As a sometime modeler myself it now makes my heart sink when I read about a "new" model that tells us that such and such is going to happen with avian influenza. Box's adage that all models are wrong but some models are useful is apt, but telling which ones are useful is becoming so difficult we'll need a model to help us do it. Two cases in point: a new economic model from Australia telling us not worry, the economic effects won't be that bad; and another airline model, this one that says if we shut down international air travel we'll gain time in the US -- enough time, according to the story, to develop and distribute a vaccine. I don't know who whose responsible for this one. Maybe the screenwriter for the Dustin Hoffman movie Outbreak, where an "antitoxin" is developed and deployed in a single afternoon to bring the movie to a satisfactory Hollywood conclusion.
A computer model of an "ultra severe" flu pandemic shows it would leave more than 140 million people dead worldwide and cost the global economy more than $4 trillion - but that its effect on the economies of the United States and Western Europe would be relatively mild.In fact, Australian economist Warwick McKibbin said his model of the way different economies respond to a pandemic suggests that capital investment in the United States and Europe will grow as investors flee less secure economies.
The model contradicts some predictions that a pandemic could plunge the world's economy into a major depression. (Jeff Nesmith, Atlanta Journal Consitution)
The McKibbin model was discussed at a meeting of The Brookings Institution recently. Using four different estimates of lethality and a 30% infection rate, the model predicted dire effects on a variety of economic sectors in developing nation economies but much less impact on developed nations. The story didn't explain why. I'm not sure I need to know the details, not because I don't think they are important, but because I wouldn't want to base any policies on anything as inherently uncertain as this. If it works out that way, it may be good for us but is still bad for large parts of the world, so I am not very comforted either way.
The NIH/MIDAS model is even weirder.
Another computer model, being developed by the National Institutes of Health, suggests that by closing its airports to international flights, the United States could "buy" a few weeks of time to prepare for a pandemic.
The number of American deaths could be dramatically reduced if pandemic preparation plans are put into effect and work is begun on developing a targeted vaccine, according to the NIH's Models of Infectious Disease Agent Study [MIDAS] program.
[snip]
Joshua Epstein of the National Institutes of Health said the MIDAS model was developed around the 1968 pandemic, using new transportation data that reflects the modern prevalence of air travel.
[snip]
The MIDAS model indicates unrestrained air transportation could cause 400 million cases of disease from such a virus, he said.
Global human travel restrictions would delay global propagation of the virus around three weeks, "and give you time to do intelligent things, like start developing a vaccine," he said.
Blocking air travel from affected countries was found to be effective at delaying the pandemic, Epstein said. "You are buying enough time ... to develop and distribute vaccine and do social distancing and all the other intelligent things you could do; you get a huge depression in the number of cases."
Presumably the whole program to get us ready during those three weeks that international air travel is shut down will be in the hands of Dustin Hoffman.
I hope the Hollywood ending isn't like On the Beach.
- Log in to post comments
My reaction to these models was exactly the same as yours, Revere.
These two ridiculous computer models express their specific plugged-in mythical data of a flu pandemic. Garbage data IN---garbage data OUT.
Model one---the "economy no problem" model:
You can put any numbers you want in the computer to get the desired result of a "limited economic impact". We really don't know what "the world economy" is doing right now---it is beyond control or measurement. All I know is that the people living in the US are not going to do well without imports-----or their service jobs---or electricity---or water. The developing countries know how to SURVIVE hardship---do we?
Model two---"shut down the airlines to buy time to get vaccine distributed".
SAY WHAT?????? I believe everyone knows by now that the vaccine will take six months to produce in quantity. People with flu are asymptomatic for a couple days.
By the time any government order is made to shut down air travel---the flu will already be spreading all over the country. It is not like we will hear a buzzer when the human to human transmission begins and park all the airplanes in the hangars.
There was extremely limited air travel in 1918---but the flu traveled like lightning.
I am so sickened by all the "soothing sunshine chatter" when so many, many, many lives are on the line.
So put "flu-aid" into just about any browser and you'll have the raw capability once it starts in and killing or not killing people as the case may be to determine whatza gonna happen. See, you get to X-box your own community into survival, death house, or a lot of what ifs. Its very accurate if you know all of the answers to their questions such as doctors and nurses that will show, hospital beds, initial kils from other areas for a mortality rate. Its very, very cool and very, very going to tell you as it did for our state electeds that we in Tennesse with the 3% kill rate they expect would produce about 58,000 H5N1 deaths out of 6 million. BUT, if you start loading the equations with reality such as the 67% rate for the last five years and the actual numbers of docs, nurses and beds start to head down in availablity the rate turns into a shambles and 4 million Tennesseans get shoved into plague pits by bulldozers within four weeks. Hard numbers, hard facts. Computers only lie when you tell them too. I dont think there is a soul on this blog that beiieves we are going to see a 3% event, or even a 5%. I think we might see about 1/3rd of the population go into the night with recurrent waves for five or six years afterwards and smoking more of us from endemic and antigenically shifting H5N1 or one of the cousins.
What would we have at 5%? Chaos is a good description. My grandmother went thru it but didnt get H1N1 in 1918. There are driveways in the old parts of Memphis that go nowhere. I asked her once where the houses were and she told me that they were flu houses and no one would move into them after the occupants were dead, so they were bulldozed. I could account for about 80 of those driveways to nowhere even now. That was 5%. At 8% I have seen stuff that indicated that it might start to tip over for control in key facilities. It would be bad enough if it happens in winter but was anyone here aware that there is only a 25 day supply of coal for the powerplants? The spin up time after a pandemic to get the coal fired plants back up online is about 50 days because they use so much just to get the mothers fired back up. So someone is going to get cold and its going to be dark. There arent that many energizer bunnies on this planet either.
Go to www.cdc.gov/eid Volume 12, Number 1, from January 2006 page 12 lower right hand corner. They pretty much acknowledged there to my way of thinking that they understand fully that we are just going to get swamped if it turns up at anything approaching 5%. Everything else is just piling on. This is a pretty cool volume that describes the pseudopandemic of 1947 and the abortive one in 1976-Swine flu. Everyone thats anyone is in this particular volume. Tautenberger, Webster, Peiris, Chen, Guan etc.
But the sand is in the gearbox folks because they say they pretty much might be able to make a vaccine, but maybe, just maybe not. To be able to make a vaccine you have to know where it is and maybe think about where its going because this stuff changes sequences like I change my socks...daily.
Models are great now arent they? They are pretty, powerpointed easily and above all give hope. I havent seen that spending 100 billion dollars would save one soul from this even as Tamiflu falls as a usable drug and indications that ventilators might do as much harm as good putting one in. So whats the next model say if we see anything above 8%. Destruction of civilization piece by piece as we know it and in percentages based upon the numbers that are actually sick or killed most likely. The unthinkable 30% as with the Black Plague of 1347 killed so many that it took almost 300 years for the population to recover. Embrace the horror or do we prepare personally for it? Decision time. I can tell you what the models will show post of the event if you dont.
I can email that to anyone who wants it. memphisservices@bellsouth.net. Its a PDF.
Make and distribute a vaccine in 3 weeks? This sounds absurd even if we're talking about 100 doses.
Great if any delay is possible. But why not start planning on all those "intelligent" things now? Why wait until 3 weeks before we know it hits?
Thanks R. I love the Pollyanna stuff.
I'd also like a little of what these folks are smoking, at least it will make the last few days bearable.
The idea that shutting down the airlines is a good move completely ignores the economic effects of that, including total collapse of the tourism industry, weird social stuff as people realise that their families are now trapped overseas, without support networks, and probably going to be cut out of the local distribution of food, let alone vaccines.
Meanwhile the airlines stop paying their bills, and their interest payments, the banks go ape und so weiter.
The economic effects could easily be as bad as the disease.
Interestingly I heard, although haven't verified yet, that the NZ Reserve Bank has a plan, on the declaration of a pandemic, to freeze ALL interest rates at zero.
On its own; a drop in the bucket, but as a sign that someone is actually thinking about the real effects of this thing, a good one.
Finally finds correct volume M. Randolph Kruger mentioned, (Haven't drank my coffee yet.)
http://www.cdc.gov/ncidod/EID/vol12no01/contents_v12n01.htm
Now, if the Reveres and M.R.K. were teamed up ;-) and in charge, I'd think New England had a chance of getting whipped into awareness and some kind of preparedness, but... meanwhile, we'll having a "state of the town" meeting that has zero, zip, nada on the agenda about being in a pandemic alert period, and local and household preparedness being key, according to scientists, HHS, feds, state, ect. ("Beam me up, Scotty!!")
One more thing.
Even Randolphs' dystopic image doesn't go far enough. He says "4 million Tennesseans get shoved into plague pits by bulldozers within four weeks."
And where, pray, is the mechanism to collect all those bodies and deliver them to the pits?
I have a pet theory, we will use the wheeled plastic rubbish bin (known in Australia as wheelie bins) to place the bodies at the kerbside and the rubbish trucks, (driven by well protected operators) will collect them.
But then, how will we know that is what we have to do? In the UK, Gravesend is the site of the mass graves of the Black Plague, but they were delivered there by mad or courageous people driving tumbrils full of bodies.
Who will walk the streets of our world crying "Bring out your dead! Bring out your dead!"?
Earl, initially a year ago before we knew what it would do and how to catch it I wouldnt. Now we know more and thats when I bought everyone here a mask-four months of NBC filters, suits, gloves and booties. My reach may not be as far but as long as they allow cargo flights that will be carrying food, I'll be out there. Slowly the awareness of this State in particular is coming about and with it real live no hock good preparedness is starting to take place. Save the four million? I doubt it. Save maybe a million out of the four, possibly. But who gets the food? I have no idea. I will leave that to the politicians. It is as they used to tell us in the military, do your job and everyone else do theirs and we will lose a few but we will survive. Even in the face of possibly overwhelming numbers, we will survive.
As for the mechanisms to collect bodies etc. The bug if it comes will kill or infect until it reaches a state of equilibrium to the population. We will all be in a state of shock and then the system will start to recover. Bring out your dead is a sign of the system working, as will be the eventual return of lights and heat in some areas. Set your expectations low during this time and you wont be too terribly dissapointed, only that you lost a few of your friends and family members. Once it starts in a High Path method, everyone, everywhere will be in the same boat. You either make it or you dont.
This is almost a direct quotation from the Joint Services Nuclear, Biological, Chemical Warfare manual. The real quotes for this are that we have time to prepare for this biological attack. The messages are the same and that is to make sure you have resources to maintain a survivable standard of living. That doesnt mean camp Beverly Hills, its survivable at 1700 calories a day. You'll shed those remaining pounds Kirstie Alley and without Weight Watchers either. But you ensure you have that and water, meds and a place to shelter thats warm you'll have it wired. Post pandemic after a billion go? Shit, I can tell you that no one knows what that landscape will be like, only that if you are in it that you should start to bloom where you are planted. Everyone else will just be planted.
M.Randolph Kruger:I hope you are posting to other forums because no one could read what you write and fail to prep. However, I fear post pandemic almost worse than pandemic. You obviously have thought hard (and clearly) on this so I don't have to explain why.
Revere: I found the MIDAS model the most ridiculous. Three weeks to save us with that elusive vaccine? Some areas have not received the seasonal flu vaccine even though we have had since last flu season to prepare. By social distancing Joshua Epstein must mean run to the hills to your prepared hide out.
Earl E: I agree with you completely.
Thanks Judy and Randolph, we are on the same page.
I already have 7k litres of water storage under my house, (in the hardest Australian drought in post-colonial history that is just prudent) and a hand pump to recover it, plus a goodly ration of food for 3 months and a strategy to go to minimum survivable intake on day one.
Although I think the measures societies take to try to stop the march to equilibrium will be at least as deadly as the disease.
On that front, you might be interested in a Keynote I gave to the eHealth Forum in Hong Kong in September. The paper is here http://tinyurl.com/y5yt84
Some interesting stuff has fallen out of that; I'll be posting details once I have the contracts confirmed at my blog. http://tinyurl.com/y5crap
I don't think we would let the virus spread, when it is as bad as 1918. We would do everything to stop it. This were almost a war situation. We are not as tolerable to didease and death as people were in 1918. Of course air-travel
and other travel would be quarantined.
Goods would be desinfected, people forced to stay inside or wear full protective cloths as the dead-swan-collectors.
We just would not let the virus spread, when we have no other choice. That includes shooting infected people refuting to isolate. That includes punishing people
who carelessly infect others or carelessly become infected.
The psychological impact will be much bigger than I have read here thus far. How will you keep little children in the house for more than two weeks? That's the period the Harvard subjects reported they will stay in their houses. But a first wave will be enduring at least one month or up to four months, so two weeks won't be enough to shut themselves up and avoid viral infection.
Any quarantaine or isolation must result in quarrels, protesting people and a lot of internal unrest. Not everywhere, but still in a lot of houses.
And Anon we need people in every street to control the isolation and there won't be enough of them out there.
If we could only convince people and teach them about H5N1 it would be a lot easier to get them prepared and disciplined during a pandemic. Not all of them, but a significant part.
Anon, there isnt going to be any real shooting going on unless someone tries to go for the infrastructure. Grocery stores, doctors offices, hospitals all are going to have proper protection in place. To be honest with you I dont think that after six weeks people are going to be moving much. Those that didnt prepare will be out of food and likely sick from trying to forage for it and contacting other humans or animals. Secondary contagion would be rife in the population at that time too. Typhoid, mumps, rubella, whooping cough all have a way of swacking around in the middle of an epidemic.
They wont be busing people to Williams death camps either. Too time consuming and they would be dead when they got there anyway. I read something the other day that said pretty much about two weeks is the extent the medical system would be able to deal with this effectively. After that they simply wouldnt have all of those normal supplies. Oxygen masks, SPUR packs, all gone. I laid in a supply of them for the kiddies to be handed out to parents if they have to haul their kids out. Yep, they are free and I am telling them only to send one parent if one is going to go because the hospitals would be contagion centers. You go to a hospital unmasked and without eye shields and you likley would never leave, nor will your children. The masks you can get a at Wal-Greens or by calling up a medical supply house. Expensive for the SPUR's as they are the bag type resuscitators-about 120 per set but you need to have at least one in the house. If it comes, you or one of your familiy members will need it. Or a neighbor.
The good news is that my Pakistanis are prepared now. Daddy came in from Karachi where he published the list and people there are preparing. He translated it from English to whatever it is over there. Good for him. Tears of the Sun.
MRK,
Why are you recommending oxygen masks instead of N95 respirator masks?
What is a SPUR pack?
Thank you.