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Friday, July 22, 2005

 

are we ready?


the world health organization issued a warning today regarding h5n1 avian influenza following the confirmation of indonesia's first confirmed case and death as a result of the virus.

"This is perhaps the only time since 1968, which was the last pandemic, that we are getting signs, symptoms and warnings from nature ... More and more birds are dying in different parts of the world -- this is the kind of signals, and early warnings that we are referring to."
the virus infected and killed three of a five-member household; the other two show no signs of infection.

8-year-old became ill with fever, diarrhoea, then cough, on 24 June. She was brought to Siloam Gleneagles Hospital, Tangerang, on 28 June, where she died with respiratory distress 20 days after onset. The 1-year-old became ill on 29 June with fever, diarrhoea, then cough, finally respiratory distress, and died 10 days after onset. The father became ill on 2 July with fever, mild cold, then cough and was taken to the same hospital on 7 July where he died 10 days after onset.
nature magazine ran a synopsis of the state of affairs a few months back. it's extremely difficult to tell how virulent the eventual strain of human contagion will be, but h5n1 has shown in the bird population a contagiousness and lethality that sparks easy comparison to h1n1, which was responsible for the 1918-19 pandemic that consumed 40 million worldwide, offering an apocalyptic punctuation to the disaster of the first world war. this new strain has already crossed into the pig population of indonesia, a concerning sign as pigs can serve as incubators for hybridizing avian and human influenza strains into versions of avian flu that are infectious in humans. it is thought that h5n1 may be speading unchecked throughout the swine population of asia.

it may not come this year. but this is something to be considered in the moment. should an outbreak begin, the pharmaceuticals that could protect us are likely to run out quite quickly, leaving us exposed, rich and poor, old and young alike.

Indeed, the potential for social unrest is a major concern for those laying pandemic plans. And demand for Tamiflu could exacerbate the problem. Who will, and who will not, be treated with this scarce but valuable resource? "It's not easy — we know there won't be enough for everyone," says Theresa Tam of the Public Health Agency of Canada. Britain, which is among the best-prepared countries, has ordered enough for about 25% of its population; Canada has stocks for just over 5% of its people; the United States currently cannot even cover 1%.
neuraminidase-inhibitor antivirals like tamiflu are available with a prescription.

UPDATE: the economist noted two new studies examining antiviral drugs.


Did you read "the great influenza"?

 
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no, actually, mr observer -- was it very good?

 
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Was it good?

Um, not really. It wasnt bad, but kind of repetitive and the prose wasnt great. Adequate.

But, that said, it was informative regarding the 1918-19 pandemic outbreak and the subsequent breakdown of "modern" systems for handling the problem. Ie., hospitals filled, health care workers over-whelmed, major cities ghost towns (Philadelphia especially hard hit) as commerce stopped because fear of crowds (too late, unfortunately).

The 1918 pandemic was spread in large part by world-traveling soldiers returning/being sent to WWI. Obviously today's transportation networks would send this thing worldwide very very quickly.

It will happen, perhaps not this fall/winter, perhaps not next, but it will happen again.

In fact, just saw the news today that in southern China (I think) swine flu (Chinese officials claiming it is spread by a bacteria, even if that is the case many bacteria are the ultimate killers of viral influenza victims b/c of weakened immune systems) has killed 134 people, with WHO watching closely.

 
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