This is about the particularly severe flu season being endured by our friends in Australia. Southern hemisphere, so the flu season is in full swing there, the reverse of the northern hemisphere. But "full swing" doesn't quite describe it, so I'm going to do this one in two parts ((all links from Flu Wiki Front Page, news for August 18). The great epidemiologist Irving Selikoff once described statistics as people with the tears wiped away. So the first post today will be statistics, or the equivalent, without the tears . Later today I'll do the other part:
As the flu epidemic continues to cripple the state's health system, an entire Sydney [Australia] emergency department has been shut down because the private hospital's operators failed to maintain staff levels.Private patients in The Hills district are now being shunted into the overloaded public system, which is already buckling under more than 3000 extra suspected flu cases flooding emergency departments in the past week alone.
The crisis comes as yet another person, a South Australian health worker, has died after being infected with the killer influenza A virus sweeping the country.
The Daily Telegraph can also reveal that a Sydney doctor is in intensive care at North Shore Private Hospital after catching influenza A.
Adding even further to the health system's woes, there has been an outbreak of a superbug at Bankstown Hospital's intensive care unit.
The Hills Private Hospital is now being investigated by the State Government to determine if it has breached its licence by failing to keep its emergency department open amid one of the worst flu epidemics in more than 20 years.
Documents obtained by The Daily Telegraph reveal that the hospital asked ambulances to bypass its emergency department on Monday because they did not have enough staff. (Daily Telegraph)
My first reaction is that if Australia's city emergency departments don't divert because of overcrowding until things reach this level, they are in much better shape than US EDs, where diversion even in summer months is common. Here are some more "statistics":
The Royal Children's Hospital in Melbourne is seeing an extra 100 patients a day as parents worry about a potentially fatal strain of influenza.
The deaths of five young children across Australia have been linked to the virus and the hospital says it is treating more cases of influenza than in previous years. (Australia Broadcasting) (
Bad, but nothing special:
Australia's Chief Medical Officer, John Horvath says the country is experiencing a worse than normal influenza season with 3091 cases reported to authorities so far. That compares with 1213 cases last year.
But experts say the strains are no more threatening than in years gone by and that people with a healthy immune system will mostly recover naturally.
Most fatalities are the result of complications like a secondary infection such as Pneumonia. Most at risk are the elderly, the very young or people with chronic illness. (Sky News)
Keep in mind this isn't pandemic flu in the sense it is a novel strain to which the population has little existing experience and immunity. This is the currently circulating influenza A/H3N2 and some H1N1. But "ordinary" flu is still nasty. This is a small taste of what even a mild pandemic flu would bring. Looked at one way, this is a really bad flu season. Looked at another way, it's just seasonal flu.
In the next post we'll look at it still another way: we won't wipe the tears away.
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Boy, Revere, I sure hope you are right this time. With the recently reported human death in Bali, Indonesia, a popular Australian vacation destination, and rumors of clusters there swirling, there's a lot of speculation that this "deadly strain" (as described in Australian and New Zealand media reports) of flu has perhaps co-mingled (sorry for the non-tech terminology) with H5N1 and that it just hasn't gained full efficiency yet. Are you really confident that this, in fact, isn't what's going on?
As for the tears, all but those with hearts of stone who read the account of the 33-year-old-mother dead within two days from this flu likely shed more than a few tears.
Nancy: According to the Australians, this is mainly H3N2 and seems to be the same strain as in the vaccine for the year. This is a reminder that "ordinary" flu can be a deadly disease. There were some seasonal flu years (I wrote about 1951 on the old site) that were worse than pandemic years in terms of mortality. So what is going on is that even for seasonal flu we don't know what's going on.
As regards the 33 year old mother, yes, that is this afternoon's post. It is a heartrending account, I agree, and wanted to use it to remind us all these statistics are real people.
The flu is mostly H3 with some H1.
The link has much more.
they _could_ show us the sequences by now,
if they _wanted_ to. Right ?
There is a dedicated discussion on the Australian flu outbreak on Flu Wiki here. Check out especially the chart of notifications, updated today. The latest figures are already 3 times last season's peak.
"According to the Australians, this is mainly H3N2 and seems to be the same strain as in the vaccine for the year."
What excuse are they using this time?
Tom, this isn't proof for your pet theory that vaccines don't work. A more rigorous look is warranted, and it'll be after the season when it happens.
Tom: to know if they need to an excuse, first we need to know the vaccination rates in Australia, if there were any reports of vaccinated people (who'd had time to respond to the vaccine) being hospitalized with the flu, and particularly if any of the children who died had been vaccinated.
My guesses are "not most", "not many, if any," and "no."
The only other reason they'd need an excuse would be to explain why more people weren't vaccinated. Assuming there was sufficient vaccine for those who wanted it and that it's promoted to high-risk groups, they don't need an excuse there either.
Thanks caia.
Dem. It really isn't a "pet theory"
......my 'pet' theory is that environmental conditions including sunspots and global warming are driving the unbelievable mutation rates of the last decade in both animal and human viruses-bacteria...including now Dengue in humans and supposedly PRSV in pigs in China...
...as well as driving the emergence of exotic diseases such as Nipah etc....
...and that there appears to be circumstancial evidence of abnormal weather patterns before each of the significant pandemics (1918-1890-1830)also associated with concurrent breakouts of other diseases including dengue...
...therefore, in my opinion, a pandemic worse than 1918 is imminent although I am not quite sure what imminent is in nature's time...
...and I don't like the fact that our collective future and all of our financial resources are being spent on two unproven technologies...primitive antivirals and primitive vaccines...
There is no conclusive scientific proof that they work and many 'field' indications that they won't...ever.
I wonder what the excuse is going to during the pandemic.
Tom, I agree that expecting that 'we're done' simply because money is invested in antivirals is risky thinking, and non-pharmacaeutical planning and public health generally would benefit from some of that money. However, research dollars are dollars well spent, and antivirals can help even without being 'the answer'.
Back to vaccines, though. Note an issue with dosing in Australia:
This is why both data collection and research are relevant before jumping to conclusions about vaccine efficacy, particularly in children.
Thanks Dem.
The antivirals will be useless...but a vaccine might just work...with the emphasis on might!!
This is THE great scientific unknown at the moment, in my opinion...that and why cancer research has failed despite an absolutely huge financial investment over many decades.
...anyway, I wish they would just get on with it and prove it one way or another...
...and I wish they would stock proven technologies that do work at the same time.
If one child or pregnant mother in this pandemic dies from secondary bacterial pneumonia because of lack of avaliable antibiotics and at least phone or internet medical advice...it will be a disgrace for us all.
...that should have read...If one child or pregnant mother in this pandemic dies from a lack of antibiotics, anti-fever medication, anti-shock medication and oral electrolytes etc...and at least back-up phone and/or internet medical advice...
...then it will be a disgrace and we will all own a share of the collective guilt.
1. Vaccination rates for flu are pretty low in Australia. A lot of the additional load on the hospitals has been parents and other finally deciding that they should get the vaccine, but doctors' and local pharmacies are running out of immediate stocks.
2. The recent change to children's vaccinations should not effect efficacy. They're upping the dose because the smaller - but fully effective - dose was too much of a pain in the arse to measure correctly with standard syringes. It's more about consistency than effectiveness.
Kavak Yelleri