outbreak! (ebola, sars, coronavirus, etc)

The Tufecki article suggests many interesting actions that could be taken, but as I suspected almost all of them rely on truly massive expenditures of money and effort, the creation of entirely capacities that do not exist yet and the expansion of some existing capacities by many orders of magnitude.

This is precisely how an expert scientist would think about the problem and it's an accurate reflection of the scale of global commitment that would be required to most effectively address the prevention of an avian flu pandemic and to minimize its global impact if prevention efforts fail. It is also an accurate reflection of the narrow limitations of expert scientists when it comes to their specialty.

I agree that if all those suggested actions were taken then society would become as protected against an avian flu pandemic as human ingenuity could devise. And all those measures taken in concert still could fail drastically because attempting to control events on a global scale is almost impossibly complex. Or events could simply deliver an outcome where no pandemic happened regardless of our actions. Chance occurrences are outside the province of scientists. They will simply acknowledge them and then have nothing more useful they can say about them.

From that list it seems sensible and possible to shut down mink farming entirely and to expand vaccination and testing efforts among poultry workers. Also, working on an mRNA vaccine should be fully funded. I can't see any of the other actions happening at the scale suggested. But the very scale of those suggested actions are a good indicator of the near-futility of halting a novel and easily communicable pathogen from creating a global pandemic.

are you basing that take off the covid-19 pandemic, which by many measures did have a blunted impact due to mitigation efforts despite being eventually ubiquitous, leaving you skeptical, or the numerous other diseases that threatened to reach pandemic status that we successfully mitigated by taking steps similar to those outlined in the article?

I don't understand this "well, we really failed to contain this recent pandemic, I guess the system can't work" when it has worked numerous times in the past. It's akin to all the people saying, hey, this y2k thing was a whole lot of nothing! The computers kept working fine, when it was the work of millions of people updating and testing computers that ended in that result.

"the near-futility of halting a novel and easily communicable pathogen from creating a global pandemic" is blowing my mind, as if humanity hasn't done this a number of times, or successfully adapted so that contagions that *did* cause pandemics no longer do so

bird flu wouldn't be as easy to spread as COVID, and its IFR would be much higher than COVID (meaning many more deaths) - so there are most definitely things that can be done that don't include shutting down society to curb this. development of vaccine/utilization of existing vaccines also a much different scenario than COVID-19.

and let's be real, the US didn't even really try to fight COVID-19 at all, not even the first year.

like...these things may not require you and I to do anything yet, but our medical and science infrastructure could and should take action.

...there were relatively effective vaccines by the end of 2020, the ability to isolate/test was patchy at best and not equitably distributed across the populace, but large swaths of society were part of a partial shutdown

there's a pretty huge difference between "we could have done it a lot better" and "didn't even really try to fight COVID-19 at all"

as if humanity hasn't done this a number of times

The measures that, for example, halted SARS and MERS resulted from public health officials using well-known methods and pre-existing powers, such as quarantine, rigorous barriers between the infected and caregivers, and rapid communication of findings among public health officials. If those measures can be counted upon to halt pandemics, then we can discount most of the actions Tufecki mentions as unnecessary.

contagions that *did* cause pandemics no longer do so

Those aren't novel pathogens.

I should clarify that I'm mostly talking about the United States (though there were many other countries who did equally poorly). the partial shutdown was ended way too early (just one month) for just about every state, and not every state restricted things as strictly. few if any met the measures the White House put in place for re-opening, so the premature re-open caused the second wave/surge.

And the reason that testing was patchy was because the CDC refused the existing COVID test kits and decided to create its own and they turned out to not work, which caused us to lose a lot of ground in testing/isolation. This would not have solved the problem outright, as it still would have been a major challenge, but it would have lead to catching clusters faster in some areas and probably slowed the growth a little.

Trump's government pushed a narrative of 'freedom' and opening America up, and mask usage began fading significantly by 2021.

I agree the vaccines were pretty much a miracle. However, my point is, using COVID as an example to suggest that fighting avian flu is futile (which I know you're not doing - i'm speaking broadly to the thread) is flawed because we didn't do a very thorough job trying to fight COVID as a country in the first place. and yes, it will take more than America to prepare/take action for avian flu, but we have to step way the fuck up this time.

Globally speaking, there is plenty that can be done and needs to be. this won't spread like COVID will, but as I said upthread, epidemiologists are quick to say the IFR as it is right now is misleading because of the small number of cases, but even though it will certainly not be 56%, it could be 4% or higher, which means many dead people. so we have duty to do something even if right now that 'we' doesn't include you and I directly.

(and of course right now, whether this will actually be a thing, human to human transmission, remains to be seen. it may be a non-event, but part of that is taking these actions to ensure it is a non-event.)

xxp Well, I can't argue if the specific criteria is a novel pathogen that spreads from livestock to humans. If it's the culling of animals and specific testing of animals alone, you can look at BSE. If it's the transmission from human to human, you can bring up SARS (2002) or ebola. If you need validation that the things mentioned are not all possible in concert in order to build up a precautionary framework, then sure, act like it's all impossible.

Livestock testing and culls aren't a new thing, but the latter is done more often as an economic safeguard than a human health safeguard.

helpful response to Zeynep's article, which supports it, but highlights a perhaps missed area of it regarding potential death toll if this became a human-human pandemic (it'd be bad, likely, like, very bad, but not extinction level)

But we don’t think this is a Last of Us or Contagion movie mortality rate for humans. I’ve already seen tweets that it will cause “billions of people to die”, which isn’t correct.

If this thing jumps, communicating this nuance is going to be very important.

— Katelyn Jetelina (@dr_kkjetelina) February 3, 2023

btw thank you to whomever turned me onto her substack, I read it all the time now

the one annoying bit is the prevailing statement that mink to mink transmission definitely occurred. this is not known, this is speculated based on what was observed, but a lot more testing is needed. that doesn't make Zeynep's article premature though. problem is readers don't really understand nuance, like everybody talks about the Y2K 'hoax' but don't realize that a lot of why it was such a non-event was all of the work that went into Y2K preparation.

more and more people are saying this

It's almost as if she thinks that information that has appeared in a NYT article isn't already sufficiently known to public health officials, and the best way to inform them is to issue a public call to action on her Twitter account. Glad to know she's on the job!

― more difficult than I look (Aimless), Saturday, February 4, 2023 10:49 AM (three days ago)

I don't have a subscription to the NYT and so I don't click on links to the NYT that will just take me to a paywall. If you'd care to name one or two of them I'd be happy to find out what they are.

― more difficult than I look (Aimless), Tuesday, February 7, 2023 4:09 AM (seven hours ago)

I’m not sure what stance was eventually rested on but I’m assured it was correct. The search party to find the goalposts is missing in action.

lol

So how are things looking for y'all?

No new cases reported here among friends and families since late November.

Tons of people I know have had it in the past month— probably around 12 or so.

Calmish for now. Happily masking away still.

I still mask in class, public transportation, libraries, movies, and shopping, but I've resumed indoor dining at lunch if it's not crowded. No complaints about masking.

Some of my friends from NY had it in November. One just came to visit me but had to leave early because his older sister in Kentucky with covid died in her sleep last week and he had to go to her funeral

My trainer friend and his wife got it in El Paso shortly after the New Year. It was not serious thankfully

Hanging with a friend that has never had it. She's part of a study.

Daughter's had Long COVID since September, life sucks

Ugh, so sorry.

sorry to hear

oh my god that's terrible

Long COVID is def becoming one of the scariest things about getting it.

lots of people i know recovering from December/January infections but treating it like a bad flu and mostly frustrated by random issues with smell, taste, endurance

Thank you, all. What alarms us is what happens after infections 2, 3, 4 etc— will it be worse each time?

I'm so sorry.

Covid has definitely fucked with my heart, hopefully not to a very dangerous degree, but I don't really know. I also find myself worrying about the next infection.

Sorry to hear that James, that's rough.

Bit of an uptick lately of cases for folks in my orbit, but so far seems to all be people who've avoided it so far. Lots of the cases seem to be that the one person in the household that avoided it when the rest of the family got it last year are now getting it.

echoing the above, very sorry to hear, James. :(

in regards to people I know, it's weird as I have had a few more friends report the VID in the last week, but wastewater in both of the counties I spend most of my time in are continuing to decline, though not as fast as before. possibly more of a 'plateau'. positivity rate in FL has been steadily decreasing for weeks, albeit not plummeting.

XBB.1.5 finally became the main variant in FL so we'll see how that impacts things.

stay strong folks

Yeah, awful news.

Meantime around here -- so patients at my hospital were down in single digits as mentioned even last week. Today? 16. Honestly think this will just keep oscillating forever.

still have yet to reach endemicity

An incredibly sobering long COVID piece. Most of them have been but this really underscores it.

https://www.scientificamerican.com/article/long-covid-now-looks-like-a-neurological-disease-helping-doctors-to-focus-treatments/

Got my second bivalent today. Six months had passed

i should check my numbers there

Got my second bivalent today. Six months had passed

― waiting for a czar to fall (Neanderthal),

wait what?? Can one do this?

You can just book and not tell them. (I also tried for a second bivalent this weekend, but gave up after 40 minutes in the queue.)

I got a second booster in June '22 and lied, so, yeah, I guess so.

27% of the city has had a bivalent booster at all, so getting a top-up (and switching brands) feels more like an action against waste than cheating the system.

anybody that uses the BinaxNOW Abbott tests been noticing any dud tests in your batches?

I never had a single problem prior to a month ago (other than user error once or twice), but on two occasions, the paper failed to change color at all when I closed the booklet, and one or two times big red splotches up and down the paper appeared. I know I did the test right as I've been doing these for 1.5 years and this is the test I use more than often. just wondering if anybody else found bad batches. about 20% of my last 16 tests that i got through insurance have had an issue.

no issues on my end as of yet.

maybe i accidentally pissed on them idk....

you're supposed to piss on the end with the "+" sign

so like… does vaccination actually protect against infection or not?

The bivalent vax keeps from you getting seriously infected/hospitalized as a result of the original omicron variants.

A friend, a research nurse, advised me to get jabbed with a second bivalent vaccine. No harm done, and it may even offer some protection for a couple months.

that’s not quite my question. if i wanted to protect others around me, would getting vaccinated make any difference?