said in a statement.“Unprecedented times call for rethinking the normal way of doing things, and in this case it means releasing people who pose little risk to their communities for the sake of public health and the dignity of people who are incarcerated,” ACLU New Jersey Executive Director Amol Singha said in a statement."

What a joke.
Title: Reason: Private sector stood ready to help but , , ,
Post by: Crafty_Dog on March 23, 2020, 04:13:02 PM
Title: China's lies
Post by: Crafty_Dog on March 23, 2020, 04:42:46 PM
Title: Darwin at work
Post by: Crafty_Dog on March 23, 2020, 08:19:59 PM
Title: Gratitude!
Post by: Crafty_Dog on March 23, 2020, 08:58:46 PM
Title: R I P. Dr. Li Wenliang
Post by: DougMacG on March 24, 2020, 05:47:19 AM

On Dec 30, 2019, Li Wenliang sent a message to a group of fellow doctors warning them about a possible outbreak of an illness that resembled severe acute respiratory syndrome (SARS) in Wuhan, Hubei province, China, where he worked. Meant to be a private message, he encouraged them to protect themselves from infection. Days later, he was summoned to the Public Security Bureau in Wuhan and made to sign a statement in which he was accused of making false statements that disturbed the public order
Title: Re: Epidemics: China Lie, Dec 31 2019
Post by: DougMacG on March 24, 2020, 06:02:24 AM
Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan Infectious Diseases Hospital, and Wuhan CDC. According to the analysis of epidemiological investigations and preliminary laboratory tests, the above cases are considered to be viral pneumonia. The investigation so far has not found any obvious human-to-human transmission and no medical staff infection.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 24, 2020, 06:14:51 AM
I posted the bored panda link on our doctor email site

As doctors we are glad we can help but are obviously not at risk like our face to face  frontline colleagues .
Title: Corona virus time-line, SCMP Dec 31, 2019, 27 people,no human to human infection
Post by: DougMacG on March 24, 2020, 06:27:22 AM
Mainstream media's first mention of the Wuhan Coronavirus. Hong Kong newspaper South China Morning Post, December 31 2019. Nothing to see here, "no human-to-human infection had been reported so far", "we are [now] quite capable of killing it in the beginning phase, given China’s disease control system, emergency handling capacity and clinical medicine support."  What could go wrong?

This is as far as a somewhat free HK newspaper can go without being jailed with the other whistleblowers. 

Besides, US Media was consumed with Nancy Pelosi holding her passed articles of impeachment and not delivering them to the Senate.

Photo: Wuhan’s Huanan seafood market, where most of the mystery viral pneumonia cases have originated. Photo: HandoutWuhan’s Huanan seafood market, where most of the mystery viral pneumonia cases have originated.

China / Politics
Hong Kong takes emergency measures as mystery ‘pneumonia’ infects dozens in China’s Wuhan city
Most patients worked at a seafood market and health workers are still trying to identify virus responsible
City authorities tell hospitals to report any more cases of the illness, which is described as being ‘of unknown origin’
Mandy Zuo, Lilian Cheng, Alice Yan and Cannix Yau
Published: 2:35pm, 31 Dec, 2019

Hong Kong health authorities are taking no chances with a mysterious outbreak of viral pneumonia in the central Chinese city of Wuhan, warning of symptoms similar to Sars and bird flu as they step up border screening and put hospitals on alert.

“The situation in Wuhan is unusual, and we are not sure about the reasons behind the outbreak yet,” said Secretary for Food and Health Sophia Chan Siu-chee said after an urgent night-time meeting with officials and experts on New Year’s Eve. “Since we are now in the holiday season, and Hong Kong has close transport ties with Wuhan, we must stay alert.”

With Wuhan reporting 27 infections so far, Chan said the Department of Health would increase vigilance and temperature screenings at every border checkpoint, including the city’s international airport and high-speed railway station in West Kowloon.
Hospital Authority chief executive Tony Ko Pat-sing said frontline medical staff had been alerted at public and private hospitals.

Central Hospital in Wuhan, the central Chinese city where an “unknown pneumonia” has so far affected nearly 30 people.

“So far, there are no suspicious pneumonia cases in public hospitals,” he said. “But once we suspect cases, including the presentation of fever and acute respiratory illness or pneumonia, and travel history to Wuhan within 14 days before onset of symptoms, we will put the patients into isolation.”

News of the outbreak in Wuhan came to light after an urgent notice from the city’s health department, which told hospitals to report further cases of “pneumonia of unknown origin”, started circulating on social media on Monday night.

The notice invoked memories of the 2002 and 2003 outbreak of severe acute respiratory syndrome, or Sars, which killed hundreds of people in mainland China and Hong Kong.
Protests took a harder toll on Hong Kong’s economy than Sars virus
2 Nov 2019

Over the past month, 27 patients in Wuhan – most of them stall holders at the Huanan seafood market – have been treated for the mystery illness.
The Wuhan municipal health commission said seven of the patients were seriously ill. Two had nearly recovered and were about to leave hospital, while the remaining patients were in a stable condition. Most patients had fevers and some were short of breath.

Hong Kong health authorities are taking no chances with a mysterious outbreak of viral pneumonia in the central Chinese city of Wuhan, warning of symptoms similar to Sars and bird flu as they step up border screening and put hospitals on alert.

With Wuhan reporting 27 infections so far, Chan said the Department of Health would increase vigilance and temperature screenings at every border checkpoint, including the city’s international airport and high-speed railway station in West Kowloon.

Hospital Authority chief executive Tony Ko Pat-sing said frontline medical staff had been alerted at public and private hospitals.

“So far, there are no suspicious pneumonia cases in public hospitals,” he said. “But once we suspect cases, including the presentation of fever and acute respiratory illness or pneumonia, and travel history to Wuhan within 14 days before onset of symptoms, we will put the patients into isolation.”

Experts from the University of Hong Kong have also been enlisted to conduct faster genetic testing of virus samples.

News of the outbreak in Wuhan came to light after an urgent notice from the city’s health department, which told hospitals to report further cases of “pneumonia of unknown origin”, started circulating on social media on Monday night.

The notice invoked memories of the 2002 and 2003 outbreak of severe acute respiratory syndrome, or Sars, which killed hundreds of people in mainland China and Hong Kong.

Over the past month, 27 patients in Wuhan – most of them stall holders at the Huanan seafood market – have been treated for the mystery illness.
The Wuhan municipal health commission said seven of the patients were seriously ill. Two had nearly recovered and were about to leave hospital, while the remaining patients were in a stable condition. Most patients had fevers and some were short of breath.

The health commission’s initial investigations, which included clinical diagnosis and laboratory tests, suggested all 27 were viral pneumonia cases.

No human-to-human infection had been reported so far, officials said, and no medical staff had contracted the disease. More pathological tests and investigations were underway.

“So far, there are no suspicious pneumonia cases in public hospitals,” he said. “But once we suspect cases, including the presentation of fever and acute respiratory illness or pneumonia, and travel history to Wuhan within 14 days before onset of symptoms, we will put the patients into isolation.”

Experts from the University of Hong Kong have also been enlisted to conduct faster genetic testing of virus samples.

Microbiologist Yuen Kwok-yung from the University of Hong Kong noted similarities with the 1997 outbreak of avian influenza, and the severe acute respiratory syndrome epidemic of 2003 – all cases in Wuhan were linked to the same seafood market, reported in December, and with a severe infection rate of 25 per cent.
“But there’s no need to panic. First, compared with 2003, we have better systems in notification, testing and infection control. We also have medicines that we can try,” Yuen said.

“In the past, we didn’t have proper isolation facilities. If you ask me will there be any chance that the severity will be the same as in 2003, I will say the chance is low. All we have to do is to be on alert.”
The 2003 epidemic infected more than 1,750 people and killed 299 in Hong Kong.
The patients in Wuhan were under quarantine while tests and a disinfection programme were being carried out at the seafood market, the city’s health authorities said.
Qu Shiqian, a vendor at the seafood market, said government officials had disinfected the premises on Tuesday and told stallholders to wear masks.
He said he had only learnt about the pneumonia outbreak from media reports.
“Previously I thought they had flu,” he said. “It should be not serious. We are fish traders. How can we get infected?”
State television reported that a team of experts from the National Health Commission had arrived in Wuhan to lead the investigation, while People’s Daily said the exact cause remained unclear and it would be premature to speculate.

People’s Daily also quoted several hospital sources in the city who said it was likely that the virus responsible was different from Sars, which infected more than 5,300 people and killed 349 in mainland China between late 2002 and mid-2003.

Tao Lina, a public health expert and former official with Shanghai’s centre for disease control and prevention, said that while a return of Sars could not be ruled out, the public health care system was now better able to handle such an outbreak.

“We don’t know whether Sars will come back after 16 years. In human history, we’ve never seen an epidemic disappear forever without the interference of vaccines. So we have reasons to be cautious, but not to panic too much,” Tao said.

“I think we are [now] quite capable of killing it in the beginning phase, given China’s disease control system, emergency handling capacity and clinical medicine support.”
Title: Is the treatment worse then the infection?
Post by: ccp on March 24, 2020, 07:27:50 AM
Title: COVID-19: Named for the year that China lied and set off the world outbreak
Post by: DougMacG on March 24, 2020, 07:45:22 AM
To call it Wuhan or China is racist(?) but to name it COVID-19 is to single out the year that China was lying about it, endangering the world.

Dec 31 2019 China was reporting "no human-to-human infection had been reported so far", and had already jailed 8 medical personnel who said otherwise.

See previous posts and Jim Geraghty's National Review article yesterday:
The Comprehensive Timeline of China’s COVID-19 Lies
March 23, 2020
Title: Re: Is the treatment worse then the infection?
Post by: DougMacG on March 24, 2020, 08:08:32 AM

I know people who feel that way and I strongly disagree.  We are in the middle of a mostly voluntary 15 day shutdown that took a couple of days to get started.  We can do this for let's say 16 days and then see where we are with it.  We need progress on every front, test kits, sanitizers, TOILET PAPER, ventilators, hospital beds and treatments.  That takes time.

OMG, you can't go to a restaurant - where the hygiene should have been looked at a lot closer a long time ago.  Flying is a privilege, not a right.  Right? 

I am able to get in my car and go almost anywhere I want and buy almost anything I want.  Young, healthy people who are inconvenienced should be thankful they are young and healthy.  That won't always be the case. 

The economy will bounce back just fine (MHO) when the medical crisis is clearly in the rear view mirror.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 24, 2020, 09:29:55 AM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 24, 2020, 10:14:47 AM

Title: Russia
Post by: Crafty_Dog on March 24, 2020, 11:44:12 AM
third post
Title: Re: Russia
Post by: G M on March 24, 2020, 12:02:48 PM
third post

Super spreader of Zuckberg-19

Title: Chris has got to be pisssssed offffff !
Post by: ccp on March 24, 2020, 01:04:25 PM

At Andy:
Title: if one wants to know how many cases in one's area of corona
Post by: ccp on March 25, 2020, 06:08:01 AM
This site is the simplest:
Title: Justin Amash vote against the bill
Post by: ccp on March 25, 2020, 12:56:21 PM
can this one Senator delay a bill?

he does make excellent points.

bail out big business ?
increase wealth gap?
massively grow government?

where would he get that idea?
Title: Report: Doomsday Model Is Likely WAY Off
Post by: DougMacG on March 25, 2020, 06:50:24 PM
More optimistic take:
Title: Re: Report: Doomsday Model Is Likely WAY Off
Post by: G M on March 25, 2020, 06:57:06 PM
More optimistic take:

Killing 2 million is hardly doomsday. Now Ebola, or something similar could be the "slate wiper".
Title: Mexico beginning to realize it is fuct
Post by: Crafty_Dog on March 25, 2020, 11:30:17 PM
Title: Re: Mexico beginning to realize it is fuct
Post by: G M on March 25, 2020, 11:45:39 PM

Better secure that border with El Norte muy rapido!
Title: FDA road blocks test roll outs
Post by: Crafty_Dog on March 26, 2020, 01:01:22 AM
Title: Re: Report: Doomsday Model Is Likely WAY Off
Post by: DougMacG on March 26, 2020, 05:33:37 AM
More optimistic take:

Killing 2 million is hardly doomsday. Now Ebola, or something similar could be the "slate wiper".

Yes, this is looking like it is our practice run, unlikely to make the list of top 100 causes of death in the US in the year of its outbreak.  The number I see today is 857 deaths in US as we approach the end of a 14 day shutdown.  It would take 69,000 deaths/yr. to make the top 100 list:

That does not mean we have over-reacted, just that it isn't a bug with a 90 or 100% kill rate.  If we ever get to universal testing I expect we find the kill rate is below 0.1%.  And there are immunizations and treatments coming.  This bug is not killing off humanity.  It's part of mortality we already face.
Title: Re: Epidemics: Nassim Taleb from Jan 26, 2020
Post by: DougMacG on March 26, 2020, 06:23:55 AM
Important paper I should have posted sooner.  I didn't fully understand what he was saying. 

"THE NOVEL CORONAVIRUS emerging out of Wuhan, China has been identified as a deadly strain that is also highly contagious."
"Fat tailed processes have special attributes, making conventional risk-management approaches inadequate."

We should have done sooner what we are doing now, but I don't think the public would have complied before they fully recognized the risk.  At the time of that writing, the ruling regime of China was still denying important aspects of the risk.

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 26, 2020, 09:31:51 AM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 26, 2020, 11:51:01 AM
we always knew that travel today would make any pandemic spread even faster.

the troops movements around the world in 1918 spread it far faster at that time.

what surprises me is back then, most deaths are thought to be from the secondary bacterial pneumonias - in the days before antibiotics which I wrongly assumed with thus mitigate deaths in the next pandemic.

Corona victims are not dying as much. from pneumonias as from acute respiratory distress syndrome wherein the lungs fill with fluid
and then the heart give out.

so antibiotics will not save most people.

that all said I am more optimistic

I think we have seen the bottom in the market
and I think the total death rates will be on lower end
due to our ingenuity in finding ways to treat, mobilization


This is not doomsday.
Though I wish I had more cash - I never have it when I need it. Only the rich keep tons of cash on hand.

I think Grannis was right

The government 's job is to step in and find ways to spread out trillions. ( into the black bottomless hole of no return)
I know much are "loans" ... yada ....

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: G M on March 26, 2020, 12:15:04 PM
It’s not doomsday, but don’t be so quick to assume we have hit bottom. Tread carefully. This is only the first wave.

Even worse than catching a falling knife.

we always knew that travel today would make any pandemic spread even faster.

the troops movements around the world in 1918 spread it far faster at that time.

what surprises me is back then, most deaths are thought to be from the secondary bacterial pneumonias - in the days before antibiotics which I wrongly assumed with thus mitigate deaths in the next pandemic.

Corona victims are not dying as much. from pneumonias as from acute respiratory distress syndrome wherein the lungs fill with fluid
and then the heart give out.

so antibiotics will not save most people.

that all said I am more optimistic

I think we have seen the bottom in the market
and I think the total death rates will be on lower end
due to our ingenuity in finding ways to treat, mobilization


This is not doomsday.
Though I wish I had more cash - I never have it when I need it. Only the rich keep tons of cash on hand.

I think Grannis was right

The government 's job is to step in and find ways to spread out trillions. ( into the black bottomless hole of no return)
I know much are "loans" ... yada ....
Title: Chinese test kits faulty
Post by: Crafty_Dog on March 26, 2020, 04:01:27 PM
Title: Re: Chinese test kits faulty
Post by: G M on March 26, 2020, 04:38:08 PM


Title: Just the flu, bro!
Post by: G M on March 26, 2020, 05:52:12 PM
Title: Why. kumbaya!
Post by: ccp on March 27, 2020, 06:04:41 AM
wow the Chinese really are our friends:

All well and good, but the "stuy deals blow to conspiracy theorists" title of yahoo post  is an obvious PC jab.

Title: Re: Why. kumbaya!
Post by: G M on March 27, 2020, 06:28:27 AM
wow the Chinese really are our friends:

All well and good, but the "stuy deals blow to conspiracy theorists" title of yahoo post  is an obvious PC jab.

Trace the Chinese funding.

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 27, 2020, 09:01:04 AM
Title: WTF?!? US Aid to China?!?
Post by: Crafty_Dog on March 27, 2020, 09:16:34 AM
Title: First U.S. Case Reported of Deadly Wuhan Virus, Jan 22, 2020
Post by: DougMacG on March 27, 2020, 09:45:06 AM
This I understand was the first US report of "Wuhan Virus".  WSJ
It is loaded with inaccuracies based on the Chinese Communist Party cover up.
The number in China went from 300 to 18,000 in days.
This is roughly what was known when Pres. Trump said we have it under control.
First U.S. Case Reported of Deadly Wuhan Virus
The coronavirus has sickened hundreds, killed six in China
[No.  It was way worse than that in China; they were lying to us, to the WHO and to the world.]

The U.S. confirmed its first case of a patient with the new coronavirus. A traveler takes precautions at Seattle’s international airport.
By Betsy McKay and Chao Deng
Updated Jan. 22, 2020 11:26 am ET

A man in Washington state has been diagnosed with a deadly strain of coronavirus, the first case to be confirmed in the U.S. in an outbreak that has sickened hundreds of people in Asia, federal and state health officials said Tuesday.

The man, who is in his 30s and is a U.S. resident, recently traveled to Wuhan, China, the city where the outbreak is believed to have started last month, according to the federal Centers for Disease Control and Prevention as well as Washington state and local health authorities. The man arrived back in the U.S. on Jan. 15.

Spread of the Virus
Since it first appeared in the central Chinese city of Wuhan last month, a newly identified coronavirus has spread across China and into neighboring countries. On Tuesday, a case was confirmed in Washington state.

Confirmed cases, deaths:  see graphic
Sources: local governments; China Central Television

He is the first patient to be diagnosed with the new coronavirus outside of Asia, where more than 300 people have been sickened and at least six have died. While most of the confirmed illnesses occurred in people in Wuhan, cases have been reported in other cities in China, as well as Thailand, Japan, South Korea and Taiwan.

The CDC said last week that it was expecting cases in the U.S., and now says it expects more. “We do expect additional cases in the United States and globally,” said Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases.

An emergency committee for the World Health Organization is scheduled to meet Wednesday to determine whether to declare the outbreak a public-health emergency of international concern, a designation that would help mobilize resources to prevent the virus’s spread around the globe.

Aware of the outbreak in Wuhan, the Washington man sought medical care when he developed symptoms a day after arriving home to Snohomish County, north of Seattle, the health officials said. He is in good condition and has been hospitalized at the Providence Regional Medical Center Everett out of an abundance of caution, the officials said.

A hospital spokesman said that the patient is being monitored in a special isolation unit “for at least the next 48 hours.” The hospital is contacting health workers and other patients who may have had contact with him, so they can be monitored for symptoms, the spokesman said.

Ground Zero for China’s Mysterious Virus
Spreading quickly from its epicenter in the city of Wuhan, a potentially lethal virus has sickened hundreds around China and reached the U.S., Japan and South Korea. Photo: Agence France-Presse/Getty Images
“The man who tested positive acted quickly to seek treatment,” said John Wiesman, Washington State Secretary of Health. “We believe the risk to the public is low.”

The fact that local health officials and a regional hospital in the Pacific Northwest have suddenly been confronted with a virus that scientists discovered just a few weeks ago thousands of miles away in central China shows how rapidly diseases can spread around the world. The risk is even greater when a new virus emerges in a busy transport hub like Wuhan, which is connected through direct and connecting flights to many other major cities around the globe.

The CDC said Tuesday that it will expand screening of airline passengers for symptoms of the new virus to two more airports: Chicago O’Hare International Airport and Hartsfield-Jackson Atlanta International Airport. All passengers from Wuhan will now be funneled through five airports where screening is taking place, said Martin Cetron, director of the Division of Global Migration and Quarantine at the CDC.

The CDC began screening at the end of last week at three airports that receive the majority of travelers from Wuhan: San Francisco International Airport, Los Angeles International Airport and New York’s John F. Kennedy International Airport. More than 1,200 passengers have been screened, but none have been referred to a hospital, said Dr. Messonnier.

A Chinese-language sign in the Seattle airport tells arriving passengers to call a doctor if they have been in Wuhan and feel sick.
The Washington state man returned to the U.S. before screening began. It isn’t clear how he was infected, deepening a mystery as to how the virus is transmitted and how easily it spreads from one person to another. He didn’t visit any animal or seafood markets in Wuhan, which were suspected sites for transmission, said Chris Spitters, health officer for the Snohomish Health District. Nor did the man know anyone who was ill.

It is also unclear how easily the virus is spreading from one human to another, the CDC said Tuesday. Coronaviruses circulate primarily in animals such as bats and pigs, and Chinese authorities initially believed that patients had been infected during contact with animals at a market. But as more cases emerged in people who said they hadn’t visited the market, they revised their stance. Chinese authorities acknowledged on Monday that the virus is spreading among humans.

China’s Mysterious New Virus Spreads Beyond the Epicenter
Chinese health authorities have reported more than 300 cases of a pneumonia-like illness that has spread to South Korea, Japan and Thailand. While different from the deadly SARS, the coronavirus is sparking memories of the outbreak in the early 2000s. Photo: Getty Images
The CDC is working with authorities in China and other experts globally to learn more about the virus, and scientists are working on the development of treatments, Dr. Messonnier said. “There is new information hour by hour, day by day that we are tracking and following closely,” she said.

Experts believe the current coronavirus to be much less deadly than severe acute respiratory syndrome, or SARS, a different coronavirus strain that killed hundreds of people around the world in late 2002 and early 2003 after it first appeared in southern China.

Even so, China’s cabinet-level National Health Commission said Monday it would treat the new coronavirus as a Class A infectious disease, meaning it would be handled similarly to cholera, the plague and to how it handled the SARS outbreak

Wuhan will take more stringent measures to prevent transmission of the disease, including canceling what it considers unnecessary large gatherings, setting up a prevention and control center, and strengthening protection of medical staff, China’s state-run Xinhua News Agency said Tuesday.

Authorities at Wuhan’s international airport are monitoring outbound travelers in an effort to curb spread of the infection.

“We recommend outsiders not come to Wuhan and also that Wuhan residents not leave Wuhan without a special reason,” Zhou Xianwang, the city’s mayor, told CCTV on Tuesday.

North Korea, which borders northeastern China, has stopped allowing entry for tourists as a preventive measure, according to two China-based travel agencies that arrange tours to the country.

In Australia, the country’s chief medical officer, Brendan Murphy, told reporters that three direct flights each week between Wuhan and Sydney would be met by officials who would inquire about sick passengers.

Philippine health authorities, meanwhile, said they are testing which type of coronavirus a 5-year-old who traveled from Wuhan this month had contracted.
Title: How WuFlu will end
Post by: Crafty_Dog on March 27, 2020, 10:31:01 AM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 27, 2020, 12:12:10 PM
"The testing fiasco was the original sin of America’s pandemic failure, the single flaw that undermined every other countermeasure."

well I dunno

I don't like to jump on the chorus band wagon

what are they saying
a virus that might have spread
(remember the other ones that did not) should have within weeks triggered production of millions of test kits available everywhere for immediate
use that may never have been needed in the first place

at every outbreak of anything everywhere will now  subject us to all sorts of God knows. what.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 27, 2020, 12:15:18 PM
another end game scenario

the "novel" corona disappears from the face of the Earth like the 1918 flu pandemic virus to never be heard from again or mutates back to a regular cold virus.
Title: unlike the convicts
Post by: ccp on March 27, 2020, 12:19:52 PM
these guys and gals cannot be released from their stations. and sent home :

(maybe some can)
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 27, 2020, 01:01:59 PM
I need citations of doctors and serious folks endorsing the off label use of the malaria drug, and of the current study being done in real time in NYC.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 27, 2020, 01:57:57 PM
"I need citations of doctors and serious folks endorsing the off label use of the malaria drug, and of the current study being done in real time in NYC."

what do you mean citations?

the general consensus as far as I know is this drug should not be used for outpatient people suspected of or having confirmed corona at all.
for those who look like they are critically ill there is controversy

I don't like doctors hoarding these for themselves or their families as reported
I have had people calling up asking for zpacks (nothing else works! - total BS). one calls up stating he thinks he has malaria  - called from Michigan.

Some doctors I work with feel these drugs should not be used at all unless in some kind of clinical trial
On that note I personally disagree.  If someone is on a ventilator and dying I think there is enough evidence these drugs may work they should
be used / offered.

though agree it is best if they are used in a way that the results can be measured so we have a better idea how well they work
they are drugs around for decades so we already know side effects etc. though we do not really understand well in the situation of corona obviously

it is important to remember the history of medicine is littered with drugs that seemed to work, theoretically should work , and either did not or indeed, not rarely made things worse.

Title: second post
Post by: ccp on March 27, 2020, 02:35:03 PM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 27, 2020, 03:08:25 PM
This seems relevant:
Title: CA dropped pandemic preps in 2011
Post by: Crafty_Dog on March 27, 2020, 03:12:20 PM

"Sharing this not to bash anybody, but to point out how difficult preparedness really is.  If you don’t need something for a long time, you can persuade yourself that you’ll never need it.  Or that it’s too expensive to maintain based on the unlikelihood something will happen.  Then it does and everyone becomes a critic."
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 27, 2020, 03:25:43 PM
"If you don’t need something for a long time, you can persuade yourself that you’ll never need it. "

yeah,  like 100 yrs

Title: Re: CA dropped pandemic preps in 2011
Post by: G M on March 27, 2020, 05:27:03 PM
Yeah, who could have foreseen the potential for a pandemic in California? The sprawling homeless camps filled with MRSA, TB, HIV, Leprosy, Hepatitis and Typhus are otherwise very hygienic!

"Sharing this not to bash anybody, but to point out how difficult preparedness really is.  If you don’t need something for a long time, you can persuade yourself that you’ll never need it.  Or that it’s too expensive to maintain based on the unlikelihood something will happen.  Then it does and everyone becomes a critic."
Title: China has totally beaten the Kung Flu!
Post by: G M on March 27, 2020, 06:36:14 PM

Glorious victory!
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 27, 2020, 11:29:03 PM
Well, if that is so, and given that Taiwan and HK do have WuFlu, then they must not be part of China.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: G M on March 28, 2020, 10:28:56 AM
Well, if that is so, and given that Taiwan and HK do have WuFlu, then they must not be part of China.

They aren’t.
Title: Just the flu, bro!
Post by: G M on March 28, 2020, 10:30:02 AM
Title: american ingenuity already at work
Post by: ccp on March 28, 2020, 10:44:02 AM

do the Chinese have such a test.  :-P
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 28, 2020, 01:12:36 PM
of course Cuomo

who thinks America was never that great
must not think much of American ingenuity............

Title: The bureacracy fuct things up
Post by: Crafty_Dog on March 28, 2020, 01:21:12 PM
But he does think a lot of bureaucracy:
Title: Today's reality check
Post by: G M on March 28, 2020, 04:39:08 PM
Title: Re: Epidemics: Taiwan?
Post by: DougMacG on March 28, 2020, 05:06:52 PM
Well, if that is so, and given that Taiwan and HK do have WuFlu, then they must not be part of China.

They aren’t.

That's right, they aren't and this is a breakthrough catch by Crafty, like when Justice Breyer referred to the woman in an abortion situation as a "mother".  Mother of what?!  Here the WHO pretends to not know Taiwan - as anything other than China, even though the stats are separate and so is the sovereignty.
Title: At least you have a high speed train from LA to SF!
Post by: G M on March 28, 2020, 05:24:25 PM

Title: First Report of Deadly Wuhan Virus, Jan 8, 2020
Post by: DougMacG on March 28, 2020, 05:41:46 PM
THIS is the first report WE had of the Wuhan virus:
[China had a scientific report on Jan 5.]

New Virus Discovered by Chinese Scientists Investigating Pneumonia Outbreak
Latest tally of people sickened in Wuhan is 59, with seven in critical condition

Public-health officials in Bangkok hand out disease-monitoring information after performing thermal scans on passengers arriving from Wuhan, China, on Wednesday.
By Natasha Khan
Updated Jan. 8, 2020 8:30 pm ET

HONG KONG—Chinese scientists investigating a mystery illness that has sickened dozens in central China have discovered a new strain of coronavirus, a development that will test the country’s upgraded capabilities for dealing with unfamiliar infectious diseases.

The novel coronavirus was genetically sequenced from a sample from one patient and subsequently found in some of the others affected in the city of Wuhan, people familiar with the findings said. Chinese authorities haven’t concluded that the strain is the underlying cause of sickness in all the patients who have been isolated in Wuhan since the infection first broke out in early December, the people said.

Chinese state media reported Thursday that the unidentified pneumonia “is believed to be a new type of coronavirus,” citing experts. State media reported that the results were preliminary and more research was needed to understand the virus.

There are many known coronaviruses—some can cause ailments like common colds in humans, while others don’t affect humans at all. Some—such as severe acute respiratory syndrome, or SARS-coronavirus, identified in 2003—have led to deadly outbreaks, lending urgency to efforts to contain the current situation.

The number of reported cases of viral pneumonia in Wuhan, the capital of Hubei province, was 59 on Sunday, rising from 27 on Dec. 31, according to Wuhan’s Municipal Health Commission, with seven people in critical condition. No deaths have been reported.

The disease afflicting patients in Wuhan hasn’t been transmitted from human to human, and health-care workers have remained uninfected, according to city health officials as of Sunday, suggesting that what is sickening them is for now less virulent than SARS. Those ill in Wuhan are believed to have become sick through exposure to animals linked to a live seafood and animal market.

Health experts say one risk is that the disease could become a bigger threat as tens of millions of Chinese travel around the country during the Lunar New Year holidays that begin in just over two weeks.

Health authorities in Singapore and Hong Kong, cities that have direct flights from Wuhan, have issued alerts and quarantined patients traveling from the region who show signs of fever or breathing difficulties.

The U.S. Centers for Disease Control and Prevention asked health-care providers and state and local health departments on Wednesday to screen patients with severe respiratory illnesses about whether they have traveled to Wuhan. Any patients meeting those criteria should be reported immediately to public health authorities, the U.S. public health agency said in a health advisory. No cases have been reported in the U.S., the CDC said, adding that it is prepared to respond “if additional public health actions are required.”

In Hong Kong on Tuesday, the government said it was taking precautions against a “severe respiratory disease associated with a novel infectious agent.” that it is seeking to make a statutory notifiable infectious disease, meaning doctors would need to report any suspected cases, and patients evading quarantine could be fined or jailed.

A visitor walked past a large photo depicting the 2003 SARS epidemic at an exhibition, ‘40 Years Through the Lens,’ at the National Museum of China, in Beijing, September 2018.
China was criticized for initially covering up SARS, which was first detected in late 2002 but was disclosed only after it began spreading widely, eventually killing 774 people globally, according to the World Health Organization. Beijing overhauled the nation’s disease control after reviews found that initial failures to contain and isolate patients with SARS allowed it to proliferate across densely populated southern China.

The Wuhan outbreak will test how much has changed.

“We learned a bitter lesson in 2003, and we do not want that to happen again,” said Alex Lam, chairman of advocacy group Hong Kong Patients’ Voices. “China should immediately release their findings so doctors across the world can better know how to tackle this illness.”

Hong Kong’s department of health, citing information from China’s National Health Commission, said the cause of the cluster of pneumonia cases detected in Wuhan was still under investigation, but other known respiratory pathogens had been ruled out.

The main clinical symptoms of those affected by the Wuhan outbreak are fever—with a few patients having difficulty breathing—and invasive lesions of both lungs, which show up on chest radiographs, the WHO said Sunday.

A mourner wearing a mask to ward off SARS under an umbrella during the funeral of a SARS doctor in Hong Kong in 2003.
It is unclear what the underlying source of the disease is, though the reported link to a wholesale fish and live-animal market could indicate an exposure link to animals, the WHO said. Bats, for example, are known reservoirs for coronaviruses, and have been found to transmit the disease to humans through a third vector such as a civet cat, as scientists found in the case of SARS.

The pattern of the unexplained pneumonia cases linked to the market selling seafood and live game strongly suggests that this is a novel microbe jumping from animal to human, said K.Y. Yuen, chair professor of infectious diseases at the University of Hong Kong’s Faculty of Medicine.

Researchers have determined that a large proportion of new infectious diseases in humans are transmitted via animals. Such illnesses are referred to as zoonoses. Two newer human coronaviruses, MERS-CoV and SARS-CoV, have been known to cause severe illness and death, according to the U.S. CDC.

The Wuhan strain is similar to bat coronaviruses that were a precursor to SARS, a person familiar with the new findings said.

Given the marked advances in hospital isolation facilities, infection-control training and laboratory diagnostic capabilities in the past two decades, it is unlikely that this outbreak will lead to a major 2003-like epidemic, Mr. Yuen said.

In Wuhan, which has China’s first Biosafety Level 4 laboratory—a specialized research laboratory that deals with potentially deadly infectious agents like Ebola—the market at the center of investigations has been shut since Jan 1.

In Hong Kong, badly hit by the SARS virus, which claimed 299 lives locally in 2003, residents have donned surgical masks on the streets and public transport in recent days, despite no local cases of the Wuhan infection being confirmed.

—Betsy McKay and Stephanie Yang contributed to this article.

Write to Natasha Khan at
Title: This could be the missing link to the pivot
Post by: Crafty_Dog on March 28, 2020, 09:12:33 PM
Title: Re: This could be the missing link to the pivot
Post by: G M on March 28, 2020, 09:21:52 PM

Title: American ingenuity to the rescue
Post by: Crafty_Dog on March 28, 2020, 09:32:31 PM
Title: Re: American ingenuity to the rescue
Post by: G M on March 28, 2020, 09:41:28 PM

2 - 5

Got a way to mass produce people to run the vents?

Title: Fauci on immunity conferred vel non
Post by: Crafty_Dog on March 28, 2020, 10:21:40 PM
Title: Re: Fauci on immunity conferred vel non
Post by: G M on March 28, 2020, 11:36:35 PM

Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 29, 2020, 01:12:21 AM
Fk!  When will I learn?  Ugh!
Title: Dutch recall faulty Chinese masks
Post by: Crafty_Dog on March 29, 2020, 01:33:57 AM
Title: one drug candidate bites the dust
Post by: ccp on March 29, 2020, 08:48:25 AM

for yrs I subscribed to NEJM then I started seeing all the PC correct articles and cancelled
I still was member of ACP and that got overwhelming PC and I cancelled.

The lead article in the Green journal this past month that I get sent to be for free is "why is there not more women in cardiology?"
   the article notes 51 % of new doctors are babes now , but only 20% of cardiologists.

My thought: why should I give a hoot.
No one is stopping them.

here it is ; good for bathroom reading which IS where I usually wind up reading it:


and you can't even use it for toilet paper for those of us not savvy foresightful enough, like GM, to stock up.
the ink comes off the paper.

well do have another package of paper left.... but am close to out on paper towels.
Title: Re: one drug candidate bites the dust, "Fail Fast"
Post by: DougMacG on March 29, 2020, 09:08:56 AM
A friend who is a successful entrepreneur in biotech says the goal [other than to succeed] is to "fail fast".

With every new theory, drug, test procedure or treatment, whether you are the investor or the scientist, you want it to fail fast [if it is going to fail at all] and move the learning from it and your time and resources into the next theory, test, drug or treatment [until you get it right].
Title: new estimate 100 to 200K?
Post by: ccp on March 29, 2020, 09:47:37 AM

a heck of a lot less then 3 to 5 million
the NYT wants to smear Trump with

that said only time will tell.
American ingenuity has not let us down yet - except maybe in politics.
Title: Front Lines NYC Doc
Post by: Crafty_Dog on March 29, 2020, 10:42:35 AM
This comes well recommended
Title: Face masks!
Post by: Crafty_Dog on March 29, 2020, 10:57:31 AM
second post
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 29, 2020, 11:24:30 AM
my sister sent me Dr Price's video
and it was noted on Watter's World last night

not a huge fan of saturday fox shows
but even with the choice of 100 stations or more I still can't find things I want to watch
  that is when I pick up a book
still reading about the 14th century plague

reading how the religious monks friars popes bishops etc were at least as much political and financial animals as religious!

at least bishopship was a collection of gays even then!
Title: Re: Face masks!
Post by: DougMacG on March 29, 2020, 11:43:10 AM
second post

Sadly, they seem to be playing down the importance of masks because we can't have any.  Is that valid reason to hide the truth, i.e. lie?

That and the hand sanitizer scandal ...  these parts of the puzzle are solvable!

Title: Mayor Di Blasio on March 10
Post by: Crafty_Dog on March 29, 2020, 12:00:38 PM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 29, 2020, 12:05:31 PM
I thought I posted response to this but didn't hit post I guess

Am doing this in between patients

I wondered about the face mask claim too.
for 36 years I was alway told when going into a patient's room in the hospital who had legionnaires or TB or other resp. born illness we. needed to wear mask to protect ourselves

now suddenly we are told they don't work
I wondered why for the new revelation ?
mask does not filter corona, mask was not tight enough,
people who wear them not taking them off correctly and just contaminating their hands? masks do not cover eyes?

or are we being fed a bunch of bullshit?

I think Doug is right
the elites decide what is best for us to know and not know.

now back to seeing patients.
I am done saying wash your hands blah blah blah
and everyone else I am sure is tired of hearing the same crap
Title: Laws of Quarantine
Post by: Crafty_Dog on March 29, 2020, 12:28:57 PM
Title: NJSP hit with the virus
Post by: G M on March 29, 2020, 03:57:49 PM
Title: 30s and 40s needing ventilators in Bay area CA
Post by: Crafty_Dog on March 29, 2020, 04:22:30 PM
Title: State of the Research
Post by: Crafty_Dog on March 29, 2020, 10:39:06 PM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on March 30, 2020, 06:16:56 AM
"Once in the ICU, patients typically need somewhere between 10 to 14 days of mechanical ventilation, Parodi said."

That is a long time

I read the Gilead drug seems to cut that length of time down a lot .

Not sure about chloroquine drug but likely that too.  ("doc I have malaria !" )

the sooner we get them off the vents the faster we get the vent tube into the next windpipe.
Title: Re: Epidemic death rate
Post by: DougMacG on March 30, 2020, 08:53:12 AM
People are speculating Wuhan plague death rates, 100,000 US?  Here is my prediction:  The [overall] death rate in the US and in the world will be statistically unchanged in this period we are in.  More COVID deaths, fewer of some of the others, less air pollution, better hygiene and distancing, fewer traffic deaths etc.  Leading causes of death will still be heart disease and cancer.  I hope the current crisis and panic does not get in the way of my friends who need cancer treatment now.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on March 30, 2020, 12:22:25 PM
The Coronavirus Threat To view this article, Click Here
Brian S. Wesbury, Chief Economist
Robert Stein, Deputy Chief Economist
Date: 3/30/2020

Total deaths in the US from COVID19 look like they'll hit at least 3,000 by the end of March. A potentially brutal April lies ahead.

In the meantime, the measures taken to limit deaths have temporarily tanked the US economy. Initial claims for jobless benefits soared to 3.283 million per week, easily the highest ever. The prior record was 695,000 in October 1982; the highest during the Great Recession was 665,000.

Policymakers have reacted to the economic damage with massive measures. The Federal Reserve has reduced interest rates to nearly zero, has begged banks to use the discount window, embarked on unlimited quantitative easing, and is backstopping an unprecedented array of markets, including commercial paper, money markets, commercial mortgages, and municipal securities.

Meanwhile, we have a newly enacted "stimulus" bill that could total $2 trillion, possibly more. These include IRS checks, a major expansion in unemployment benefits, as well as a broad combination of grants, loans, and loan guarantees for businesses (large and small), hospitals, schools, and state and local governments.

The federal budget deficit for this fiscal year, previously estimated by the Congressional Budget Office to be about $1.1 trillion, could easily run around $2.5 trillion, and that's without other major spending bills. Since World War II, the largest budget deficit relative to GDP was 9.8% in 2009; but a $2.5 trillion deficit this year could be about 11.8% of GDP.

Of course, these monetary and fiscal measures are on top of the massive economic interference - designed to stem the virus -by governments at all levels. The longer these measures persist, the greater the risk of atrophy setting in for small business across the country, making them less able to reopen in the future. The loss of intangible capital would be enormous, the internal knowledge of how to get things done. Slower economic growth in the post-COVID19 world would be the result.

It's important that the expansion of government is not made permanent. The New Deal took annual federal spending from about 3% of GDP to about 10% of GDP (before World War II) and we never went back, or even close. Policymakers need to avoid making COVID19 an excuse for another permanent leap upward in the size of government, which would erode future living standards versus where they would otherwise go.

Once we have a vaccine, some things have to change. Governments at all levels should consider "strategic health reserves" of masks, ventilators, respirators,...whatever is needed in an emergency, so we don't have to take drastic measures again. Our recent response should not be a periodic feature of American life.

Dr. Fauci recently said there could be 100,000 – 200,000 deaths. The mid-point would be 47 people per 100,000 residents, not much different from the number of people the US lost to the flu in early 1953, late 1957, early 1960, the peak of the 1968-69 Hong Kong Flu, or early 1976.

Those episodes didn't permanently expand government and neither should this one. In order to be better prepared in the future, we need a vibrant private sector, not a permanent expansion in government.
Title: OC CA
Post by: G M on March 30, 2020, 01:52:13 PM
Title: the impeachment russia gig for the left
Post by: ccp on March 30, 2020, 02:03:32 PM
CNN et al.

is not going to let Orange man get any credit and will keep saying it everything is his fault.

every time I wiz by CNN the bottom hashtag is something , anything negative
about Trump or the response or death toll is rising and not enough tests.
Title: fake news network
Post by: ccp on March 30, 2020, 02:44:57 PM
Title: Ron Paul another view
Post by: ccp on March 30, 2020, 05:37:13 PM

he was a gynecologist I think

I agree about the power grabbing and the use of this for political gain
but not really with the rest
Title: Eh tu, CNN?
Post by: Crafty_Dog on March 30, 2020, 08:07:54 PM
Title: The bureaucracy did it
Post by: Crafty_Dog on March 30, 2020, 08:31:03 PM
Title: Federalist: The bureaucracy did it
Post by: Crafty_Dog on March 31, 2020, 03:50:16 AM
Title: Hungary's Orban given total power
Post by: Crafty_Dog on March 31, 2020, 04:28:02 AM
Hungary’s parliament gave Prime Minister Viktor Orbán the right to rule by decree until his government decides the coronavirus crisis has ended, defying criticism from European Union leaders that the pandemic is providing cover for his and other governments to crack down on democratic freedoms.

The bill, passed on Monday almost entirely by votes from the prime minister’s nationalist party, Fidesz, contained two important provisions: If parliament is unable to meet, which its leaders have already said would be difficult, Mr. Orbán could continue to govern under a state of emergency, creating and suspending laws by decree. Only Mr. Orbán’s government, or a two-thirds majority in parliament, could decide when this period would come to an end.

Secondly, the law imposes a maximum of five years’ prison time against those who intentionally spread false news or “distorted truth” that is seen to be detrimental to the government’s efforts to fight the virus and address its economic toll.

Military police patrolled the Hungarian capital on Monday, amid a national lockdown to halt the spread of the new coronavirus.
The law came under criticism from EU leaders and some legal scholars, who said that the coronavirus crisis has now given Mr. Orbán autocratic powers that can only be clawed back by his own cabinet, or his party, which controls two-thirds of seats in parliament.

The bill is part of a spate of new measures in Europe that target individuals who share rumors or falsehoods that hinder the battle against the pandemic.

Mr. Orbán has rejected such criticism, saying that the EU has been less helpful to Hungary than China, which sent 3 million medical masks last week. Fighting the virus will require unusual measures for an indefinite period, said Mr. Orbán, who has promised to relinquish his rule-by-decree powers as soon as the crisis ends.

“There are situations in which one cannot be polite,” he said during a radio broadcast on Saturday. “So I plainly told EU nit-pickers, if I may put it that way, that this is not the time to come to me pontificating about all sorts of no doubt fascinating legal and theoretical questions. Because now we have a crisis, now we have an epidemic, and now we must save lives.”

Hungary has had 447 confirmed Covid-19 cases as of Monday, with 15 deaths, since its first case on March 4. Members of Mr. Orbán’s party said they worried that the government would cease to function if they fell ill before affording their prime minister extraordinary powers.

Related Video
Coronavirus Update: Social-Distancing Extended and Make-or-Break Week


Coronavirus Update: Social-Distancing Extended and Make-or-Break Week
Coronavirus Update: Social-Distancing Extended and Make-or-Break Week
The White House extends social-distancing guidelines to April 30, bills are due this week for millions of Americans, and while China gradually reopens, India sees a mass exodus of workers leaving cities. WSJ’s Shelby Holliday has the latest on the pandemic. Photo: Michael Ciaglo/Getty Images
“We needed a law for the worst-case scenario when parliament is unable to operate,” said a Fidesz member of parliament who declined to be named because he wasn’t authorized by the party to speak to the press. “What if all of us will be in the hospital?”

The law is one in a number of emergency measures that human-rights groups worry will leave parts of the world less democratic than before the coronavirus pandemic, including Russia, Bolivia and Israel.

Europe has seen a crackdown on press freedoms and social media, as some governments try to snuff out news that they feel spreads unwarranted panic. Serbia, Montenegro and Hungary have launched investigations into some social-media posts, and in some cases arrested individuals involved. In February, police in Budapest raided a building and detained two people suspected of seeding articles and Facebook posts that inflated Hungary’s death toll.

“Political leaders could abuse the coronavirus crisis to undermine democracy,” wrote Andras Racz, senior fellow at the German Council on Foreign Relations. “Europe’s biggest risk is Hungary.”

Mr. Orbán, a nationalist known for fencing off his border to migrants, has long feuded with the EU’s center-right and liberal blocs. The 56-year-old prime minister, who has led Hungary for nearly half of its postcommunist history, has won repeat landslide elections in part by campaigning against the union’s political establishment.

“We’re not preventing anyone from doing their job,” said Eric Mamer, the spokesperson of the European Commission, after receiving a question on Mr. Orbán’s comments on Monday. “At the same time, however, we are vigilant and we ensure compliance with EU standards in all areas of politics during the fight against the coronavirus.”

Write to Drew Hinshaw at
Title: Bipartisan Bureaucratic Responsibility
Post by: Crafty_Dog on March 31, 2020, 09:27:50 AM
Title: Bad Orange Man or Gov. Cuomo?
Post by: Crafty_Dog on March 31, 2020, 10:51:42 AM
Title: Cuomo chose ventilator rationing years ago
Post by: Crafty_Dog on March 31, 2020, 10:57:58 AM
Title: Dems misleading WuFlu claims
Post by: Crafty_Dog on March 31, 2020, 12:59:15 PM
fourth post
Title: Antibodies of the Survivors
Post by: Crafty_Dog on March 31, 2020, 01:03:21 PM
Title: Certificates of Need fouling things up
Post by: Crafty_Dog on March 31, 2020, 01:08:30 PM
Title: FDA and CDC blocking uncertified face mask imports
Post by: Crafty_Dog on March 31, 2020, 05:01:34 PM
Title: Re: FDA and CDC blocking uncertified face mask imports
Post by: DougMacG on March 31, 2020, 05:33:24 PM

Is it too much to ask that everyone get a mask and a 2 ounce bottle of sanitizer as we head into MONTH SIX of the Wuhan Plague?

Screw the $1200.  Let us buy what we need to protect ourselves and know that the people around us have the ability to cover their mouth and clean their hands on the fly a hundred times a day if they have to.  Too much to ask, or are we too G*d D*mned regulated for safety to find our way to safety?
Title: Re: FDA and CDC blocking uncertified face mask imports
Post by: G M on March 31, 2020, 07:22:07 PM

Is it too much to ask that everyone get a mask and a 2 ounce bottle of sanitizer as we head into MONTH SIX of the Wuhan Plague?

Screw the $1200.  Let us buy what we need to protect ourselves and know that the people around us have the ability to cover their mouth and clean their hands on the fly a hundred times a day if they have to.  Too much to ask, or are we too G*d D*mned regulated for safety to find our way to safety?
Title: Testing for antibodies
Post by: Crafty_Dog on March 31, 2020, 08:12:06 PM
Title: stop whining; this is a rare pandemic
Post by: ccp on April 01, 2020, 08:18:52 AM
do your job or stay home,
and stop blaming Trump for a natural phenomenon. everyone is doing the best they can asshole:

Title: Chinese Commies lied
Post by: Crafty_Dog on April 01, 2020, 10:24:03 AM
Title: GPF: Brazil, Bolsonaro, vertical isolation and economy first
Post by: Crafty_Dog on April 01, 2020, 10:32:40 AM
April 1, 2020   View On Website
Open as PDF

    The Method to Bolsonaro’s Madness
By: Allison Fedirka

Known for his contrarian and uncouth behavior, Brazilian President Jair Bolsonaro frequently comes under intense scrutiny for his decisions. The latest controversy stems from his refusal to shut down economic activity in response to the coronavirus outbreak. Many governments face this decision but few have opted for Bolsonaro’s economy-first approach. The policy hasn’t been well received at home: Governors have lined up against him, media outlets have raised the idea of removing him from office, and even Facebook removed a video of Bolsonaro speaking to street vendors on the grounds that the content violated misinformation standards related to the virus. But however controversial it may be, there is a method to Bolsonaro’s apparent madness. Brazil’s economy is simply too weak to deliberately close down for a prolonged period of time.


Brazil first addressed the coronavirus as an economic problem rather than a public health one because the economic effects arrived a month before its first confirmed case. At the end of January, Brazilian mining giant Vale suspended operations in China and restricted travel to and from the country. In early February the electronics industry, particularly makers of small electronics such as mobile phones, started experiencing supply chain problems, and by mid-month firms were implementing short-term closures and discussing furloughs. Leading solar power companies in Brazil, also highly dependent on China, forecast supply shortages in April and May as well as a 5-10 percent drop in sales. Brazilian beef exports – worth billions of dollars when it comes to China trade – experienced a sharp drop in demand, putting small and medium-sized slaughterhouses in peril of closing. Oil giant Petrobras, which sends 72 percent of its exports to China, also reported slumping demand. The shipping industry and exporters expressed worries about a potential shortage of containers by April. All this occurred before Feb. 25, when Brazil reported its first confirmed case of COVID-19.

Once the virus arrived in Brazil, the question in the government of balancing competing demands between health and economic needs unsurprisingly turned contentious. Bolsonaro leads the economy-first camp, downplaying health risks in public and rejecting restrictions on social movement on the grounds that they will destroy the economy. He advocates “vertical isolation,” which calls for the elderly and those with preexisting conditions to self-isolate while everyone else goes about business as usual. On the public health side, several state governors, led by Sao Paulo’s Joao Doria and accompanied by Rio de Janeiro’s Wilson Witzel, have called for restrictions on movement for the whole population. Together, these two states account for nearly 40 percent of national gross domestic product and are home to 63.2 million of Brazil’s 210 million inhabitants. Restricting economic activity in these states will greatly reduce the country’s GDP. On one hand, the governors fear that their densely populated major cities are conducive to the virus’ rapid spread. But on the other hand, those cities also have concentrations of poor neighborhoods whose residents cannot afford extended periods of limited or no work.

A further complication is the question of jurisdiction. In mid-March, the executive proposed legislation aimed at centralizing power to regulate the closure of businesses and social distancing measures to ensure an efficient response. The proposal now has 126 amendments and is currently in a joint commission for discussion, allowing governors to pursue their own measures in the meantime. A second measure that addresses workers’ rights and unemployment during the crisis has already been rejected by some legislators as unconstitutional. Judges have weighed in, encouraging the federal government to coordinate efforts more closely with states.

Bolsonaro is reluctant to limit economic activity because the Brazilian economy is weak and can ill afford another economic crisis. Brazil has yet to recover from its two-year recession from 2015 to 2016. During that time, GDP contracted by nearly 7 percent. In the three years since, the economy essentially stagnated, registering growth of just about 1 percent annually. Prior to the recession, in 2014, Brazil overtook the United Kingdom to become the seventh-largest economy in the world, with a GDP of $2.4 trillion. Now the economy ranks ninth globally, with a GDP of $1.89 trillion. The unemployment rate in 2014 was 6.8 percent before doubling to 13.7 percent in early 2017. Now unemployment has been reduced to 11.6 percent, though the quality of jobs created is low, as is remuneration.
(click to enlarge)
Plans Interrupted

Bolsonaro was elected in 2018 on a pledge to reform and jump-start the economy, but economic measures taken early in his term have reduced the country’s arsenal for dealing with the impending global recession. Last year, the government focused on structural reforms and facilitating household consumption, which accounts for over 70 percent of GDP. The central bank launched monetary easing in July 2019 in an effort to boost lending to consumers. In the second half of 2019, the government also permitted individuals to withdraw funds from their Workers’ Severance Fund accounts to help boost economic activity. The effect of these policies was supposed to kick in during the first half of 2020, but the onset of the global recession doomed the strategy from the get-go. In just two months, the central bank cut interest rates to 3.75 percent from 4.5 percent. Though there is still room to go lower, these rates are already very low by Brazilian standards.
(click to enlarge)

The global downturn has hampered other stimulus policies. A privatization drive was intended to raise 150 billion reais ($29 billion) this year, but this week the electric utilities company Eletrobras postponed its privatization plans until 2021, and others will likely follow. The government also loosened rules to give foreign companies equal footing in competition for government contracts, with public tenders valued at 50 billion reais, but foreign investment interest has dried up. Finally, the government planned limited trade deals to open markets and diversification in trade with China, the U.S., Mexico and India. But trade has fallen off a cliff, and governments are focused on mitigating the contagion and economic damage at home.

Other plans to remake the economy have had to be repurposed to limit the short-term damage from the virus. A plan launched in February called Brazil More included funds to incentivize startups and provide more credit to small and medium-sized businesses, but it will now be used to save existing companies. Around the same time, after months of study, the central bank loosened reserve requirements in a move that could inject up to 135 billion reais into the economy. The central bank will also allow individuals to use personal retirement plans as collateral to access lower interest loans.

And lastly, there are the reforms that risk being undone as a result of the government’s all-out effort to mitigate the impact of the recession. One of the main objectives of the reforms was to cap government spending and reduce debt. However, in mid-March, it became apparent that government bailouts and other costly measures would be necessary to prop up the Brazilian economy. A state of emergency was declared, enabling the government to remove national spending caps and launch a 147.3 billion-real support package to ensure liquidity, prevent layoffs and support vulnerable groups. The government also intended to reduce its support for states’ debt but has now released an 85.8 billion-real bailout package for them (and that’s after suspending debt payments). At the end of 2019, the government stayed on track for a primary budget surplus of 1 percent of GDP, well below the official goal of 2.3 percent. The National Treasury now anticipates a primary deficit for 2020 of 4.5 percent of GDP (over 350 billion reais), well over the previous goal of 124.1 billion reais.

Difficult Choices Ahead

Support packages like these can keep firms afloat only for so long, and the ability to extend them depends on disposable resources. Herein lies the problem for Brazil: It has very limited headroom to deal with these matters. There are already concerns over the potential for a credit crisis and future lack of investment. The government does have $359 billion in reserves, but it is extremely reluctant to tap these resources – the government would do so only if it believed it was entering the worst-case scenario. All of this is further complicated by the fact that dollar gains against the real since the start of this year resulted in a 43.4 billion-real increase in gross debt, and low oil prices have wiped out tens of billions of reais in oil-related royalties and tax revenue (the budget was based on an average price of oil of $61.25 per barrel).
(click to enlarge)

Under these circumstances, Bolsonaro’s effort to preserve what’s left of Brazil’s economy at any cost does not seem unfounded.

At present, the economic pause in parts of Brazil has been in place for only a couple of weeks. During this time, the government has worked to better position the economy to stay afloat. The calls for vertical isolation demonstrate that the government believes it is reaching the limits of its ability to save the economy from severe recession if more economic activity is not restored soon. Bolsonaro, of course, is not alone in being trapped between two bad policy options, and many leaders will soon have to decide when measures to protect public health no longer outweigh the economic cost. When this shift will occur depends on the economic resilience of the country in question, and Brazil came in with a weak hand already half-played.   

Title: NRO: The Truth about the NSC pandemic team
Post by: Crafty_Dog on April 01, 2020, 10:43:43 AM
third post
Title: Just a coincidence?
Post by: G M on April 01, 2020, 06:59:05 PM
Title: FBI warned of Chinese researchers transporting disease samples in US
Post by: Crafty_Dog on April 01, 2020, 09:25:36 PM
Title: Re: FBI warned of Chinese researchers transporting disease samples in US
Post by: G M on April 01, 2020, 09:28:36 PM

We do know that China did know it had a very contagious virus rapidly spreading in China and did nothing to attempt to keep the disease contained within it's borders.
Title: Re: Just a coincidence?
Post by: DougMacG on April 02, 2020, 05:33:41 AM

From the article:  "it shouldn't take Perry Mason to conclude that a virulent coronavirus outbreak which started near a biolab that was experimenting with -- coronavirus -- bears scrutiny."

Tucker Carlson video:
"The virus likely came from  one of these two labs in Wuhan."
"There were no horseshoe bats living within 900 km."

"27 of 41 infected patients were found to have contact with the Huanan Seafood Market in Wuhan. We noted two laboratories conducting research on bat coronavirus in Wuhan, one of which was only 280 meters from the seafood market. We briefly examined the histories of the laboratories and proposed that the coronavirus probably originated from a laboratory....

... somebody was entangled with the evolution of 2019-nCoV coronavirus. In addition to origins of natural recombination and intermediate host, the killer coronavirus probably originated from a laboratory in Wuhan."
Given that this outbreak was said to begin in early winter when most bat species in the region are hibernating and the Chinese horseshoe bat’s habitat covers an enormous swath of the region containing scores of cities and hundreds of millions people, the fact that this Wuhan Strain of coronavirus, denoted as COVID-19, emerged in close proximity to the only BSL-4 virology lab in China, which in turn was staffed with at least two Chinese scientists – Zhengli Shi and Xing-Yi Ge – both virologists who had previously worked at an American lab which had already bio-engineered an incredibly virulent strain of bat coronavirus – the accidental release of a bio-engineered virus from Wuhan’s virology lab cannot be automatically discounted, especially when the Wuhan Strain’s unnatural genomic signals are considered.

UPDATE 2/14, 3:02am EST: A probable smoking pre-print has been released, by the National Natural Science Foundation of China:

“In summary, somebody was entangled with the evolution of 2019-nCoV coronavirus. In addition to origins of natural recombination and intermediate host, the killer coronavirus probably originated from a laboratory in Wuhan.”

In a predictable turn, that article has been removed and both researchers have since deleted their profiles off of the ResearchGate site completely. Furthering the appearance of a cover-up, back on January 2nd, the Wuhan Institute of Virology’s director sent out a memo forbidding discussion of an “unknown pneumonia in Wuhan” after ordering the destruction of all related lab materials a day earlier, making it abundantly clear that the Chinese government knew about this outbreak long before they took any steps to contain it, or made any public announcement.

Chinese government researchers isolated more than 2,000 new viruses, including deadly bat coronaviruses, and carried out scientific work on them just three miles from a wild animal market identified as the epicenter of the COVID-19 pandemic.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: DougMacG on April 02, 2020, 05:41:06 AM
"Coronavirus: pathogen could have been spreading in humans for years, study says
Virus may have jumped from animal to humans long before the first detection in Wuhan, according to research by an international team of scientists
Findings significantly reduce the possibility of the virus having a laboratory origin, director of the US National Institute of Health says"

Doug's observations from above:  Wouldn't that be, 'reduce the probability'.  You can't reduce a "possibility".

All of the studies indicating its likely otherwise leave open the possibility that This Virus Came Directly from That Lab.


Coronavirus: pathogen could have been spreading in humans for years, study says
Virus may have jumped from animal to humans long before the first detection in Wuhan, according to research by an international team of scientists
Findings significantly reduce the possibility of the virus having a laboratory origin, director of the US National Institute of Health says

Published: 29 Mar, 2020

An international team of scientists say the coronavirus may have jumped from animal to humans long before the first detection in China. Photo: APAn international team of scientists say the coronavirus may have jumped from animal to humans long before the first detection in China. Photo: AP
An international team of scientists say the coronavirus may have jumped from animal to humans long before the first detection in China. Photo: AP
The coronavirus that causes Covid-19 might have been quietly spreading among humans for years or even decades before the sudden outbreak that sparked a global health crisis, according to an investigation by some of the world’s top virus hunters.

Researchers from the United States, Britain and Australia looked at piles of data released by scientists around the world for clues about the virus’ evolutionary past, and found it might have made the jump from animal to humans long before the first detection in the central China city of Wuhan.
Though there could be other possibilities, the scientists said the coronavirus carried a unique mutation that was not found in suspected animal hosts, but was likely to occur during repeated, small-cluster infections in humans.

The study, conducted by Kristian Andersen from the Scripps Research Institute in California, Andrew Rambaut from the University of Edinburgh in Scotland, Ian Lipkin from Columbia University in New York, Edward Holmes from the University of Sydney, and Robert Garry from Tulane University in New Orleans, was published in the scientific journal Nature Medicine on March 17.

Dr Francis Collins, director of the US National Institute of Health, who was not involved in the research, said the study suggested a possible scenario in which the coronavirus crossed from animals into humans before it became capable of causing disease in people.
“Then, as a result of gradual evolutionary changes over years or perhaps decades, the virus eventually gained the ability to spread from human to human and cause serious, often life-threatening disease,” he said in an article published on the institute’s website on Thursday.

In December, doctors in Wuhan began noticing a surge in the number of people suffering from a mysterious pneumonia. Tests for flu and other pathogens returned negative. An unknown strain was isolated, and a team from the Wuhan Institute of Virology led by Shi Zhengli traced its origin to a bat virus found in a mountain cave close to the China-Myanmar border.

The two viruses shared more than 96 per cent of their genes, but the bat virus could not infect humans. It lacked a spike protein to bind with receptors in human cells.

Coronaviruses with a similar spike protein were later discovered in Malayan pangolins by separate teams from Guangzhou and Hong Kong, which led some researchers to believe that a recombination of genomes had occurred between the bat and pangolin viruses.
Doctors in Wuhan began noticing a surge in the number of people suffering from a mysterious pneumonia in December. Photo: Handout
But the new strain, or SARS-Cov-2, had a mutation in its genes known as a polybasic cleavage site that was unseen in any coronaviruses found in bats or pangolins, according to Andersen and his colleagues.

This mutation, according to separate studies by researchers from China, France and the US, could produce a unique structure in the virus’ spike protein to interact with furin, a widely distributed enzyme in the human body. That could then trigger a fusion of the viral envelope and human cell membrane when they came into contact with one another.

Some human viruses including HIV and Ebola have the same furin-like cleavage site, which makes them contagious.

It is possible that the mutation happened naturally to the virus on animal hosts. Sars (severe acute respiratory syndrome) and Mers (Middle East respiratory syndrome), for instance, were believed to have been direct descendants of species found in masked civets and camels, which had a 99 per cent genetic similarity.

There was, however, no such direct evidence for the novel coronavirus, according to the international team. The gap between human and animal types was too large, they said, so they proposed another alternative.

“It is possible that a progenitor of SARS-CoV-2 jumped into humans, acquiring the genomic features described above through adaptation during undetected human-to-human transmission,” they said in the paper.

“Once acquired, these adaptations would enable the pandemic to take off and produce a sufficiently large cluster of cases to trigger the surveillance system that detected it.”

They said also that the most powerful computer models based on current knowledge about the coronavirus could not generate such a strange but highly efficient spike protein structure to bind with host cells.

The study had significantly reduced, if not ruled out, the possibility of a laboratory origin, Collins said.
“In fact, any bioengineer trying to design a coronavirus that threatened human health probably would never have chosen this particular conformation for a spike protein,” he said.

The findings by Western scientists echoed the mainstream opinion among Chinese researchers.
Zhong Nanshan, who advises Beijing on outbreak containment policies, had said on numerous occasions that there was growing scientific evidence to suggest the origin of the virus might not have been in China.

“The occurrence of Covid-19 in Wuhan does not mean it originated in Wuhan,” he said last week.
A doctor working in a public hospital treating Covid-19 patients in Beijing said numerous cases of mysterious pneumonia outbreaks had been reported by health professionals in several countries last year.

Re-examining the records and samples of these patients could reveal more clues about the history of this worsening pandemic, said the doctor, who asked not to be named due to the political sensitivity of the issue.

“There will be a day when the whole thing comes to light.”
Title: Epidemic, Gov Kristi Noem, South Dakota
Post by: DougMacG on April 02, 2020, 06:35:06 AM

4 minutes, worthwhile.
Title: Re: Epidemics: observations, queries
Post by: DougMacG on April 02, 2020, 06:50:07 AM
From Scott Johnson, Brian Sullivan, posted on Powerline:

• New York has 10 times more Wuhan virus cases per capita than the rest of the country. If banning travel from China made sense, why doesn’t it make sense to restrict the interstate travel of New Yorkers in some fashion?

• The elderly and those with underlying health issues are most at risk of dying from Wuhan virus. Why don’t we find ways to isolate and protect them without shutting the entire country down?

• The United States has reported 14 deaths per million of population. Italy and Spain have reported over 200 deaths per million. France, England, and Germany have reported an average of 35 deaths per million. Critics claim Trump’s response is costing American lives. If relatively fewer Americans have died than every other major European country, what is the basis for the critics’ charge?

• Governor Cuomo said New York would start enrolling patients in clinical trials to test hydroxychloroquine last week, but the trials are described as “not yet recruiting” on the site? Why are these trials delayed?

• On January 21 the first case of Wuhan virus was confirmed. Ten days later, after Trump promulgated his order limiting travel from China, critics condemned the step as unnecessary and xenophobic. Are these critics still of the same opinion? (Note: Thank “The Senator who saw the coronavirus coming.”)

• The model Minnesota government officials used to justify our current shutdown policies projected that 1.5 percent, or 74,000, of all Minnesotans could die from the Wuhan virus. If these modelers used these same assumptions to estimate deaths in the United States, their model would project 5,000,000 Americans deaths. This is roughly 3 times more deaths per capita than died from the Spanish flu in 1918-19. Do Minnesota government officials think the Wuhan virus is possibly 3x more deadly than the Spanish flu? What model are they using?
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on April 02, 2020, 10:01:08 AM

Title: Chinese second waves?
Post by: Crafty_Dog on April 02, 2020, 10:14:29 AM
China’s “second waves” start to build. A county in the central Chinese province of Henan went back into lockdown mode on Wednesday following a modest surge in coronavirus infections. Yunnan province, meanwhile, is preventing citizens from crossing into Vietnam, Laos and Myanmar. The broader body of evidence suggests China is still generally bringing the outbreak under control. But as we’ve noted, its behavior at home will speak louder than somewhat dubious Chinese data regarding its success in managing the outbreak. And given that China is facing a surge of imported cases and still trying to figure out just how big a threat is posed by asymptomatic cases, the risk of coronavirus revival in China is high enough – and the geopolitical implications of an uncontainable second wave would be wide-ranging enough – that any such events merit close observation. Irrespective of just how much China has the virus contained, its economy is also facing a second wave of damage as foreign demand for its exports plummets. Both the state and Caixin PMI surveys released this week showed contractions in new orders. Small and medium-sized enterprises are getting hit particularly hard.
Title: Tucker: Does Chinese Scientific Paper hold clue about the origins?
Post by: Crafty_Dog on April 02, 2020, 01:24:09 PM
Title: Bill Gates' solution
Post by: Crafty_Dog on April 02, 2020, 02:13:51 PM
Title: FDA fux things up yet again
Post by: Crafty_Dog on April 02, 2020, 02:25:52 PM
fifth post
Title: Second wave hitting Hong Kong
Post by: G M on April 02, 2020, 02:33:50 PM
Title: Time for a Second Opinion: Vertical vs. Horizontal
Post by: Crafty_Dog on April 02, 2020, 04:01:03 PM
Title: After the lockdowns are lifted, then what?
Post by: Crafty_Dog on April 02, 2020, 04:24:40 PM
Title: Re: Time for a Second Opinion: Vertical vs. Horizontal
Post by: G M on April 02, 2020, 05:40:19 PM

I guess some people still can’t grasp the concept of exponential growth, or visualize what happens when you push the medical infrastructure beyond capacity. Lockdown is buying us time. At a serious financial cost, to be sure. Break the medical system and everyone gets to die in big community hospice centers pretending to be hospitals. Then people with other medical issues will also die from lack of treatment or medication along with virus victims.
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on April 02, 2020, 07:46:23 PM
last week our calls were ~ 39 % corona. = correction ~30 not 39. 
now closer to 50 %
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: G M on April 02, 2020, 07:54:00 PM
last week our calls were ~ 39 % corona
now closer to 50 %

32 days ago, the NY Slimes reported the FIRST NY case of coronavirus. Where will we be 32 days from now?

Title: homemade mask materials
Post by: ccp on April 03, 2020, 06:14:28 AM
Title: WSJ: Testing is our way out
Post by: Crafty_Dog on April 03, 2020, 07:33:41 AM
Testing Is Our Way Out
Returning to normal is too dangerous. Lockdowns are unsustainable. Let’s save lives without a depression.
By Paul Romer and Rajiv Shah
April 2, 2020 7:21 pm ET

For now, social distancing is the best America can do to contain the Covid-19 pandemic. But if the U.S. truly mobilizes, it can soon deploy better weapons—advanced tests—that will allow the country to shift gradually to a protocol less disruptive and more effective than a lockdown.

Instead of ricocheting between an unsustainable shutdown and a dangerous, uncertain return to normalcy, the U.S. could mount a sustainable strategy with better tests and maintain a stable course for as long as it takes to develop a vaccine or cure. The country will once more be able to plan for the future, get back to work safely and avoid an economic depression. This will require massive investment to ramp up production and coordinate the construction of test centers. But the alternatives are even more costly.

Two types of testing will be essential. The first test, which relies on a technology known as the polymerase chain reaction, or PCR, can detect the virus even before a person has symptoms. It is the best way to identify who is infected. The second test looks not for the virus but for the antibodies that the immune system produces to fight it. This test isn’t so effective during the early stages of an infection, but since antibodies remain even after the virus is gone, it reveals who has been infected in the past.

Together, these two tests will give policy makers the data to make smarter decisions about who needs to be isolated and where resources need to be deployed. Instead of firing blindly, this data will let the country target its efforts.

Here’s a simple illustration of how test data can save lives. Every day millions of health-care professionals go to work without knowing whether they are infectious and might spread the virus to their colleagues. We both have close relatives on the front lines. As soon as one of them developed a cough, she pulled herself out of service. But at that point she may have been infectious for several critical days. If she and her colleagues had all been tested every day, her infection would have been caught earlier and she would have isolated herself sooner.

To be used as a screening mechanism at the beginning of a shift, the test would need to be able to give a result within minutes. Developers are making progress on speeding up these PCR tests—so much so that the aforementioned physician received the results from her second test, conducted five days after the first, before those from the first test. Abbott and Roche, two pharmaceutical companies, are moving forward with tests that can decrease reporting times from days or hours to minutes. Now that the doctor has recovered, an antibody test could help determine when she can return to the frontlines of patient care.

As testing capacity expands, the same tests could be offered to all essential workers, such as police officers and emergency technicians, and then to other overlooked but critical workers—pharmacists, grocery clerks, sanitation staff. The next step would be to test people throughout the country at random to get up-to-date information about who is infected now and who has ever been infected.

For those who are currently infected, governments can provide immediate assistance to make sure they don’t infect anyone else, especially family members. Those infected before who now have antibodies may be less susceptible to reinfection. If that is proved in the weeks to come, they could also return to work.

Putting this system in place will take resources, creativity and hard work. Test developers will have to increase the production rate of kits by an order of magnitude. In his work fighting Ebola in West Africa, Dr. Shah saw how a virus can cause a 30% reduction in economic output. Mr. Romer’s back-of-the-envelope calculation is that the recession caused by the coronavirus pandemic has already caused a 20% reduction in U.S. output, which means the country is losing about $350 billion in production each month. If a $100 billion investment in a crash program to make antibody and PCR tests ubiquitous brought a recovery one month sooner, it would more than pay for itself.

Building this testing system would be complicated and require the best of American science, business and philanthropy working together. But it is the type of challenge that the U.S. has overcome before. It isn’t viable to wait a year or two for a vaccine before getting people back to work safely. To save lives and prevent a depression, testing on a massive scale is essential.

Mr. Romer is a professor at New York University and a 2018 Nobel laureate in Economics. Dr. Shah is president of the Rockefeller Foundation and served as administrator of the U.S. Agency for International Development, 2010-15.
Title: China's defective equipment
Post by: Crafty_Dog on April 03, 2020, 08:41:38 AM
Title: Re: Epidemics:Mask debate
Post by: DougMacG on April 03, 2020, 09:25:17 AM
IYI bureaucrats opposed to masks used (bogus) arguments abt the protection of the wearer ("not perfect", etc.)

They didn't think that since it ALSO prevents (more effectively) ASYMPTOMATIC sick pple from spreading it, there wd be yuuge systemic effect.

    - n.n. taleb 4/2/20

[IYI: intellectual yet ignorant.]
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: DougMacG on April 03, 2020, 10:11:01 AM
Attributed to Martin Luther regarding the plague:
"I shall avoid places and persons where my presence is not needed in order not to become contaminated and thus perchance inflict and pollute others and so cause their death as a result of my negligence.

If God should wish to take me, he will surely find me and I have done what he has expected of me and so I am not responsible for either my own death or the death of others.

If my neighbor needs me however I shall not avoid place or person but will go freely as stated above. See this is such a God-fearing faith because it is neither brash nor foolhardy and does not tempt God."
"Martin Luther, Luther’s Works, Vol. 43: Devotional Writings II, ed. Jaroslav Jan Pelikan, Hilton C. Oswald, and Helmut T. Lehmann, vol. 43 (Philadelphia: Fortress Press, 1999), 119–38."
Pandemic wisdom from other religions:
“Trust in Allah but tether your camel first — because Allah has no other hands than yours.”
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on April 03, 2020, 11:49:37 AM
during the great Black Death
a moniker first used in the 19 th century previously known as the great pestulence

the wealthy in England would escape to their chateaus castles etc.

their death rate ~ 25 %

everyone else~ 35 or up to 40 or more %.

they were half right
the plague was mostly spread from the bite of  flea infested rats

so did these flea infested rats travel from the cities into the rural areas ?  or was some of the deaths in the rural areas from cattle to human anthrax that happened around the same time?

unlike Martin Luther , the wealthy were not likely thinking of contaminating others when they fled to their estates in the countryside.

Title: Dr. Fauci on Jan 21
Post by: Crafty_Dog on April 03, 2020, 01:47:08 PM
Title: Cuomo cuts off his nose to spite NY's face
Post by: Crafty_Dog on April 03, 2020, 02:27:27 PM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: ccp on April 03, 2020, 02:30:55 PM
Cuomo cuts off his nose to spite NY's face

will never hear this in MSM

where are all those f'ng columbia profs coming and claiming he is killing people by refusing this offer from Remington?

Title: Pandemic Local Stats
Post by: DougMacG on April 03, 2020, 05:00:52 PM
Just talked with neighbor, a nurse at the major west suburban hospital here in the Twin Cities.  They have 17 COVID cases out of 361 beds.  Week 4 of exponential growth.

Therefore the liquor stores are open but the golf courses are all locked up.  Essential / non-essential.  Target is open but a friend's gift shop is state ordered shut.  Housing open, rent optional.  Eviction courts closed.
Title: If Talib and Omar get their way
Post by: ccp on April 03, 2020, 05:29:08 PM
Therefore the liquor stores are open but the golf courses are all locked up.  Essential / non-essential

soon prisons emptied
of criminals
and those who don't cover faces with scarf or hijab or walk their dog
fill up the prisons again

Title: CDC expert: How could we have been so wrong?
Post by: Crafty_Dog on April 03, 2020, 08:12:42 PM
A Pandemic Expert Tells Us Why She Was So Wrong About Coronavirus
'I just assumed that the US system would be a little bit better...and I just couldn't have been more wrong.'
By Matthew Gault
31 March 2020, 1:39pmShareTweetSnap


In the early days of the coronavirus pandemic, many public health experts were sure that the virus could be beaten before it had a disastrous impact: as long as testing was robust, and the systems in place functioned properly, America would pull through relatively unscathed.

They may have been right, but we’ll never know, because testing has not been robust, and the systems in place have all failed miserably.

One expert I spoke with in late February was Theresa MacPhail, a medical anthropologist, Assistant Professor at Stevens Institute of Technology, and author of the book The Viral Network: A Pathology of the H1N1 Influenza Pandemic. MacPhail worked with the CDC in 2009 as a volunteer intern as part of its Global Disease & Detection unit, taking part in global conference calls on the H1N1 pandemic and seeing how the organization is structured. She was in Hong Kong during its H1N1 outbreak.

In late February, she spoke optimistically with me about America’s ability to handle the coming Covid-19 outbreak. In early March, she got sick with what she believes to be Covid-19. She reached out to me recently, insisting to go on the record again to say that she was wrong, and that she put too much faith in the CDC and America’s ability to manage the crisis.

How are you feeling?
I feel guilty. I feel like I should have known better.

What was it about our previous conversation that made you feel guilty?
I made a lot of assumptions and didn’t think twice about having made them. I know I’m not alone, I’m just one of the only people that is saying publicly, "Well, I got this completely wrong."

I think it was overconfidence. I feel like what we're seeing is a bit of hubris. We're basically suffering, partially, because there was no plan for when the [Center for Disease Control] fucked up, because they don't fuck up, or they haven't in the past. They don't have a protocol for when they can't do an assay. And that's exactly what happened. Their assays didn't work. And there was no plan for that.

What do you mean by an assay?
I just assumed that the US system would be a little bit better, would be a little bit more robust and do more testing and containment than China was able to do, and I just couldn't have been more wrong.

When we talked, I was still so confident that this response was gonna look like the 2009 [H1N1] pandemic response, which was a good response. Initially, it had some problems… but once they realized what was going on, they kicked into gear and everything went pretty well.

One thing that's super different is that the CDC in 2009 provided central leadership. They were proactively reaching out to state, regional, and local Health officials saying, ‘Here's what you need to be doing. Here's what this should look like.’ And people did it.

I am scared and enraged because there's no central authority here. I don't understand what's going on. The CDC isn't giving press briefings. They're just absent. And that could be because the administration is muzzling them. Or it could mean that there's disarray inside the CDC. And I guess all of that will come out.

But I feel guilty because I knew them. So it's a bit like not wanting to think your Uncle Bob did something wrong or was capable of doing something wrong. That's why I feel bad, because I just assumed that this response would look like the old response. And it doesn't at all, and I just feel so awful.

I wasn't one of those people sounding the warning alarm. I really felt like we had a shot at containing [it]. But that meant that we had to have tests. I didn’t realize what 10 years of underfunding public health had done.

You got sick after we spoke last, right?
I was never tested, but if I had to lay bets I would say I have it. I’m still sick now. I’m on day 25. I got sick on March 1. It was the classic sore throat, feeling a little bit disgusting, and then at day five or six my fever started to spike. It got as high as 102.5 and never went below 100, despite taking massive amounts of fever reducer.

I started having tightness in my chest. I had a dry cough. I went to the ER on March 9. They put me in a separate room. Before all this went down, I had been contacted to go to Washington to the House of Representatives and give a public statement before Congress about what we’ve learned in pandemics past. Of course, that all got shot out of the water.

I asked the ER doctor, “Can you tell me in your professional opinion, are you prepared for this?” He said, "Absolutely not." He had been doing this for 12 years. He was there for the 2009 pandemic. He said in 2009 they were overprepared. They had extra flu kits, they had extra supplies, they were ready. They had been prepared by the Department of Health. The communication had been clear. He said, "I hate to tell you this but we’re underprepared now. We don’t have extra supplies. We don’t have any tests." That’s when I started to think, "This is serious."

The only way we get out of this, the only way we return to a semblance of normal, is massive testing. And I’m starting to get worried because when are we doing that? It’s mind boggling.

You’ve mentioned a few times that past responses were better. What do you mean?
After SARS [in 2003], everyone got real serious for a minute. And there was a lot of funding going into public health surveillance and response because the world got a little preview of what could happen, what was possible. And I feel like maybe that's also why 2009 went better. It was only six years after SARS, people had been drilling, and they had been planning, and they had been prepping. And they had a little bit more money because of SARS.

Why do you think this happened and how do we make sure it doesn’t happen again?
We’ve been too successful. It’s the same story with vaccinations. As a culture, we have no institutional or cultural memory anymore of what it’s like to live with microbes. This is a crash course. It’s a wake up call. My hope is, the only thing that keeps me going, is maybe we’ll learn a lesson from this.

Fund public health. Maybe we’ll change our culture so that it’s not expected or brave of you to go to work sick. Maybe we’ll start to protect each other the way Asian cultures do. It’s pretty normal in Asian societies to wear a mask when you’re sick when you go out in public and to stay home if you can. We are the exact opposite. We wear masks to protect ourselves and we feel free to show up at a meeting when we have a fever.

The CDC has to be cut free of political influence. I can’t believe the agency is a federally-appointed administration. Everytime the administration changes, the leadership of CDC changes and that’s insane. We need to find a way to give places like the CDC and [National Institute of Health] autonomy with oversight.

How are you processing your guilt?
I have made a resolution that going forward, I will not make the same mistake twice. I will not be so certain about what I know in the future. And I will do more due diligence on trying to figure out what the current situation is. And as a second thing that I'm doing with my guilt is I'm being extremely honest with my students and with my colleagues.

This article originally appeared on VICE US.

Title: Fact Check: Obama DID delete N95 masks and not replace them
Post by: Crafty_Dog on April 03, 2020, 08:23:00 PM
Title: Re: CDC expert: How could we have been so wrong?
Post by: G M on April 03, 2020, 09:44:03 PM

A Pandemic Expert Tells Us Why She Was So Wrong About Coronavirus
'I just assumed that the US system would be a little bit better...and I just couldn't have been more wrong.'
By Matthew Gault
31 March 2020, 1:39pmShareTweetSnap


In the early days of the coronavirus pandemic, many public health experts were sure that the virus could be beaten before it had a disastrous impact: as long as testing was robust, and the systems in place functioned properly, America would pull through relatively unscathed.

They may have been right, but we’ll never know, because testing has not been robust, and the systems in place have all failed miserably.

One expert I spoke with in late February was Theresa MacPhail, a medical anthropologist, Assistant Professor at Stevens Institute of Technology, and author of the book The Viral Network: A Pathology of the H1N1 Influenza Pandemic. MacPhail worked with the CDC in 2009 as a volunteer intern as part of its Global Disease & Detection unit, taking part in global conference calls on the H1N1 pandemic and seeing how the organization is structured. She was in Hong Kong during its H1N1 outbreak.

In late February, she spoke optimistically with me about America’s ability to handle the coming Covid-19 outbreak. In early March, she got sick with what she believes to be Covid-19. She reached out to me recently, insisting to go on the record again to say that she was wrong, and that she put too much faith in the CDC and America’s ability to manage the crisis.

How are you feeling?
I feel guilty. I feel like I should have known better.

What was it about our previous conversation that made you feel guilty?
I made a lot of assumptions and didn’t think twice about having made them. I know I’m not alone, I’m just one of the only people that is saying publicly, "Well, I got this completely wrong."

I think it was overconfidence. I feel like what we're seeing is a bit of hubris. We're basically suffering, partially, because there was no plan for when the [Center for Disease Control] fucked up, because they don't fuck up, or they haven't in the past. They don't have a protocol for when they can't do an assay. And that's exactly what happened. Their assays didn't work. And there was no plan for that.

What do you mean by an assay?
I just assumed that the US system would be a little bit better, would be a little bit more robust and do more testing and containment than China was able to do, and I just couldn't have been more wrong.

When we talked, I was still so confident that this response was gonna look like the 2009 [H1N1] pandemic response, which was a good response. Initially, it had some problems… but once they realized what was going on, they kicked into gear and everything went pretty well.

One thing that's super different is that the CDC in 2009 provided central leadership. They were proactively reaching out to state, regional, and local Health officials saying, ‘Here's what you need to be doing. Here's what this should look like.’ And people did it.

I am scared and enraged because there's no central authority here. I don't understand what's going on. The CDC isn't giving press briefings. They're just absent. And that could be because the administration is muzzling them. Or it could mean that there's disarray inside the CDC. And I guess all of that will come out.

But I feel guilty because I knew them. So it's a bit like not wanting to think your Uncle Bob did something wrong or was capable of doing something wrong. That's why I feel bad, because I just assumed that this response would look like the old response. And it doesn't at all, and I just feel so awful.

I wasn't one of those people sounding the warning alarm. I really felt like we had a shot at containing [it]. But that meant that we had to have tests. I didn’t realize what 10 years of underfunding public health had done.

You got sick after we spoke last, right?
I was never tested, but if I had to lay bets I would say I have it. I’m still sick now. I’m on day 25. I got sick on March 1. It was the classic sore throat, feeling a little bit disgusting, and then at day five or six my fever started to spike. It got as high as 102.5 and never went below 100, despite taking massive amounts of fever reducer.

I started having tightness in my chest. I had a dry cough. I went to the ER on March 9. They put me in a separate room. Before all this went down, I had been contacted to go to Washington to the House of Representatives and give a public statement before Congress about what we’ve learned in pandemics past. Of course, that all got shot out of the water.

I asked the ER doctor, “Can you tell me in your professional opinion, are you prepared for this?” He said, "Absolutely not." He had been doing this for 12 years. He was there for the 2009 pandemic. He said in 2009 they were overprepared. They had extra flu kits, they had extra supplies, they were ready. They had been prepared by the Department of Health. The communication had been clear. He said, "I hate to tell you this but we’re underprepared now. We don’t have extra supplies. We don’t have any tests." That’s when I started to think, "This is serious."

The only way we get out of this, the only way we return to a semblance of normal, is massive testing. And I’m starting to get worried because when are we doing that? It’s mind boggling.

You’ve mentioned a few times that past responses were better. What do you mean?
After SARS [in 2003], everyone got real serious for a minute. And there was a lot of funding going into public health surveillance and response because the world got a little preview of what could happen, what was possible. And I feel like maybe that's also why 2009 went better. It was only six years after SARS, people had been drilling, and they had been planning, and they had been prepping. And they had a little bit more money because of SARS.

Why do you think this happened and how do we make sure it doesn’t happen again?
We’ve been too successful. It’s the same story with vaccinations. As a culture, we have no institutional or cultural memory anymore of what it’s like to live with microbes. This is a crash course. It’s a wake up call. My hope is, the only thing that keeps me going, is maybe we’ll learn a lesson from this.

Fund public health. Maybe we’ll change our culture so that it’s not expected or brave of you to go to work sick. Maybe we’ll start to protect each other the way Asian cultures do. It’s pretty normal in Asian societies to wear a mask when you’re sick when you go out in public and to stay home if you can. We are the exact opposite. We wear masks to protect ourselves and we feel free to show up at a meeting when we have a fever.

The CDC has to be cut free of political influence. I can’t believe the agency is a federally-appointed administration. Everytime the administration changes, the leadership of CDC changes and that’s insane. We need to find a way to give places like the CDC and [National Institute of Health] autonomy with oversight.

How are you processing your guilt?
I have made a resolution that going forward, I will not make the same mistake twice. I will not be so certain about what I know in the future. And I will do more due diligence on trying to figure out what the current situation is. And as a second thing that I'm doing with my guilt is I'm being extremely honest with my students and with my colleagues.

This article originally appeared on VICE US.

Title: AG Barr releasing criminals?!?
Post by: Crafty_Dog on April 03, 2020, 10:33:51 PM
Title: Re: Epidemics: Bird Flu, TB, AIDs, Superbugs, Ebola, etc
Post by: Crafty_Dog on April 04, 2020, 10:23:58 AM

Could someone get and paste here the article today on Inside the Corona Virus Testing Failure?

Thank you.
Title: Inside the coronavirus testing failure
Post by: DougMacG on April 04, 2020, 11:13:44 AM
Link added:
Inside the coronavirus testing failure: Alarm and dismay among the scientists who sought to help
A technician transfers a sample to a tube for coronavirus testing at a lab in Seattle on March 27. (Jovelle Tamayo for The Washington Post)
By Shawn Boburg, Robert O'Harrow Jr., Neena Satija and Amy Goldstein
April 3, 2020

On a Jan. 15 conference call, a leading scientist at the federal Centers for Disease Control and Prevention assured local and state public health officials from across the nation that there would soon be a test to detect a mysterious virus spreading from China. Stephen Lindstrom told them the threat was remote and they may not need the test his team was developing “unless the scope gets much larger than we anticipate,” according to an email summarizing the call.

“We’re in good hands,” a public health official who participated in the call wrote in the email to colleagues.

Three weeks later, early on Feb. 8, one of the first CDC test kits arrived in a Federal Express package at a public health laboratory on the east side of Manhattan. By then, the virus had reached the United States, and the kits represented the government’s best hope for containing it while that was still possible.

For hours, lab technicians struggled to verify that the test worked. Each time, it fell short, producing untrustworthy results.

That night, they called their lab director, Jennifer Rakeman, an assistant commissioner in the New York City health department, to tell her it had failed. “Oh, s---,” she replied. “What are we going to do now?”

In the 21 days that followed, as Trump administration officials continued to rely on the flawed CDC test, many lab scientists eager to aid the faltering effort grew increasingly alarmed and exasperated by the federal government’s actions, according to previously unreported email messages and other documents reviewed by The Washington Post, as well as exclusive interviews with scientists and officials involved.

In their private communications, scientists at academic, hospital and public health labs — one layer removed from federal agency operations — expressed dismay at the failure to move more quickly and frustration at bureaucratic demands that delayed their attempts to develop alternatives to the CDC test.

“We have the skills and resources as a community but we are collectively paralyzed by a bloated bureaucratic/administrative process,” Marc Couturier, medical director at academic laboratory ARUP in Utah, wrote to other microbiologists on Feb. 27 after weeks of mounting frustration.

The administration embraced a new approach behind closed doors that very day, concluding that “a much broader” effort to testing was needed, according to an internal government memo spelling out the plan. Two days later, the administration announced a relaxation of the regulations that scientists said had hindered private laboratories from deploying their own tests.

By then, the virus had spread across the country. In less than a month, it would upend daily life, shuttering the world’s largest economy and killing thousands of Americans.

In a statement to The Post, the CDC said an investigation of the initial problems is ongoing. The test is now in use in every state and is “accurate and reliable,” the agency said.

Stephen Hahn, the commissioner of the Food and Drug Administration, which regulates testing, told The Post the agency is continuously adapting to an “unprecedented global public health crisis."

“Right now, our efforts are focused on doing everything we can do to fight COVID-19, but we know there will certainly be a time to learn larger lessons from the agency’s response,” he said in a statement, referring to the disease caused by the novel coronavirus.

In an interview Thursday, Brett P. Giroir, a Public Health Service admiral who on March 12 was named the top administration official on the testing effort, acknowledged the government should have moved more decisively to detect and contain the virus.

“There was a clear need for a more aggressive posture,” said Giroir, an assistant secretary at the Department of Health and Human Services, adding that agency leaders named him to the new role because “unprecedented steps needed to take place.”

Asked who was responsible for the delays in the early stages of the crisis, he paused.

“A problem like this is bigger than any single agency,” he said. “Clearly, there needed to be a higher level of leadership and organization.”

The need for a test

The first reports about a strange, possibly unknown virus started leaking out of China in late December. Scientists and researchers in the United States and around the world began paying keen attention to the apparent epicenter of the spread, a sprawling industrial city in central China called Wuhan.

Among those keeping close track were virologists and other specialists at the CDC, the country’s flagship public health agency. Founded in 1946 to fight malaria in Southern states, the CDC is at the vanguard in the fight against infectious diseases throughout the nation. It employs some 22,000 epidemiologists, biologists, behavioral scientists and others. Recent successes include rapid responses to contain the Zika, MERS and Ebola viruses.

In early January, the CDC publicly treated the virus from Wuhan as a distant potential threat, issuing an advisory urging that the “usual precautions” be taken when traveling abroad.

The agency also began laying plans to protect the country. Led by Lindstrom, one team began considering the kinds of tests, technically called assays, that could identify the virus.

Lindstrom is a microbiologist with an impressive track record: He had helped develop a testing method critical to detecting the H1N1 virus in 2009. During a Jan. 7 conference call, he told public health officials that the CDC’s aim was to “plan for the worst, hope for the best,” according to an email exchange among scientists and others. Lindstrom, like several other officials named in this report, did not respond to requests for interviews.

On Jan. 10, CDC scientists received an important break when the Chinese government published the pathogen’s genetic sequence. The sequence, a long string of letters representing the RNA structure of SARS-CoV-2 described a coronavirus never before seen in humans. It also gave scientists a path to create a precise diagnostic test that could detect the virus.

CDC has long led the nation’s efforts to create diagnostic tests when a public health threat emerges. The agency usually distributes the tests to a network of state and county public health labs nationwide, using the results to track and contain new pathogens until large-scale commercial tests come on line.

But state and local public health labs juggle an immense array of responsibilities, including water and food safety, and government studies dating back two decades have found the public health labs often lack the money and resources to keep pace with the demands.

On the Jan. 15 call, Lindstrom told more than a dozen public health officials that the CDC planned to make its test available to all state and county public health labs. He assured them “there will not be pressure for everyone (at least from CDC) to implement unless the scope gets much larger than we anticipate right now,” according to the email summary written by Kelly Wroblewski, director of infectious disease programs at the Association of Public Health Laboratories.

CDC scientists were not the only ones interested in creating a test. Commercial laboratories began to mobilize, and scientists at major hospitals and universities sprang into action to develop tests of their own.

One of them was Alex Greninger, 38, an assistant director of the University of Washington’s clinical virology lab. For Greninger, the chance to create a diagnostic test for a novel coronavirus was a rare opportunity.

Researchers at the University of Nebraska, Stanford University and elsewhere also began taking their first steps toward inventing tests for the virus to use in their own labs. These academic labs didn’t have the capacity to process the millions of tests that would be needed in the event of a pandemic, a scale that is achievable only by commercial labs, but their limited testing capabilities might have helped efforts to detect and slow the virus in its early stages.

On Jan. 16, the day Greninger started buying supplies for his test, a 35-year-old man who had recently visited Wuhan became ill with flu-like symptoms after returning to the Seattle area, according to a CDC incident report. The man went to his doctor, who swabbed his nose and sent the sample to the CDC, according to the report.

Four days later, using its newly developed test, the CDC confirmed that the man was the first person in the United States known to be infected with the novel coronavirus.

In a CNBC interview two days after that, President Trump downplayed the threat to Americans.

“We have it totally under control,” he said.

Early December
Dec. 31
Jan. 7
Jan. 8
Jan. 10
Jan. 15
Jan. 16
Jan. 17
Jan. 20
Early December

The first presumed case of the novel coronavirus, which causes the disease covid-19, appears in Wuhan, China.
Dec. 31

China informs the World Health Organization about a strange pneumonia-like illness.
Jan. 7

The Centers for Disease Control and Prevention begins planning for tests. In an email, Stephanie Chester from the Association of Public Health Laboratories tells her colleagues that the CDC’s chief microbiologist said the agency’s aim is to "plan for the worst, hope for the best."

Right now the pathogen is still unidentified, but if it is identified and is truly novel, they will be putting together an EUA assay. He said they are in a "plan for the worst, hope for the best" mode. A lot of their response efforts are contingent on being able to actually get data and info out of China. The main concern for the US PHLs is general travel and people returning from the Chinese New Year in the coming weeks. Will let you know if I hear more.
Jan. 8

The CDC issues an official health advisory recommending travelers to take the usual precautions.

Read the full document
Jan. 10

China publishes the pathogen’s genetic sequence.
Jan. 15

The first known person in the United States to be infected with the virus arrives in Seattle from China. On the same day, CDC scientists say the agency will make its tests available to all state and county public health labs.
Jan. 16

Alex Greninger, a scientist at the University of Washington who was creating a coronavirus test, orders the necessary chemical reagents. He is one of several scientists across the country rushing to design their own test.
Jan. 17

Nancy Messonnier, a CDC official, says that "for a family sitting around the dinner table tonight, this is not something that they generally need to worry about."

Since the outbreaks of MERS and SARS, we have made improved in our capacity in the United States and around the world. We’re now better poised to respond to this new threat quickly and collaboratively. Based on the information that CDC has today, we believe the current risk from this virus to the general public is low. For a family sitting around the dinner table tonight this is not something that they generally need to worry about.
Jan. 20

After developing a test over the weekend, the CDC in an internal incident report confirms the first positive case of the coronavirus in the United States.

Read the full document
A significant moment

Designing the test took CDC scientists seven days — a stunningly short period of time for a health-care system built around the principles of medical quality and patient safety, not speed.

The CDC could use the test in its Atlanta labs but could not send it out to public health labs until it won approval from the FDA. On Jan. 28, Lindstrom and others at the CDC assured public health scientists in a conference call that “CDC’s goal is to get (FDA approval) as quickly as possible and expects the assay will be ready to deploy within two weeks, possibly sooner,” according to an Association of Public Health Laboratories’ summary of the call.

Although the CDC test was a priority, the FDA was also fielding inquiries from other test developers. At the end of January, about 20 companies and scientific groups were talking with the FDA about their plans to develop tests, according to two government officials familiar with those inquiries who like many others interviewed for this story spoke on the condition of anonymity to discuss sensitive matters.

At the same time, pressure on the Trump administration to take action was growing. The number of people who had died of the infection worldwide spiked to 200 by Jan. 30, when the World Health Organization declared the virus a public health emergency of international concern.

The next day, Health and Human Services Secretary Alex Azar announced a health emergency in the United States. At the time, Azar was the leader of the White House’s newly created coronavirus task force.
Secretary of Health and Human Services Alex Azar speaks during a January briefing with members of President Trump's coronavirus task force. (Jabin Botsford/The Washington Post)

The declaration was one of the most significant moments in the unfolding crisis. Such declarations provide the FDA flexibility to speed up approvals for critical medical products, including commercial diagnostic tests. But they also trigger strict limits on scientists in government-certified clinical labs at universities, research centers and hospitals.

Those labs are typically permitted by the FDA to make and use their own tests without government approval, including to make decisions about patient care, as long as they use them only in their own facilities and do not sell them.

But once Azar announced a public health emergency, tests created in such laboratories had to receive an “emergency use authorization,” or EUA, from the FDA. The additional regulation is intended to ensure the efficacy of tests in public health crises in which inaccurate results could be damaging.

The new regulatory hurdle stalled efforts like the one underway by Greninger at the University of Washington. Greninger and other scientists were located in some of the nation’s early coronavirus hot spots, where successful tests might have helped reveal the scope of the outbreak. Suddenly, their hands were tied.

Clinical scientists fumed about the new obstacle, according to exchanges in private online chat groups among academics and scientists.

“The EUA process is flawed, broken, and inefficient,” Couturier, the medical director and diagnostic specialist at ARUP Laboratories in Utah, wrote later on ClinMicroNet, a private message system for microbiology lab directors across the world.
Alex Greninger, an assistant director of the University of Washington’s clinical virology lab, said his efforts to develop a test for coronavirus were stalled by an FDA regulation. (Jovelle Tamayo for The Washington Post)

In a statement this week, the FDA said its regulations “had not hindered or been a roadblock” to the rollout of tests.

“Every action the FDA has taken during this public health emergency to address the COVID-19 pandemic has balanced the urgent need to make diagnostic tests available with providing a level of oversight that ensures accurate tests are being deployed,” the agency said.

But in his interview, Giroir offered a different analysis.

“If someone says they were a barrier, to me, you have to believe them,” he told The Post. “If they thought it was a barrier, it becomes a barrier.”

One person familiar with the emergency declaration told The Post that FDA career staff did not raise concerns about the EUA’s burdens on clinical labs to Azar or to FDA leaders. Azar oversees the FDA.

Hahn had been confirmed by the Senate as FDA commissioner on Dec. 12 — just seven weeks before Azar’s declaration. Before that, Hahn was a radiation oncologist and chief medical executive at the MD Anderson Cancer Center in Houston.

Hahn’s agency approved the CDC test on Feb. 4, making it the country’s only accepted test for the novel coronavirus. Public health officials in New York City, Nebraska, Colorado, Minnesota, New York State and elsewhere began receiving them four days later.

The test kits contain compact collections of chemicals known as reagents. The chemicals help isolate viral genetic material and then amplify it so that it can be detected by probes that also came with the kit.

Scientists in the local labs quickly recognized something was wrong. The assays often produced results that suggested the virus was present in samples in which scientists knew it was not.

On Feb. 8, when lab technicians for New York City’s health department ran the test on samples that contained the virus, they saw on their computer screens a logarithmic curve sloping upward, indicating the virus was present. The problem was, they saw something similar when they ran the test on distilled water that contained no trace of the virus.

When they finally gave up that evening, the technicians called their director, Rakeman. Shortly before midnight, she relayed the bad news in an email to local health authorities. “The issue will need to be investigated and could result in significant impact to testing availability at the CDC and across the country until the issue is resolved,” she wrote.

New York State lab officials also passed on the news, according to documents and interviews. “There is a technical problem in one of the reagents which invalidates the assay and will not allow us to perform the assay,” the lab director of New York State’s Wadsworth Center, Jill Taylor, wrote to state health officials in an email that same night.

“I am sorry to not have better news,” she wrote. “It is a bummer.”

Word that some labs were having problems with the test quickly made its way back to the CDC.

“Is this something to worry about?” Daniel Jernigan, a leader of the CDC’s coronavirus response, wrote to the Association of Public Health Laboratories the next morning as he prepared to board a plane.

It was, he was told.

Later that day, Scott Becker, chief executive of the association, raised concerns to another CDC official. “The states and their governors are going to come unglued,” he wrote, adding later, “If CDC doesn’t get ahead of this it will be a disaster.”

As they struggled to make the test kit work, many of the public health labs realized they might succeed by eliminating one of its three main chemical components. But under the FDA’s emergency rules, they could use the test only as it was approved. The flaw meant they could not use it at all.

“The silence from CDC … is deafening,” Joanne Bartkus, the Minnesota health department’s lab director, wrote to Becker on Feb. 10. “What is going on? We are getting questions from our governor’s office and other labs are getting media requests asking when we will be starting.”

By Feb. 12, a total of 2,009 tests had been conducted in the United States, according to CDC data.

“We’re screwed from a testing standpoint if this thing takes off in the US,” Susan Butler-Wu, director of medical microbiology at the Los Angeles County and University of Southern California Medical Center, warned in a Feb. 13 email to fellow scientists.
Scott Becker, chief executive of the Association for Public Health Laboratories, raised concerns to the CDC about issues with its test. (Bill O'Leary/The Washington Post)
Falling behind

The United States was clearly falling behind in the fight against covid-19. Other countries such as Singapore and Taiwan were ramping up testing quickly. In South Korea, 1,000 people were being tested each day by mid-February, a number that would increase more than tenfold by the end of the month.

The Geneva-based World Health Organization, meanwhile, had already delivered 250,000 diagnostic tests designed and manufactured by a German lab to 70 laboratories around the world.

Academic and hospital researchers including Greninger eagerly experimented with the German lab design early on and found it workable, but U.S. health officials continued on their own path.

“To our knowledge, no discussions occurred between WHO and CDC (or other USG agencies) about WHO providing COVID-19 tests to the U.S.,” WHO spokesman Tarik Jasarevic told The Post.

Hahn defended the U.S. government’s approach at a news conference weeks later.

“In the U.S., we have policies in place that strike the right balance during public health emergencies of ensuring critical independent review by the scientific and public health experts and timely test availability,” he said in a White House press briefing. “What’s important here is that we have a test that the American people can trust.”

The FDA’s confidence in the flawed test was based in part on assurances from the CDC that it could be fixed easily, according to officials familiar with the agency’s deliberations.

In its statement to The Post, the CDC said it collaborated closely with the FDA and “encouraged our government partners to work with the private sector to develop diagnostic tests for commercial use and to remove restrictions for … labs in hospitals and universities across the county.”

On Feb. 16, officials from the FDA and CDC met to discuss solutions, including the possibility of eliminating the component of the test that was causing problems, officials said. FDA officials said that would be a fast solution that could quickly get the public health labs up and running. But in the following days, the FDA learned that some public labs were reporting continuing problems with the test, the officials said.

As officials struggled to understand the test flaws, leading clinical labs were spending much of their time and energy on the FDA’s paperwork and data demands to win approval for their tests.

The Mayo Clinic created its first-ever rapid response team. A third of the 15 members were devoted solely to the FDA’s data and paperwork demands. Like others on the team, they worked 15-hour days for three weeks.

“It’s unlike anything we’ve ever done before,” said Matt Binnicker, a director of clinical virology at Mayo.

He said they decided to persist because, in a worst-case scenario, the public health labs alone could not test on the scale that would be needed. “The public health infrastructure is really not set up to handle a pandemic,” he said.

At the University of Washington, Greninger and his fellow scientists were initially baffled by an FDA process they viewed as baroque. They had always worked under strict guidelines, aimed at protecting patients and guaranteeing quality. But the EUA was a bureaucratic puzzle they had never encountered.

“The most pernicious effect of the current regulatory environment is that it kneecaps our ability for preparedness should a true emergency emerge,” Greninger wrote to colleagues on Feb. 14.

Greninger channeled his energy into the paperwork problem, spending more than 100 hours filling out forms and collecting information needed for the application, he told The Post. But when he finally submitted the material, an FDA official told him the agency could not accept it — because he had emailed it.

“We received your email and attachments regarding the UW 2019-nCoV assay pre-EUA,” an FDA official wrote on Feb. 20. “However, we have not received the official submission through DCC.”

“What is the DCC?” Greninger wrote back.

“The Document Control Center,” came the reply.

“What is the Document Control Center?”

Greninger then learned about another requirement. Under FDA rules, he was supposed to digitally copy the electronic documents he had emailed to the FDA, burn the copies onto a disk and mail the hard disk to an office in suburban District of Columbia.

Greninger shared his exasperation in a Feb. 20 email to a colleague: “repeat after me, emergency.”

In a statement, an FDA official said information sent by Greninger on Feb. 19 was promptly reviewed, despite not having been submitted properly, and was found to be insufficient to demonstrate that the test would work. The official said that after that interaction, “we immediately addressed how we receive applications.”

“The FDA is improving ways we interact with developers of products to address the pandemic, including those we don’t normally interact with,” the official said.

By the time Greninger sent his email, the FDA was in discussions with dozens of test developers, a number that was growing quickly. But none had managed to complete a formal application to the FDA, according to officials familiar with the agency’s actions. FDA officials interpreted the paucity of applications as a sign of limited ability or interest, the officials said.

Some private labs struggled to obtain samples of the virus necessary to verify their tests and complete their applications, according to government officials and lab representatives. An FDA official said that, at the time, the agency supported efforts to help those labs secure the necessary samples.

Jan. 28
Jan. 30
Jan. 31
Feb. 4
Feb. 8
Feb. 13
Jan. 28

HHS Secretary Alex Azar praises the CDC for developing a coronavirus test in one week: "This was really a historic accomplishment."
Jan. 30

The World Health Organization declares a "public health emergency of international concern."

It is important to note that as the situation continues to evolve, so will the strategic goals and measures to prevent and reduce spread of the infection. The Committee agreed that the outbreak now meets the criteria for a Public Health Emergency of International Concern and proposed the following advice to be issued as Temporary Recommendations.
Jan. 31

Azar declares a public health emergency, triggering tight restrictions on FDA approvals for tests called emergency use authorizations, or EUAs. Though meant to expedite approval of medical products, the EUAs added delays to the development of coronavirus tests at clinical labs at hospitals and universities.

Following the World Health Organization’s decision to declare the 2019 novel coronavirus a Public Health Emergency of International Concern, I have declared today that the coronavirus presents a Public Health Emergency in the United States.
Feb. 4

The CDC receives an emergency use authorization from the FDA to distribute its test to public health labs around the country. The CDC also announces it will start shipping test kits to around 100 public health labs. It is the only test kit available.
Feb. 8

CDC test begins arriving at labs in New York, Nebraska, Colorado, Minnesota and elsewhere. By the end of the day, public health lab directors tell the CDC it doesn’t work properly. Through the weekend, the lab directors share notes of the test not working and start to realize, "this could be really bad."

The silence from CDC on the nCoVtest kit failures is deafening. What is going on? We are getting questions from our governor’s office and other labs are getting media requests asking when we will start testing. We need to be able to respond.
Feb. 13

Susan Butler-Wu, director of medical microbiology at the Los Angeles County and University of Southern California Medical Center, warns in an email to fellow scientists: "We’re screwed from a testing standpoint if this thing takes off in the US."
Anxiety intensifies

On Feb. 22, an FDA official named Timothy Stenzel flew to Atlanta. The director of a diagnostic office at the FDA, Stenzel was a key figure in the decisions about testing. The purpose of his visit was not clear to CDC officials, but he said he wanted to understand the testing development and help find a way to fix the troubled assay, according to three people familiar with the visit.

Stenzel spent much of the following week attending CDC meetings, touring the facilities and offering suggestions about how to cobble together viable tests from existing materials, the officials said.

At the same time, CDC officials, including Jernigan from the agency’s influenza division, urged Stenzel to convince the FDA to approve other tests under development in private laboratories.

Anxiety about the lack of widespread testing, meanwhile, was cresting among scientists and public health officials nationwide. Many felt the country could wait no longer.

On Feb. 24, the Association of Public Health Laboratories formally asked Hahn to loosen the FDA’s rules.

“We are now many weeks into the response with still no diagnostic or surveillance test available outside of the CDC for the vast majority of our member laboratories,” the association’s letter said. “While we understand that the EUA process is open to [public health labs], we believe a more expeditious route is needed at this time.”

Two days later, the FDA allowed public health labs to begin using the CDC test, with the troubled component eliminated.

On Feb. 27, Anthony S. Fauci, the government’s top infectious disease expert, added to the pressure to expand testing further. He spoke in person with Brian Harrison, Azar’s chief of staff, and underscored the urgent need to accelerate the approval of new tests, according to two people familiar with the call. At noon that day, Harrison convened a teleconference of officials from the FDA, CDC and other agencies.

In strong language, Harrison told the group to come up with a new test approval plan before they left the meeting. The participants scrambled to swap ideas. At the FDA and CDC, Stenzel, Jernigan and others worked on a memo into the evening that outlined a new strategy.

The memo, “A Plan to Increase Covid-19 testing in the U.S.,” frankly acknowledged that the original approach had not worked. The spread of the virus was “leading to significant impact on healthcare systems and causing social disruption,” it said.

“CDC has worked with FDA to assure that testing is available at Public Health Laboratories to support public health investigations and control efforts; however, a much broader interagency approach is needed to fill the greater need for diagnostics by commercial manufacturers and laboratories capable of developing their own tests.”

It recommended giving clinical laboratories, such as the University of Washington, leeway to create and begin using their own tests while seeking FDA approval. The memo was forwarded to top government officials, including Azar, who supported loosening the regulations.

The next day, Greninger and scores of other clinical scientists appealed to Congress in a letter of their own. They complained that “significantly more stringent” FDA rules had nearly frozen the country’s fight against the virus.

“Notably, no test manufacturer or clinical laboratory has successfully navigated the EUA process for SARS-CoV-2 to date,” the Feb. 28 letter said. “Therefore, the CDC test remains the only test available with EUA status, and it has not been made available to hospital laboratories.”
A laboratory test kit for coronavirus that was developed by the Centers for Disease Control and Prevention. (CDC/AP)
FDA’s turnaround

On Feb. 29, the FDA finally reversed course, opening the way for clinical labs outside the government to begin testing for coronavirus. Under a revised policy Hahn announced at a White House briefing, the labs would have to notify the FDA when testing began, but they would not have to submit paperwork for 15 days.

“The FDA recognized the urgent need for even faster testing availability,” the agency said in a statement this week. “Although laboratories could use the EUA pathway, many were hesitant or didn’t know the pathway was available to them.”

Giroir told The Post that the FDA was right to reverse itself but could have done so sooner.

“In retrospect, it might have been useful earlier, right?” he said. “I mean, it was the right decision to make.”

On March 2, Greninger and his colleagues at the University of Washington went live, testing 30 patients in a single day. Two days later, they tested 202 people. That number soon soared to over 2,800 per day, roughly the equivalent of a quarter of tests done by all state and federal public health labs on the same day.

About two weeks after the FDA loosened its grip on testing, two major manufacturing giants, Roche and Thermo Fisher Scientific, won approval. By then the number of confirmed cases in the United States had grown to more than 2,000.

On March 12, Fauci, who runs the National Institute of Allergy and Infectious Diseases, told lawmakers the problem was not simply the failure of the CDC test. The coronavirus testing debacle had exposed deep structural problems in the nation’s public health system, he said.

“Yeah, it is a failing, let’s admit it,” he said. “The idea of anybody getting it easily the way people in other countries are doing it, we’re not set up for that. Do I think we should be? Yes, but we’re not.”

Feb. 14
Feb. 18
Feb. 24
Feb. 26
Feb. 27
Feb. 28
Feb. 29
Mar. 11
Mar. 12
Feb. 14

As of this date, more than three dozen public health labs are having problems with the CDC test. Greninger writes a message to his colleagues about the bureaucratic difficulties for clinical labs at universities trying to make their own tests.

The most pernicious effect of the current regulatory environment is that it kneecaps our ability for preparedness should a true emergency emerge, as Susan notes. Why bother getting ready as a clinical lab if you think that you won’t ever be allowed to do anything until May or June (per the time frame on the prior Zika virus EUAs).
Feb. 18

The CDC warns clinical laboratories around the country against testing on their own without FDA approval. Meanwhile, it has still not provided public health labs with instructions on how to modify its test to make it work properly.
Feb. 24

A coalition of public health labs asks the FDA for permission to make their own tests: "We are now many weeks into the response with still no diagnostic or surveillance test available outside of CDC for the vast majority of our member laboratories."

We are now many weeks into the response with still no diagnostic or surveillance test available outside of CDC for the vast majority of our member laboratories. While we understand that the EUA process is open to PHLs, we believe a more expeditious route is needed at this time.

Read the full document
Feb. 26

The FDA commissioner sends a letter to the coalition of public health labs that had asked for permission to make tests: "False diagnostic test results can lead to significant adverse public health consequences -- not only serious implications for individual patient care but also serious implications for the analyses of disease progression and for public health decision-making.

Read the full document
Feb. 26

The CDC announces to public health labs that a workaround for the test has been approved.
Feb. 27

CDC Director Robert R. Redfield testifies to the House Foreign Affairs subcommittee on Asia, the Pacific and nonproliferation that the "CDC believes that the immediate risk of this new virus to the American public is low." Privately, the CDC concluded that a "much broader" effort to testing is needed.  An internal memo titled, "A Plan to Increase Covid-19 testing in the U.S.," frankly acknowledged the approach was not working. The spread of the virus was "leading to significant impact on healthcare systems and causing social disruption," it said. "A much broader interagency approach is needed to fill the greater need for diagnostics by commercial manufacturers and laboratories capable of developing their own tests."

Read the full document
Feb. 28

Dozens of clinical laboratory scientists from across the nation write to Congress asking for more leeway to create new tests, saying "this regulatory process is significantly more stringent than that required for every other virus we test for."
Feb. 29

The FDA reverses course and announces it will permit clinical labs to develop tests with less stringent review. By this date, the CDC and public health labs have tested 3,999 people nationwide.
March 11

WHO declares the coronavirus outbreak a pandemic.
March 12

Anthony S. Fauci, the nation�