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View Diary: Bird Flu Stories: Next Steps (63 comments)

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  •  Prepare For Worst, Hope for Best (none)
    I have been one of those urging caution.  For about 2 weeks I became totally obsessed with bird flu beyond a rational point.  I started thinking the future of the world is in the balance and chaos is on the verge of erupting.

    Then I spoke with my girlfriend, a med student here in Cornell Hospital in NYC - and one of the leading centers for infectious disease.  She has been making it a point to speak with as many leading experts as possible in order to calm my panicked ass down.  She succeeded.

    Bird flu is real, the threat is real, and the damage it can do is real.  But most of us are going to be just fine.  

    Don't forget, the number one reason so many died in 1918 was that the flu led to pneumonia, and good treatments for pneumonia were hard to come by.  That is NOT the case today.

    The vast, vast majority of us will be fine.  The most realistic dangers are as follows:

    1. The old and infirmed are most at risk.

    2. The health care system can be overburdened by those not at risk and running to the ER for every sniffle and cough, preventing treatment from getting to the most needy.

    3. Underdeveloped countries with poor healthcare will certainly be at risk (you're fooling yourself if you think some of those who have died already in Indonesia, et al, might not have lived had they had access to better healthcare).   So you can add flu to malaria, AIDS, and the other diseases decimating Africa and the developing world.  

    and finally:

    4) The economy.  Many Asian countries lost 2% of their GDP because of SARS (certainly an overreaction).  The economic impact could be a major problem.  

    But a little anecdote: Cathay Pacific, the airlines based in Hong Kong, lost over 50% of its traffic as a result of SARS.  FIFTY PERCENT!!  After a few months its very existence was in doubt.  A couple years later it is now one of the most profitable and popular airlines in the world.  Recovery will happen.  

    Plan for this thing, but don't panic.

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    by dansac on Sun Oct 23, 2005 at 07:49:53 AM PDT

    •  good points, all (4.00)
      Don't forget, the number one reason so many died in 1918 was that the flu led to pneumonia, and good treatments for pneumonia were hard to come by.  That is NOT the case today.

      but that part's wrong. what led to so many deaths was the ARDS that developed from cytokine storm in the 20-29 year olds. That was quite different than years prior, when the same era deaths were the usual kids and oldsters.

      Our ability to handle ARDS is only minimally better now than in 1918. We have a 35% mortality rate in the best hands. And the ICUs would, of course, be swamped. Caring for ARDS without an ICU would lead to 1918-proportional mortality.

      See also discussion here.

      Don't panic. But don't underestimate the problem, either.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Oct 23, 2005 at 08:38:55 AM PDT

      [ Parent ]

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