Showing posts with label H1N1. Show all posts
Showing posts with label H1N1. Show all posts

5/22/2009

Now, this flu:

I'm taking a break from the scheduled Interdome "era of good feelings" media channel to bring you a little update on H1N1: the dreaded gripe porcina.

But the reason I am doing so is to present some facts, so I will keep the commentary down to one paragraph, beginning now:

After the hysteria of the discovery of the flu, it was only natural to have the media hype give way to the hype about the media hype. And of course, now it's all a big joke, kind of proceeding like this.

CDC: knock, knock.
Public: Who's there?
CDC: flu pandemic.
Public: PANDEMIC?!?! FUCK!
CDC: flu pandemic.
Public: PANDEMIC!!! FUCK!!!
CDC: flu pandemic.
Public: oh, FLU pandemic? Fuck that.
CDC: flu pandemic.
Public: ....
CDC: flu pandemic?
CDC: flu pandemic???

Once everybody realized what they had been saying all along, that it was a pandemic of the flu, not of ebola or Mexican-Immigrant-Insta-Death, they stopped caring. But it doesn't change the fact that it is a flu pandemic. Still serious business. And yes, there are those statistics out there, that are oh-so-easy to retweet, small number of people get pig sick, everyone wears masks; lots of people get AIDS, nobody wears a condom. Here's another one: someone comes up with a witty twitter post, and everyone retweets it; someone tries to teach you about pandemics, and you still don't wear a condom.

So that little rant about meme pandemics aside, here are some actual statistics about the current pandemic.

We are not yet one month into the pandemic. This means we don't have a lot of data, but we have some. Here's what it shows.

Less than one month in, there have been nine deaths in the US, and 6,552 confirmed cases. This does not sound so bad, especially compared to a disease like AIDS. But this is less than a month in, and the rate appears to be accelerating.

The same thing is true for the world at large. Today, we stand at 86 deaths, and 11168 reportedly confirmed cases.

Here's a graph of what that looks like.


There's also a clicky map here.

This shows us that yes, it appears that we are really in Phase 5 of the WHO epidemic speedometer. No, not a panic, but a real pandemic.

The basic reproduction number, or R sub 0, is "is the mean number of secondary cases a typical single infected case will cause in a population with no immunity to the disease in the absence of interventions to control the infection." From analysis of the cases in Mexico, researchers guess the number for H1N1 to be 1.4 to 1.6. Genetic analysis guesses 1.2. This is higher than seasonal flu, but on the low end of other pandemics (1918, 1957, and 1968 was 1.4-2). It is early to be guessing this number, and Mexico is an interesting situation because of the discrepancies in reported cases of the disease in the early stages of March and April. Yet, some scientists seem to be comfortable enough to publish. So, this is not just the seasonal flu in terms of transmission potential.

Now: mortality. Preliminary findings put the case-to-death percentage at 0.3% to 1.4%, with the number most likely being 0.4%. In the US, the current percentage is 0.1%; in the world it is 0.7%.

Once the pademic reaches stage 6, the WHO implements the Pandemic Severity Index. Using the limited data we have now, if they were to declare today, the world would be in stage 3, one step up from Asian and Hong Kong flu, but not as high as stage 6, which was the severity of the 1918 Spanish Flu, with a case-fatality rate of over 2%.

Okay. Now the point (briefly).

No, we are not going to be dying in the streets. But this is still a real pandemic, and it seems that it will not stop. Barring any consequences like mutation to a very different virulence, or the new symptom of projectile bleeding eyeballs, there are still going to be a lot of sick people in the world over the next year or so. YES: SICK WITH THE FLU. ONLY THE FLU. But even .4% or all of those people dying is a lot of people dying.

Not to mention the incredible strain on the health care systems of the world to deal with 30% of the world getting sick. No, the actual fatality rate is not too impressive, especially compared to the amount of damage we humans are able to inflict on ourselves with war, and the like. But our infrastructure is going to be strained. Can you imagine health insurance companies dealing with 30% of their customers coming in for diagnostic tests over the course of a year? What about those without health insurance? What about those in countries without health systems?

As of now, most countries are even delaying or stopping their reports to the WHO. When so many people are getting sick, and the storm shows no signs of abating, what's the point? Indeed, what is the point to care about H1N1, when it's pace seems unchangeable? What's the news in that?

5/05/2009

A Long Cough Ending in Silence

Prepare yourself for the mostly timely, Internet-syndication-ready post you've ever read.

TWITTER-H1N1-SOCIALWEB-TECHOBAMAMERICA-2.0-POSTINGLY!!!!

You should have already linkbacked this post. You should have already favorited, commented, Delicious'ed, and StumbleUpon'ed this post.

It absolutely kills me that StumbleUponed is now a legitimate verb.

This is also going to be one of those long, winding posts of mine, wherein I grab you by the hand, and take you through a winding, decaying carcass of a strip mall set up as some post-apocalyptic museum in homage of a dead country-western band, recently sainted by the local zombie cult.

By this, I clearly mean a cavernous shell of hyperlinks, which you will no doubt avoid, because who knows how long they have been sitting out and eww, I mean government document PDFs? You actually want me to read that?

But do not fear; just like those other times past, I also have a destination. A point, in which you will finally exit into that harsh, glaring desert sun, wondering if the wind-stripped carcasses of animals long extinct are actually bleaching white in the sun, or if it is your previous notions and categories now lying in the dust, rib cages bare, exposed to the truth. That is, you would feel that extraordinary realization, if you hadn't bolted for the emergency exit a third of the way through, totally unbeknownst to me. Where do they keep going? Are they spontaneously combusting in the face of pure, restrained gnosis? Or are they cowering in some corner, reduced to an archaic animal state by the depth of that psychic well? (It's either Lawnmower Man or Altered States with me, all the time, isn't it?)

Either way--enough with the introductions. Pay attention, jerks. I've got about eight tabs open in my browser, and I swear to god, they ain't going to re-tweet themselves.


Well, we've already made a big stink about the fact that the media was about eighteen hours behind the H1N1 news. Major media victory for Wikipedia and Twitter, and no one is really surprised. The media it seems, has sort of grimly taken defeat, even ignoring this opportunity for a major Media x.x, Twitter-caught-not-wearing-panties story, instead moving on to other things. Kind of like the bully who finally stops picking on the little kid who all of a sudden has a lot of friends and doesn't even quite remember the bully's name anyway, because "This sucks, and I'm going to go light bugs on fire."

The Government, interestingly enough, has been on the Twitter side of winning, it seems. Maybe they are that skinny kid, finally figured out that a sense of humor really impresses everybody a lot more than stomping people and throwing their shoes on the roof. The CDC and other gov't organizations have refrained from big media appearances, sound bites, and Good Morning America tutorials on how to duct tape your family's orifices closed. They played the hand close to the chest, releasing a little bit of information, not confirming or denying a whole lot, and then mildly suggesting "to check our new, H1N1-ready web site for updates." This sort of thing kills the media. What good is attending a press conference if all the info is a RT away from everyone knowing it anyway? They can't even be the primary link anymore! Pandemicflu.gov doesn't sell any advertising! Fuck!

Everyone and their Internet-Marketer-Pyramid-Schemer is up to date on the dead media story. However, to some crazy asshole who is fascinated by government bureaucracy, there is something even more pungent about this story. A government person saying, "yeah, just check our websites for updates..." What?!?! Two years ago, this would be a punch in the face. A punch in the face, and then a kick in the groin, spit in the face, and the delivery of one of Sean Connery's lines from The Rock.

Three or so years ago I was working for a non-profit hosting a conference about disasters and global warming. We were researching people to invite as speakers, and needed to have some more people from the government come out. Getting referred to a website for contact information was the complete brush off. First of all, there wasn't any contact information: maybe just an assistant's email, a operator's phone number, or a comment form. Second, there wasn't even any real websites: instead, there were circuitous paths of links, taking you from within agency to inter-agency, to liason, to office of the under-secretary. Site map? Ha! The only thing more irritating was trying to navigate a school of higher education's website.

Case-in-point: I use this as my go-to example of Bush era bureaucracy. I was trying to find someone worth inviting from the Department of Homeland Security. That website was totally ridiculous. I managed to find the re-organization flow charts, (you might remember after Katrina, DHS was totally re-organized to make it "better") hoping that it was only because of the reorganization that I couldn't manage to hit upon a single page listing the mailing address of anyone.

Here is a flow chart from 2004 (It's on the 3rd page. Note how two pages of instructions are required for this flow chart).

Now, here is a chart from 2008, after the re-organization
. Note the first chart of DHS is followed by an additional 24!!! charts, detailing each component. Much simpler, no?

But it actually is far more complex than that. If you read the entire history of DHS organization, you will find out that the Katrina re-organization was actually the fourth re-organization, or perhaps three and a half, stemming from the legislation planned for the third reorganization, but ending up different. The second chart I listed is the current state of affairs at DHS. All in all, DHS has gone through approximately EIGHT re-organizations in it's six year history from 2002 to Spring 2008--roughly a re-organization every six months or so, except for an unusual period of stability in 2004. But don't take my word for it (35-page history of a seven-year old bureau, including twelve unique pages of historical charts).

And one wonders how DHS lost $15B in contracted money in six years...

Despite the neo-con Cheney politics, and the fear-mongering control of the country with the Patriot Act, and other various criminal and Fascist acts during those eight years, I hope the legacy Bush becomes historically known for is a brilliant ability to gut a government with a mixture of control and laisse-faire policies. This sort of bureaucracy is a completely new addition to the history of totalitarianism. On one hand, spying (both internal and external), intimidiation, fear-mongering, and torture become common-place. On the other hand, certain budgets are sliced to bits, while other agencies are given so much money and manpower they can't do anything but eat themselves, like a cancer. It's diabolical, really. I'm reminded of certain parts of Catch-22: Lt. Scheisskopf and his parades--then the announcement that all parades will be postponed, which he throws himself into effort of announcing, as much as he had formerly poured effort into the parades. Remember, in the end of the book, it's Scheisskopf that becomes the commanding general. If like any other runaway leader, Bush had had about twenty years behind the wheel, we would be cooking our neighbors in the rubble.

But hey, things are different now, right? Change done happened, and he fixed the websites! DHS hasn't re-organized since March 2008! The people won!

Wait a minute--what's this? Swine flu? Shit.

No matter, I'll just check my Twitter. See how hip this government is? CDC has a Twitter account, informing me of emergency information as it happens. All I have to do is opt-in, and bing! Updates to my mobile, or wherever. Technology is awesome!

Let's see who else @CDCemergency is following. Maybe I'll get some other good government info while I'm at it, WebTwoOhing it up. Whoa. Following 74. Looks like WHO, the White House, a dozen other specialty government crisis units, about nine FEMA regions, and every major metro Red Cross has a Twitter account too. That's a lot of Emergency Tweets.

There's got to be a better way. I know! I'll follow @CDC_eHealth: providing me all the latest opportunities, so I can connect with only the real important ones. That's the ticket. Let's see, they're directing me to their very own Social Media site! Amazing! Obama! Social Media government: this country is making leaps and bounds!

But... whoa.

Five CDC widgets?

Website badges with scrolling updates?

A CDC YouTube Channel?

CDC Podcasts
?

RSS feed?

A CDC Flickr site?

A CDC Facebook page?

A CDC MySpace page?

CDC eCards?!?!?!?

What, no Match.com profile? I'm not kidding. Those all really exist.

What is the deal? I demand a flow chart to determine which one of these sources is updated first! Where is the transperency in this Web 2.0 re-organization?

I know information sets us free, but this is getting ridiculous. I think technology is great like everybody else--but this reminds me of a keynote speech at SXSWi I've haven't read.

All kidding and paranoia about incipient governmental bureaucracy aside (the two naturally go hand in hand), we are discussing health here. Health, to some people, is a very important issue. In fact, as I recently mentioned, it is one of those just ever-so-volatile human issues that can leap in to flames of paranoia at the slightest spark. Something about the integrity of the body just drives people wild, builds them into mobs, and makes them ready to sacrifice themselves and their neighbors for their own safety. Terry Jones talks about it a bit here. Totally history, folks. True.

Health is also one of those knobs by which governments in power tweak the biomass of humanity, turning up the flame when necessary, and diffusing it at other times. When will a people accept a curfew, or refuse to cross a line, no matter what? When you call it a "quarantine". Information about health is a very dangerous game to play with--an outbreak is one of those Foucauldian moments when the juridico-discursive, the pathologico-institutional complex, and the sexual biologico-paranoia of the mass just lines up perfectly. It's a post-structuralist textbook example, here.

But here, let's ask Foucault himself. (Bear in mind he is literally discussing madness, here, but I think the parallel is obvious.)

"All those forms of unreason which had replaced leprosy in the geography of evil, and which had been banished into the remotest social distance, now became a visible leprosy and offered their running sores to the promiscuity of men. Unreason was once more present; but marked now by an imaginary stigma of disease, which added its powers of terror.
"Thus it is the realm of the fantastic and not within the rigor of medical thought that unreason joins illness and draws closer to it. Long before the problem of discovering to what degree the unreasonable is pathological was formulated, there had formed, in the space of confinement and by the alchemy peculiar to it, a melange combining the dread of unreason and the old specters of disease. From a great distance, the old confusions about leprosy functioned once again; and it is the vigor of these fantastic themes which was the first agent of synthesis between the world of unreason and the medical universe. They first communicated through the hallucinations of fear, combining the infernal mixtures of "corruption" and "taint". It is important, perhaps decisive for the place madness was to occupy in modern culture, that homo medicus was not called into the world of confinement as an arbiter, to divide what was crime from what was madness, what was evil from what was illness, but rather as a guardian, to protect others from the vague danger that exuded through the walls of confinement." (205 in my Vintage edition).

If you're unfamiliar with Madness and Civilization, the point Foucault is making here is that in the 18th century there was a unification conducted with illness and "unreason", a new concept of mental defect growing along with the age of reason. This "madness" was also made synonymous with prisons, and the spirit that caused people to deport lepers made them wish to imprison the mad. Doctors, therefore, become unique personas in that they are not called upon simply to diagnose or treat the insane, but to keep them away from society.

The theme is not so unfamiliar to us. In an age of remarkable health breakthroughs, American society has sanitized certain health problems. Heart disease, diabetes, cancer, and even AIDS are now Lifestyle problems--not disease. If you die of one of these things it was merely a lapse of your willpower, just as you probably should have lost that weight after college, but you didn't. If it was an infection, it was probably somebody else's fault--the doctor, the hospital, or the farmer who shat on your strawberries.

Disease happens in the third world now. Organic, health-conscious parents don't innoculate their children anymore--instead they give money to polio charities, fighting disease somewhere else. They send malaria nets to Africa, or failing that, just adopt the kids back here. Sickness, for us, is a lifestyle problem (sorry guys, can't go out drinking tonight, I've got a cold) or a foreign, developing issue. (Hey, water issues are real important in sick countries where they don't have the bold look of Kohler!)

So when that developing nation so close to home develops a new strain of flu, it is a foreign problem. More than that: it is a dirty problem. It is swine flu, a biblical association with that dirty, most guilty food-choice we have, despite the fact it is also part bird flu and part good-old-fashioned human flu. The Israelis may have been the only ones to say it, (god-bless 'em!) but the connotation was obvious. It is south-of-the-border-disease, the land of eating-the-wrong-parts-of-the-animal. Isn't that where all those tomatoes came from???

So what do the people do? Call the doctors. No, they aren't calling them to get better hand washing instructions--something that could actually save them, just like it always has from the flu--they are asking them for protection. Close the borders, deport them, where is it now, where is it NOW, is it NEAR ME oh god but I must KNOW instantly, in real time!

Despite the fact that this is the same lifestyle sickness, more or less, that keeps countless young singles from going out on a perfectly good weekend night during the winter months, and also regularly kills 36,000 people a year. It is a pandemic. Somebody wake up the media and let them know.

My point, of course, is not to say that a new flu pandemic is not important to fight, track, and limit in spread. These things are still important, just like they always are with germs. And what is still the best tactic to fight it? Revoking Green Cards? Keeping Twitter refreshing every 30 seconds? No! Wash your goddamn hands!

We have, in this country, a mental imbalance: a disease. We have a pathological image of our bodies. We do not understand them, we fear them, and we seek to control them. Our bodies are our disease, which we seek to forget, to ostracize, and to reduce, hiring countless doctors to keep our bodies' functions limited and out of sight.

With the constantly expanding horizon of our consciousnesses, we seek to control our bodies. Our vast information networks are kept humming, diagnosing us via Web MD, perpetuating a lifestyle of paranoiac-pathologization. Our government keeps unfolding in a vast fractal pit of total information awareness, swallowing meaning into great vacuums of data.

The diagnosis and the cure. The diagnosis is the unknown, the foreign. The cure is control, research, and constant recitation of the litanies of the social democracy. The diagnosis is diet and exercise, the cure is going to the doctor. The diagnosis and the cure... what about good old protein, and amino acids? A little exercise? Those are important? Quick, prescribe me some! Pills with proper doses, and rotating regiments of calculated maximum heart rates. I can lifestyle my way out of this! I can spend enough money to make it happen!

These regimes are building up around us, a bureaucracy of reason walling us in as the departments of our ego re-organize, and re-organize again, knowing eventually it will find that proper pattern to guarantee Body Security. If we can't do it with weapons, we can do it with information. If we can't do it with information, we'll do it with meta-information. Organize our thoughts, our approach, our strategy, and try again. Hypothesize, plan, outline, and try again. Metastasizing units of thought, processing, processing, processing, spitting out ideas, sound bites, mnemonics, top ten lists, and headlines. An immune system, attacking its own organs, because it's programming told it to.

Where is the flesh, in all of this? Where are the running noses, the dripping eyes, the clean, clear flows of mucus bleeding our vessels and cavities off, flushing them clean with the secretions made for that very purpose? They've been stopped up, dammed, and cut off at the source with the same stimulants and steroids that keep us achieving, moving forward, and purifying the lifestyle.

Where is the good, clean fat cells? The stores of energy, our bodies own batteries, tucked away into the crevices of our skeletons like the granaries of a city grown fat on its success and its peace. Our aesthetic has become one of famine, because our neurotic minds can't handle the body weighing it down. We run on fumes, because the sloshing of fuel makes us quiver in fear at the sound of our insides.

Where is the muscle? The smooth, knitted fibers, trained not only for efficiency but for adaptability by constant use, the dynamic infrastructure of daily work, the conversion of the body into a tool of the trade of living, rather than into an infomercial exercise device itself.

In 2006, the greatest cause of stopped MTA trains due to sickness were because of people passing out from not eating.

The ability not to fart or urinate in front of a lover is the subject of modern television drama.

We have iPhone apps for counting calories, but our doctors refuse to put our medical records online.

We wear masks against the flu, but teenagers can't figure out condoms.


It's the horrible truth of the world, really. I don't expect it to change. As a species, we are of a certain nature that plunges toward the future, shedding flaming members of our composite humanity into the wind like particles of smoke. Only it massive, gushing clouds are they even really visible.

This is the point at which I regretfully break off, cutting you loose. Unfortunately, nothing so poignant as a desert or a carcass--instead, merely the beginning of another long hallway of Internet, stretching out in front of you.

But if you want a little souvenir of truth to take with you, I guess all there is to say is that any blog post that's going to tell you anything uncomfortably true is probably going to start ironically, and end tragically.

get well soon human,

Adam

4/26/2009

We Bring You an Important Interruption:

Swine Flu, otherwise known as Influenza A H1N1.

Not to be alarmist, but even if you are not normally interested in these sorts of semi-apocalyptic world events, you may want to pay attention, at least until there is some real idea of how big this is going to spread. Unfortunately, because of the way rumors spread about these sorts of things, and the really, truly unbelievable USELESSNESS of the major media on this issue, we probably won't know what's really happening until its over, and by that time it will be too late for the people who will be the casualties.

The media is providing this, generally, as the story:

"Some people, we don't really know how many, are like, pig-sick, or something. California, Kansas, Texas, New York, Mexico. Maybe some other places? Some disease researcher types think it might be serious."

Thanks.

Twitter and Wikipedia, on the other hand, are much better, but still not the magic media bullet. @timoreilly passed on this Google map of current outbreaks. This is not really that informative, but contextualizes the current status well.

He also passed on this posting, by a former flu researcher, Terry Jones, that while not providing that much in the way of new, breaking information, cuts away A WHOLE LOT of the bullshit.

As far as the exact, current state of things, (not including the late-breaking news reports that are more "late" than anything else, not to mention conflictual) I've found the often-updating Wikipedia page about the current outbreak to be the best summation, because it lists all the info on one page, with sources.

Terry Jones is also Twittering at @terrycojones. The current Twitter tags for the epidemic seem to be #H1N1 (which in itself is much more factual information than any media report) and #swineflu.

Here are some of the most important facts about epidemics in general, pulled from Terry Jones' blog posting, which I feel deserve repeating:

"The current virus is already known to be resistant to both amantadine and rimantadine, though oseltamivir is still effective."

"If you ask virologists what the probability is that there will be another pandemic, they’ll tell you it’s 1.0. It’s just a matter of time until it happens. it’s like a non-zero probability state in a Markov process.When it does happen, what you do in the first phase is critically important."

"The current WHO standard influenza test kit is not very useful in identifying this strain. They have issued instructions warning against false negatives."

"The acting-director of the CDC has already said: “There are things that we see that suggest that containment is not very likely.” That is a remarkably candid statement. I think it’s very clear that the cat is out of the bag. The question is how bad is it going to be. That’s impossible to tell right now, because we do not know what the virus will look like in the future, after it has had time to mutate and adapt inside humans.:

"The new virus has been popping up in various places in the US in the last days. I expect it will go global in the next couple of days, maximum."

"Instead of peaks in just the very young and the very old, there was a W shape, with a huge number of young and healthy people who would not normally die from influenza. There are various conjectures as to the cause of this. The current virus is also killing young and healthy adults."

"The social breakdown in a pandemic is extraordinary."

"History dictates that you should probably not believe anything any politician says about pandemic influenza. There has been a strong tendency to downplay risks. All sorts of factors are at work in communicating with the public. You can be sure that everything officially said by the WHO or CDC has been very carefully vetted and considered. There’s no particular reason to believe anything else you hear, either :-)" [emphasis mine]

"In conclusion, I’d say that the thing is largely out of our hands for the time being. We’re going to have to wait and see what happens, and make our best guesses along the way."


Other things:

Facemasks don't prevent viruses. But, they do prevent spittle, fluids, and that sort of thing, which transmit viruses.

While I implicitly do not trust governments or leaders, I do trust the CDC and the WHO. They are run by scientists, by and large. If the CDC or the WHO approves a vaccine or a certain procedure, I would take it/follow it. I've done a little bit of reading about the spread of outbreaks, and it is most often that one person who slips past quarantine spreads the virus to a new location. You may hate needles, or believe some conspiracy about vaccines, but in taking the risk upon yourself by refusing treatment, you are putting the entire population you may contact at risk. Sorry--I know, but its how biology works. Put the species before yourself, this one time.

However, that being said, I do not trust FEMA in the slightest. Not that we are at that point--but just to juxtapose, while CDC is run by scientists and doctors, FEMA is run by politicians and Blackwater types, who would totally doom a portion (especially an "undesirable" portion) of the population to save themselves. Or at least, they would have their heads so far up their gold-bricking grafting asses as to not know hand sanitizer from napalm. I don't know how much has changed since the previous administration, but if that agency is anything like what it was in 2005-7, I would dodge those criminals. CDC are the folks who are going to save our asses, whereas FEMA are the ones hoarding virgins in the Dr. Strangelove mine-shaft bunkers. The really sad part about some conspiracy theories is that some are true. Remember I said that.

Okay--enough scaremongering for now. Really though: just pay attention, listen up, and don't believe rumors unless you get the facts from someone trustworthy. In lieu of that, cover your mouth, and wash your damn hands.