Sentences to ponder

by on April 27, 2009 at 7:11 am in History, Medicine | Permalink

Cities that instituted quarantine, school closings, bans on public
gatherings and other such procedures early in the epidemic had peak
death rates 30 percent to 50 percent lower than those that did not.

That is from a study of the pandemic of 1918-1919 and here is more, from 2007.  The best place to follow what is going on in Mexico — where such restrictions are now common — is ElUniversal.  People in Mexico are dying of the flu every day; what is the chance that only the benign version of the virus crosses the border?

Andrew April 27, 2009 at 7:40 am

Probably as likely as only benign Mexicans crossing the border.

Candadai Tirumalai April 27, 2009 at 10:09 am

In the 1918-19 influenza epidemic younger
people (those in their 20s and 30s) proved
particularly vulnerable, apparently because
their vigorous immune systems went into
overdrive, causing problems. That pattern
seems to apply so far to this outbreak.

athelas April 27, 2009 at 11:26 am

Here is the study on which the article was based: http://jama.ama-assn.org/cgi/content/abstract/298/6/644

The Science in Society blog has posted a response to recent news, putting it in perspective with previous flu pandemics.

From a presentation I recently did on the topic:
Western world suffered least; urbanization exposed people to previous influenza viruses
Medical intervention of dubious value
Only in 1943 was influenza recognized as a viral disease

Quarantines, isolation, close churches and schools
Measures should be early and sustained.
St. Louis closed schools and canceled public gatherings early, maintained >10 weeks
New York isolated sick in hospitals or makeshift wards, quarantined homes, >10 weeks
But median only 4 weeks

JohnMcG April 27, 2009 at 1:13 pm

Well, isn’t there a selection bias here?

We tend to remember cases where intervention prevented a disaster, or that lack of intervention made it worse, but we don’t remember when unnecessary intervention cost us big, or was foregone saving a lot of money and resources.

I don’t know enough about the swine flu to know if such measures are prudent, but if they are taken, I certainly hope it is is on the basis of more than this single data point.

Rachel April 27, 2009 at 1:44 pm

I’m not sure that study means anything. What were total death rates? I could easily see an intervention that slightly lowered transmission rates, and so peak death rates were lower. But in the end, everybody who was vulnerable still caught the flu and total death rates were identical.

Gordon Mohr April 27, 2009 at 3:18 pm

what is the chance that only the benign version of the virus crosses the border?

Giant assumption not in evidence there: that there are two distinct versions of the current virus, and one is benign.

What I’ve read is that the virus in the confirmed US cases is identical to the one in Mexico, suggesting something other than the viral strain itself accounts for the excess Mexico deaths (if those are not some statistical mirage from misattribution).

Diet? Air quality? Waterborne parasites? Coincident infection by other agents? Drug interactions?

brian April 28, 2009 at 12:20 pm

‘Humans do not naturally extrapolate geometrically, I think.’ This one made me laugh, but it is extremely true and speaks to others points.

The difference between a few hundred deaths and a few million deaths from a virus that spreads geometrically is only a handful of additional iterations. Geometric expansion quickly explodes in a way people do not intuitively appreciate, which is why viral pandemics are so dangerous, they could be no big deal or huge worldwide problems and the difference between the two could be very small…

As to the 150 deaths in Mexico vs. none in the rest of the world it is also possible that the mortality rate of the new virus is much less then the official infected vs dead in Mexico stats relate. I suspect that the official people infected numbers in Mexico is vastly under reported, probably not even intentionally, which would make the mortality rate appear higher and raises the questions about why so few deaths elsewhere in the world. If is is under reported to a large degree then our experience may be mimic Mexico.

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Die US-Notenbank weckt Hoffnung auf ein Ende der schwersten Rezession seit Jahrzehnten. Den Leitzins aber lässt sie unverändert.

Die US-Notenbank weckt Hoffnungen auf Licht am Ende des düsteren Konjunkturtunnels. Zwar sei die größte Volkswirtschaft der Welt in den vergangenen Wochen weiter geschrumpft, doch habe sich das Tempo scheinbar verlangsamt, teilte die Federal Reserve (Fed) am Mittwoch mit.

Ein Hoffnungsschimmer auch an der amerikanischen Verbraucherfront: Zwar drückten Arbeitslosigkeit, gesunkener Wohlstand und schwierige Kreditbedingungen weiterhin auf die Kauflaune. Doch gebe es bei den Verbraucherausgaben “Zeichen der Stabilisierung”, hieß es von der Fed nach der turnusgemäßen Sitzung ihres Offenmarktausschusses.

Die Fed sei zuversichtlich, dass die Maßnahmen zur Stützung des Finanzsektors Wirkung zeigten und dazu beitragen, dass sich “schrittweise” wieder Wachstum einstelle. Inflationsrisiken sieht die US-Notenbank zunächst nicht am Horizont – im Gegenteil. Der Preisauftrieb könne sogar “für einige Zeit” unterhalb der Rate bleiben, die gut für das Wirtschaftswachstum seien.

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