Avian flu has been attracting blogosphere attention for much of the last year, including from Glenn Reynolds and Andrew Sullivan. I have had a hand in starting an avian flu blog. Recently I have finished work on a 40 pp. piece on what we should do about avian flu, here is the pdf link. Here is the Executive Summary. My core approach is to rely on decentralization and incentives. I am skeptical of quarantine or use of the army. Well-functioning, decentralized health systems will likely save the most lives. Stockpiling Tamiflu or vaccines is often overrated in potential effectiveness. We also should, when needed, purchase the relevant intellectual property rights for a fair price rather than simply confiscating those rights. We should ease liability for vacciner makers and institute prizes for good vaccines. Better-developed prediction markets would be useful for charting the progress of the flu. Your comments, of course, are welcome, either below or email me.
Related Posts (on one page):
- Avian Flu:
- What should we do about avian flu?
Nor is it fair to say (as you didn't, but media reports have been saying for months) that we are "due" for a pandemic based on the time since the last major flu outbreak -- this is the gambler's fallacy, if you've rolled the dice 35 times and and not gotten "snake-eyes," your odds of getting snake-eyes on the next roll are still: 1/35.
I personally doubt there's enough data in say the 1000 years or so of useful history to make any claims about whether we're "due" for a pandemic or not.
1. The H5N1 virus has a mortality rate of approximately 50% in the human cases where it was contracted via direct contact with birds. That's roughly 2x as deadly as the 1918 Flu that killed more than 40 Million. (Src: Scientific American - Last Month)
2. The H5N1 virus is about 100x as transmissible (among susceptible mammals) as the 1918 Flu. Recent studies have shown that while it takes an initial infection of 1000 1918 viruses to kill a mouse, it only takes an initial infection of 10-15 H5N1 viruses to start a lethal infection. (Src: Science News, Week of Nov 1)
Yes the virus is not current transmissible between humans, but there is nothing to indicate that if or when it acquires the genes required for human transmission, either of these factors will be reduced. In my book that's more than enough reason to be concerned.
As for the other points: It’s not a matter of odds, it’s a matter of frequency. The historical record shows that for as long as humans have tracked such things, a flu pandemic has occurred every 30-35 years. By that measure, we are due as the last one was in 1968.
Are there any examples of anyone saying we should only prepare for the current strain of the virus? Tyler Cowen's paper doesn't.
is 1/36... not 1/35...
Quarantine, of course, is one of the most effective methods of stopping any transmission of infectious disease. I think, however, that it's been well demonstrated that we no longer have the capability of restricting a population to a defined region (or out of one). Don't think for two seconds, however, that it won't be tried. I think we've all seen enough Hollywood to envision the stereotypical containment (example: Outbreak starring Dustin Hoffman, Dreamcatcher starring Morgan Freeman). If only things would be that easy. I'm predicting (thanks to the irrational overreporting by the Mainstread Media) that quarantines will be imposed in more of an anarchy model... During the recent SARS epidemic, a coworker of mine was quite vocal about his collection of 30 firearms, and quite insistant that if SARS got close to home, that he expected us to join him at the entrance to town in an armed posse to keep folks out of our small town... As extreme as that sounds, isn't that what happened in New Orleans on a bridge leading out of the city?
I am no mathematician, statistician or even logician (other than in some of my legal arguments), but this one is not too difficult for me:
There are four options for gender combinations in a two-child family:
Girl/Girl
Girl/Boy
Boy/Girl
Boy/Boy
The first option is out since we know one of the children is a boy. So that leaves a one in three chance that both children are boys.
If we knew that the first child was a boy or that the second child was a boy, two of the possibilities would be out and the odds of the other child being a boy would be only one in two.
H5N1 was first found in 1959, in Scotland. In the 46 years since, it has not developed human to human transmission.
The historical record shows three influenza pandemics, all within the last 87 years. I have lived through two of them without effect. Most of the "experts" talking about influenza pandemics are speaking with far more certainty than knowledge.
Extensive blogging found here.
More seriously, I suspect that the deadliness of avian flu is overstated as they're not testing everyone under the sun, only those who turn up sick enough to see a doctor. They'll thus miss folks who are unaffected or mildly affected and yet did catch the virus from a bird. Not saying it's not plenty deadly, just probably not quite so bad as it might look.
Yes, the gamblers fallacy is a fallacy because dice have no memory.
Human immune systems, however, do indeed have a memory, especially WRT viruses. That memory is about seventy years long, the lifetime of a human, and it may well be that we get a pandemic whenever more than half of the humans now alive were never exposed to the previous one.
-dk
there's no "of course." the efficacy of quarantine to stop further transmission of an infectious disease is dependent on a number of factors, including but not limited to:
* the infectivity/transmission rate of the disease
* the mode of transmission of the disease
* when in the epidemic curve the outbreak is discovered
in today's world (US, anyway), i tend to think that quarantine would be more likely to be met with anger and resistance than compliance.
I'm a firm believer in corner-loading one's Fulhams, but it would take a really subtle offset to produce this small a shif in the odds. Probably never get caught, tho.