Monday, October 16, 2006

BETTING ON A LONG SHOT
#187


The slow burn of cases in Indonesia continues unabated, with the 53rd and 54th fatality being reported over the weekend. Reports from the field indicate that crucial supplies, such as protective garments, are in short supply, and that hospitals are screening a great many suspected cases of Avian Flu.


From Nepal we are getting word of a `mysterious illness’ striking 400 villagers in a remote area of the country, with at least 8 fatalities so far. The illness strikes swiftly, and had symptoms similar to SARS.


So while Avian Flu has not been in the news much of late, it hasn’t gone away. Mostly though, we’ve been hearing of seminars like the one described below. This one, held in Australia, and reported on by the Australian Broadcasting Company, has a twist.


Conference told of bird flu risk for health workers
Sunday, October 15, 2006. 7:00am (AEST)

The doctor who diagnosed the first case of SARS in Toronto has urged Australian governments to ensure front-line health workers are protected in the event of a flu pandemic.

Tom Stewart from Toronto University has addressed the Australian and New Zealand Intensive Care Society's conference in Hobart.

Dr Stewart says seven of his colleagues became ill during the SARS outbreak in 2002, and three succumbed to the virus.

He says despite the risks, doctors and nurses rejected pleas from their families to stay at home.

"There was a lot of stress on my colleagues, and a lot of after-effects of that stress," he said.

"That could be better more improved by preparation, training, teaching, a plan on how we're going to deal with a surge of critically ill patients, where we're going to put them, who's in charge."

Hundreds of medical experts are discussing the scenario of an Avian influenza pandemic at the Hobart conference.

They say bird flu has already been detected in 53 countries, and if the virus spreads to Australia the predicted mortality rate is 35 per cent.

Professor Marcus Skinner, from Tasmania's North West Regional Hospital, says existing preparedness plans do not anticipate the rapid erosion of front-line hospital staff in the event of an avian flu outbreak.

"We need to be able to identify early these patients, so that they can go down the path of appropriate isolation and management and that at the same time we can protect our scarce staffing resources, particularly in rural areas," he said.

The conference concludes today.



Notice the paragraph highlighted in red. A prediction of a 35% mortality rate. This is a far cry from the 2% to 5% number bandied about by most authorities. It is roughly half the current mortality rate, and so it may be optimistic, but it is a quantum leap forward over the estimates provided by other entities. And probably closer to the truth.


While both of my readers are aware that I have seriously doubted (and decried) the overly optimistic numbers provided by the CDC and our federal government on mortality and morbidity of this virus, I point this out not for personal vindication, but because people and agencies are basing their plans on the lower numbers.


There are school districts that still believe this will be little worse than ordinary flu, and intend to keep the schools open. They do so because they accept the figures spewed forth by the CDC, speaking of a 30% attack rate, and less than a 3% mortality rate. Why, by those numbers, the odds of dying from this virus are only 1 in 100!


Of course, use the Australian conference numbers, and the commonly held belief that the attack rate would be 60%, and suddenly the odds of dying are 1 in 5.


As to which side of the argument is right, the CDC with their lowball numbers or independent researchers and experts with their higher forecasts: No one knows.


Today, 60% of those who contract the illness die, and that’s with virtually unlimited hospital support. Tamiflu, IV’s, and even ventilators. Those items will be in short supply during a pandemic. Not everyone who needs them will have them available (an understatement). It would take a dramatic drop in the lethality of this virus, once it goes pandemic, to achieve the lower numbers. Maybe it will happen.


But too many people are betting too many lives on a long shot.