#189
The comments (related in my last blog) by doctor Woodson regarding the likelihood of a pandemic this winter has caused a good deal of stir on the Internet, and with good reason: Dr. Woodson is a well respected member of both the medical and the flu community. A few have questioned his motives: He is, after all, an author, trying to sell his book. But most dismiss that because he has made most of his book available online, and for free.
Last night, Dr. Woodson clarified his concerns on the wiki. I present those comments here so that might readers might judge for themselves.
Some of you have asked why I started this thread and what does it mean? The answer is simple. This winter we could see the start of the pandemic. While is true that the timing of the pandemic’s beginning is not something anyone can predict, we do know is that the flu likes the cold weather and is much more active then than in the summer. It is also true that we cannot say with certainty that H5N1 will achieve pandemic status but we do know that this strain and its variants have spread itself around quite a bit over the last decade. I happen to think that H5N1 will become pandemic, possibly as soon as this coming winter.
Make no mistake about it; the odds are very high that you and your family will survive this event. I have developed a number of different mathematical models looking at mild, moderate and severe influenza scenarios. In the absolutely worst one I can imagine, the chances of survival are 95% for the population as a whole in the US and the EU.
While I do expect a severe pandemic, in my opinion, the most likely clinical attack rate is 40% with a case fatality rate of 8%. This equates to a death rate of 3.2% of the population as a whole or a 96.8% likelihood of survival the average person.
For more information about this topic, here is a link to an original article on the www.birdflumanual.com website entitled Illness and Death During the Pandemic:
I am not saying that an event of this magnitude will be easy for our society to handle. On the contrary, it is my view that a case fatality rate of 5% or greater will result in a temporary collapse of our economic and social order in the developed world and more prolonged and catastrophic economic, civil, and political effects in other region most particularly in Africa, the Middle East, Pakistan, China, and the Koreas.
It is easy for me to identify with many of the comments made by the members of this community. Coming to terms with an event like pandemic influenza requires a great deal of thought and can be gut wrenching. It requires quite a bit of unconscious psychological processing too. I spent a lot of time playing a series of “what ifs”. This game involves imagining “if this happens the result is likely to be that”.
The journey can get pretty dark as is reflected by many comments I have read on this and other threads. As one moves along the darkness passes. At some point, the time for psychological processing will end. You emerge into the light with a better understanding of what is happening, what to do about it and when to do it. Your head is clear and you are not afraid. For the fortunate, a quite confidence develops that you will survive the pandemic. There is a certainty that you have the knowledge and resolve to help your family and friends do the same. While you remain pandemic-aware, you will no longer be pandemic-obsessed.
Reaching this state requires patience and persistence in your study and work to get an understanding of this event. You will have gathered a sufficient set of facts and realizations and begin your preparations in earnest. You will do what needs to be done, and then get on with your life. Influenza moves at its own speed and in its own time. When its time comes, you know that you will be ready to face it and will survive.
These comments remind me of my 7th grade teacher at Tuxedo Elementary School in Atlanta, GA, Mrs. Hogan. One of her favorite quotes was “Ye shall reap as ye shall sow”. In my opinion, these words apply well to our task today as we face the coming influenza pandemic.
Grattan Woodson, MD, FACP
