Saturday, September 16, 2006

Swine Flu?

This is a great article by Dr. Martenson on the recent swine flu 'epidemic'. While he normally focuses on current economic issues - he couldn't help but notice all of the media attention over the past few months regarding the swine flu virus (who hasn't?). As usual - he applies some basic math and logic to what we're being told - and as usual - things don't quite add up. There is some very important information in this article regarding vaccinations, drug companies, legislation (granting immunity to makers of swine flu vaccinations) and the swine flu - so I encourage you to read this entire article when you have time.

In case you were wondering - Dr. Martenson received a PhD in neurotoxicology from Duke University before receiving an MBA and entering the business world - so he has extensive training as a Scientist - and knows good science from bad.


In Session - Swine Flu?

This is an "off topic" post and you should feel free to skip it if your inclination is towards financial and economic content. I am going to connect a few dots and then engage in some idle speculation.
My job is to stretch out there and look for information and my particular skill involves connecting dots. Sometimes what catches my eye is the presence of news, sometimes it is the absence of news where there ought to be more, and the rest of the time it is a string of news items that simple don't make sense when they are all put in one spot.

I am seeing a strange pattern that, as a past scientist, does not make sense to me and it concerns Swine flu. There are simply too many articles now that don't surmount the even lowest hurdles of math and logic.

It begins with an article trumpeted on the front page of my local newspaper a week ago and which caught my eye both for its strident, fear-mongering tone and glaring lack of math skills (emphasis mine):

Swine flu could hit up to 40 percent in US

ATLANTA (AP) - In a disturbing new projection, health officials say up to 40 percent of Americans could get swine flu this year and next and several hundred thousand could die without a successful vaccine campaign and other measures.

The estimates by the Centers for Disease Control and Prevention are roughly twice the number of those who catch flu in a normal season and add greater weight to hurried efforts to get a new vaccine ready for the fall flu season.

Swine flu has already hit the United States harder than any other nation, but it has struck something of a glancing blow that's more surprising than devastating. The virus has killed about 300 Americans and experts believe it has sickened more than 1 million, comparable to a seasonal flu with the weird ability to keep spreading in the summer.

The math: (300/1,000,000) = 0.03%.

Let's run this against the US population.

0.03% (*) 305,000,000 = 91,500.

So even if the entire US population came down with the Swine Flu we would expect the maximum number of fatalities to come to 91,500 not "several hundred thousand."

And if only 40% got infected, as the article states as an upper limit, then we would expect a maximum of 36,600 deaths not "several hundred thousand." In other words, this article flunks basic math by a wide margin.

This is simple math.

Whenever the MSM gets the math this wrong, I sit up and take notice. Sometimes it is a careless oversight, hey they happen, but more often than not it means that an agenda is being pushed. Our job is to decipher what that agenda might be. Fuzzy Numbers always get my attention these days.

In the "hundreds"

So far swine flu ranks as a "mild" or "moderate" flu. In other words, about the same as what we experience every year.

"The real issue with any infectious disease is how it's spreading, not how it looks in the laboratory," said Marc Siegel, a national flu expert and author of the book "Bird Flu: Everything You Need to Know About the Next Pandemic."

Siegel said 0.2% of swine flu cases are resulting in death, a mortality rate that suggests the virus is of mild to moderate virulence. In fact, Siegel said the mortality rate is probably even lower since most swine flu deaths are being reported, but many nonfatal cases are likely going unreported.

"I think there's a few million cases and the deaths are still in the hundreds," Siegel said.
Even here we might note that "deaths in the hundreds" and cases in the "millions" will yield a mortality rate in the hundredth of a percent range not the tenth of a percent range. In the UK, however, officials have estimated the mortality at 0.5%, or some 16 times higher than 0.03% indicted in our math above, but still not especially deadly in the range of viruses we encounter each year as a normal part of the flu seasons.

How can we account for the difference between 0.03% and 0.2% or 0.5%? Easy, the method of counting that results in those higher estimates is so flawed that you would flunk the high school student who proposed it as a solution on a basic statistics exam.

Swine flu death rate estimates 'flawed'

At present, the estimate of the death rate in the UK and the US is 0.5 per cent, meaning that about five people die for every 1000 people infected. Accurate estimates are needed so that health authorities can best target treatment and vaccination strategies.

But a new analysis suggests three main reasons why current estimates may be wide of the mark.
The first and main source of uncertainty is the unknown number of infected people, who recover at home without notifying their doctors that they are ill, or receiving a diagnosis.

So although doctors know how many patients are dying of swine flu in hospitals, they don't know what proportion of all cases are life threatening.

But they need both figures to work out the "case-fatality ratio" – calculated by dividing the number of fatal cases by the total number of cases.

"We don't know the denominator," says Azra Ghani, head of a team at Imperial College London tracking development of the epidemic in the UK.

I can use stronger words than the title of the above article. The estimates are not "flawed" they are "certainly wrong, and way too high."

One simply cannot just count the number of fatalities at the hospital and divide it by the number of people that presented themselves to the hospital. Not by a long shot. The vast majority of people simply do not ever present themselves. Obviously.

It would be the same as taking the total number of people that present at the hospital with bee stings and dividing this into the number of them that die there and then stating that "the bee sting fatality rate is really high!!" Of course this would be wrong because most people do not even present at the hospital when stung by bees. The same is true for flu patients. Obviously.
But of course epidemiologists know this leaving me scratching my head as to why the higher numbers were ever reported in the first place. It is simply bizarre.

To summarize up to this point, we have a mild to moderate flu strain that has already infected millions but only killed a few hundred but a press that is actively promoting death rates well beyond official estimates of mortality which are themselves skewed badly to the high side. Something is not adding up here.

Given an apparent lack of any rational basis for fear we nonetheless find that governments across the world have already moved to grant Swine Flu vaccine makers blanket immunity from any possible future lawsuits in their rush to get untested vaccines into rapid use. For good measure, they granted themselves immunity too.

Swine flu vaccine makers get immunity from liability

July 17, 2009

Vaccine makers and federal officials will be immune from lawsuits that result from any new swine flu vaccine, under a document signed by Secretary of Health and Human Services Kathleen Sebelius, government health officials said Friday.

Immunity from side effects of untested vaccines was granted because there is a huge rush to get vaccines out prior to the conduct of any safety or efficacy trials. Again, this seems unusual to me given the relatively low mortality associated with Swine Flu.

And this rush to market is true not just in the US, but all over Europe as well. Everything else is being set aside, including normal immunization programs in favor of untested vaccines. One difference is that in the UK the liability was transferred to the government itself.

Drug firms dodge swine flu liability

THE UK government has been forced to accept legal liability for the swine flu vaccine amid concerns it could trigger life-threatening side-effects among the population at large.

Ministers have taken on all the risk for the 60 million doses they have ordered from GlaxoSmithKline and the Baxter group, after both firms said they would refuse to produce it unless legally protected.

In a separate development, the scale of the mass vaccination programme in Scotland has brought a warning that other routine immunisation programmes might have to be delayed.

The head of the NHS in Scotland has told health boards that the delivery of the vaccine to the country's five million residents will be a challenge "unprecedented in scale and in scope".

So here's where we have to ask ourselves, what's going on? Given the state of official budgets all over the world, why this sudden rush to treat a flu strain that is apparently of only mildly greater concern than normal? Unprecedented in scale and scope? I find it hard to imagine that a flu strain with a fraction of a percent mortality rate has conjured such fear amongst the leadership.

I think it is fairly safe to speculate that there's something here about Swine Flu that is not being said to the general public. The possibilities might include:

1. There's concern that the strain could/will mutate into something far more lethal in the near future (in which case the vaccine for the less lethal strain may or may not work).

2. This isn't really about flu at all.

My ears were first pricked up about something fishy going on with the whole virus/vaccine thing back in February with this explosive but remarkably suppressed news item that first came out in a major Canadian newspaper before inexplicably disappearing from nearly everywhere except blogs.

Baxter: Product contained live bird flu virus

The company that released contaminated flu virus material from a plant in Austria confirmed Friday that the experimental product contained live H5N1 avian flu viruses.

And an official of the World Health Organization’s European operation said the body is closely monitoring the investigation into the events that took place at Baxter International’s research facility in Orth-Donau, Austria.

“At this juncture we are confident in saying that public health and occupational risk is minimal at present,” medical officer Roberta Andraghetti said from Copenhagen, Denmark.

“But what remains unanswered are the circumstances surrounding the incident in the Baxter facility in Orth-Donau.”

The contaminated product, a mix of H3N2 seasonal flu viruses and unlabelled H5N1 viruses, was supplied to an Austrian research company. The Austrian firm, Avir Green Hills Biotechnology, then sent portions of it to sub-contractors in the Czech Republic, Slovenia and Germany.

There are two reasons this struck me as explosive at the time:

1. Baxter released a mix of seasonal and live flu viruses. This is the perfect recipe for creating the conditions for accidental recombinations in a live host that could result in the much deadlier bird flu attaining the much more transmissible characteristics of the common seasonal flu virus. Why were they combined at all? Even if inactivated, why do this? Under no circumstances should they have been combined. What is the explanation for their mixture? What was supposed to be shipped instead and how is it possible that something so horribly different occurred?

2. Accidentally releasing live virus, either in combination or individually, from a Level III
biofacility is a completely unlikely event. The number of safeguards are enormous. The chance of bypassing all of these by accident is simply unthinkably remote.

Taken together, there's just something highly improbable about both the fact that this incident happened at all and then the nearly complete silence surrounding it afterwards. I am sure it was embarrassing on many levels but the fact that it was nearly completely hidden from public view is somewhat troubling and I think it would have been better to treat it openly.

Further, I think that in a normal world Baxter should have been immediately overrun with government agents seeking to understand how such a serious lapse could have happened and immediately lost their license to operate until a formal inquiry elucidated exactly what transpired. To my knowledge absolutely nothing happened even though this was the equivalent of a nuclear power plant purifying some plutonium and then accidentally shipping it to Pakistan.

Instead we learn Baxter is eagerly anticipating a banner year for their Swine Flu vaccine business.

July 16 (Bloomberg) -- Demand is so great for swine flu vaccines that some manufacturers are rejecting orders and will be able to sell as much as they produce, said Robert Parkinson Jr., chief executive officer of Baxter International Inc.

Baxter, based in Deerfield, Illinois, has contracts with five countries for 80 million doses and has stopped taking new orders that it may not be able to fill, Parkinson said today in a call with investors. The swine flu pandemic will be a boon to the company this year and mutations in H1N1 and other strains may create a lasting new business for the company, he said.

While we can all be glad that the company that accidentally releases contaminated live virus strains is going to make a pile of money off of flu vaccines especially if mutations and recombinations occur (that's sarcasm, by the way), I am going to be dead last in line to receive an untested vaccine from a company with a track record that includes accidentally shipping live bird flu virus (that wasn't sarcasm). I have zero faith in their motives or methods and since there's been absolutely no public accounting for this lapse that I can find, I find it quite difficult to place my trust in Baxter.

If there was a good reason for what happened, I would really like to hear it. Seriously. I think being able to trust your drug company is kind of important.

Finally, here's one final bit of news that came out today (7/29/09) that left me really scratching my head.

Military planning for possible H1N1 outbreak

WASHINGTON (CNN) -- The U.S. military wants to establish regional teams of military personnel to assist civilian authorities in the event of a significant outbreak of the H1N1 virus this fall, according to Defense Department officials.

The proposal is awaiting final approval from Defense Secretary Robert Gates.

The officials would not be identified because the proposal from U.S. Northern Command's Gen. Victor Renuart has not been approved by the secretary.

The plan calls for military task forces to work in conjunction with the Federal Emergency Management Agency. There is no final decision on how the military effort would be manned, but one source said it would likely include personnel from all branches of the military.

It has yet to be determined how many troops would be needed and whether they would come from the active duty or the National Guard and Reserve forces.

Civilian authorities would lead any relief efforts in the event of a major outbreak, the official said. The military, as they would for a natural disaster or other significant emergency situation, could provide support and fulfill any tasks that civilian authorities could not, such as air transport or testing of large numbers of viral samples from infected patients.

As a first step, Gates is being asked to sign a so-called "execution order" that would authorize the military to begin to conduct the detailed planning to execute the proposed plan.

While I am all for using the resources of this country to ease a crisis, I am more than a bit confused by this plan. There's nothing (yet) in the data to suggest that a Swine Flu outbreak is going to be anything other than an ordinary sort of event this fall.

The proposal is said to come from a General Victor Renuart which struck me as odd because he is the head of NORAD. From his bio:

General Victor E. Renuart, Jr. is the Commander of the North American Aerospace Defense Command and United States Northern Command, headquartered at Peterson Air Force Base, Colo.

What does NORAD have to do with developing proposals to provide ground assistance to FEMA? Last time I checked NORAD was in charge of Air Defense. I would think that a branch of the military that was more attuned with logistical aspects of things would have been a better fit.

Perhaps one of the Army logistics and support battalions that have been managing to supply the several divisions halfway around the world in Iraq would have been a good choice.

Reading along a bit further, the picture clarifies a bit:

In 2006 he was selected as the Senior Military Assistant to the Secretary of Defense, Washington, D.C.

This indicates that rather than a proposal landing on Gate's desk for him to respond to, as the article suggests, there's a good chance that the task of developing such a proposal was delegated from Gates to General Renuart and that Gates now has that proposal.

So the question becomes, why is the Defense Department anxious to spend time preparing for Swine Flu at this time? What do they know that I don't know?

One piece for me is to speculate that perhaps this has nothing to do with Swine Flu. Perhaps this merely provides the opportunity to cement a working relationship with and between FEMA and the military for other purposes.

Perhaps the article, if written more truthfully, would read like this (note: I made these up obviously):

Military planning for possible economic collapse

WASHINGTON (CNN) -- The U.S. military wants to establish regional teams of military personnel to assist civilian authorities in the event of a significant collapse in the economy this fall, according to Defense Department officials.

Or perhaps this:

Military planning for feared Swine Flu mutation

WASHINGTON (CNN) -- The U.S. military wants to establish regional teams of military personnel to assist civilian authorities in the event of a significant shift in lethality of the current strain of Swine Flu if only two more base pair shifts happen in its capsule code, according to Defense Department officials.

Who knows?

All I know is that the current hyperbole coming out of the press plus the official reactions to Swine Flu are out of alignment with the currently reported lethality of the Swine Flu. Something is not adding up here.

Personally? I will not be first in line to get a vaccine for Swine Flu this year. I think I'll hang back and watch for a while.

In the meantime, there's something off about this story and I wish I knew what was going on behind the scenes.

But if it turns out that Swine Flu presents a more serious threat than they are letting on, then you should prepare for that. And if it turns out that Swine Flu is going to be used as an excuse for some other activity, then basic readiness is called for there as well.

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