News you can use: swine flu and face masks

Have you had the experience when hiking of shifting your way-too-heavy pack a bit and it feels better for a while? I feel like doing that just now. Enough with the hopelessness of getting real health care reform during our one opportunity in a generation. Enough with so-called Democrats, whether they’re warming chairs in the Oval Office or on Capitol Hill. Let’s talk about swine flu, and, specifically, face masks. Should you or should you not stock up on face masks?

The CDC–. Wait, I’ll start over. Even if you feel the government is not your friend, the CDC really does know about face masks. Honest. The CDC starts the discussion at what are known as N95 masks. These are rated to stop 95% of airborne particles and droplets that are larger than 0.3 microns in size. As you can see in the picture, these are reasonably formidable, thick, stuffy-to-breathe-through face masks.

The good news is that aerosolized droplets exhaled or sneezed out are mostly larger than 0.5 microns. The bad news is that if the particle floats long enough to evaporate the associated water, a “naked” flu virus is on the order of 100 nanometers. That’s 0.1 microns. Now, a bare virus doesn’t survive, but if it retains, say, half its water droplet, it might well be smaller than 0.3 microns. In other words, it’ll pass through the mask as easily as you can pass through a doorway.

Note that I’m not even addressing the issue of the space between the mask and your face. This is all assuming you have a perfect fit with no gaps which are, say a tenth of a millimeter big. A tenth of a millimeter is 100 microns. Picture how big that looks to a 0.5 micron droplet.

Australian Virus Researcher Says Swine Flu May have Escaped from a Lab

Bloomberg is reporting that The World Health Organization (WHO) is examining a study of the swine flu virus by Adrian Gibbs, a respected researcher whose work contributed to the development of the flu drugs Tamiflu and Relenza.

Adrian Gibbs, 75, who collaborated on research that led to the development of Roche Holding AG’s Tamiflu drug, said in an interview that he intends to publish a report suggesting the new strain may have accidentally evolved in eggs scientists use to grow viruses and drugmakers use to make vaccines. Gibbs said he came to his conclusion as part of an effort to trace the virus’s origins by analyzing its genetic blueprint.

“One of the simplest explanations is that it’s a laboratory escape,” Gibbs said in an interview with Bloomberg Television today. “But there are lots of others.”

[….]

Gibbs and two colleagues analyzed the publicly available sequences of hundreds of amino acids coded by each of the flu virus’s eight genes. He said he aims to submit his three-page paper today for publication in a medical journal.

Conflucians Say: The first 100 days and the pandemic panic of 2009

How has Obama done in his first 100 days? Did he meet or fail to meet your expectations?  What is his overall grade?  How about individual performance on the economy, health care, foreign policy, constitutional issues, balance beam and uneven parallel bars?

And for your homework, study this image:

There will be a quiz on it later.

Join us at 10PM EST for Conflucians Say on PUMA United Radio (PURrrr)

Thursday: Chrysler, Cytokine Storms and Crowd Control

Eight years of the Bushies have left me paranoid.  I suspect there is a dosier on me in the Department of Homeland Security, I worry about being able to get on planes, and periodically I say “Hi!” to the NSA when I’m on the phone.  It’s hard for me to see myself as a threat to anyone but distrust has become ingrained in many of us since 9-11.  I don’t like to think ill of our government but something feels deeply weird about the recent flu pandemic.

But before I get to that, the big news today is that Chrysler is on the verge of bankruptcy due to the recalcitrance of bondholders to strike a deal with Treasury.  That’s right, banks and hedge funds have been holding out expecting that the government will sweeten the pot instead of forcing the automaker to bankruptcy court where assets will be sold and thousands of jobs lost.  What happens to Chrysler will surely happen to GM and when that happens, I would expect to see a lot of very angry autoworkers who will see their way of life disappear due to the unchecked greed of bank and hedge fund managers. And this is partially due to the gentle handholding that the Bush and Obama administration have been giving the banks since they lost all of our money.  It could get really ugly.  James Kwak at Baseline Scenario has more to say about banks and the government in a Cuban Missile Crisis scenario that will make your blood boil.  Just go read it.

Back to the flu thingy.  Mexico has now issued directives on crowd control due to the “pandemic” swine flu:

The president said a shutdown of a broad range of public services and activities would start Friday and continue through Tuesday, encompassing the long Cinco de Mayo holiday weekend. Most federal offices will be closed; restaurants, schools and museums will remain shuttered; and spectators will be barred from all professional soccer matches.

Churches are expected to be nearly empty on Sunday.

The measures came as the World Health Organization raised its alert level on swine flu to Phase 5 on Wednesday, based on the flu’s continuing spread in the United States and Mexico. Phase 5, the next-to-highest level in the worldwide warning system, has never been declared since the system was introduced in 2005 in response to the avian influenza crisis. Phase 6 means a pandemic is under way.

Worldwide, at least 10 countries have confirmed cases of swine flu.

“All countries should immediately activate their pandemic preparedness plans,” Dr. Margaret Chan, the W.H.O. director general, said at a news conference in Geneva. While she emphasized the need for calm, at times she spoke as if a pandemic had already begun, saying, for instance, “W.H.O. will be tracking the pandemic.”

Now, I’m not a health professional but this seems to me to be a bit of overkill.  I have to assume they know something I don’t but so far there is no evidence that this particular flu triggers a cytokine storm.  A cytokine storm is what killed young healthy adults during our worst flu pandemics in the past.

triggering a cytokine storm

It was the reason for half of the deaths from the 1918 Spanish Flu and was also present in the Asian and Hong Kong flus of the recent past.  A cytokine storm is what happens when your immune system takes it up to 11.  The body sort of overreacts to the flu antigen and unleashes an immune system “storm” of macrophages, T-cells and other elements of its defense arsenal.  Usually, there is a feedback mechanism that tells the body to stop before it goes too far and damages itself.  In cytokine storms, the feedback mechanism doesn’t get triggered so the body can’t stop itself.  People with robust immune systems, where all systems are ‘go’ most of the time, tend to fare the worst during these kinds of flu.

But here’s the thing.  As recently as yesterday, the CDC bulletin on Swine flu makes no reference to a cytokine storm.  It just looks like a normal seasonal flu with the expected symptoms.  The people most at risk are the typical populations: kids under 5, senior citizens, people with compromised immune systems.  Nevertheless, Mexico is closing up shop, going on siesta and cancelling tickets to their soccer games.  It seems a bit extreme.  The only thing I can think of that would provoke this kind of reaction is that the vaccine makers didn’t see this one coming and they don’t have a vaccine ready.  So, we’re all kind of vulnerable- to a typical flu.  If you get it, you can expect to be sick and uncomfortable.  You probably won’t be able to take the cheap anti-virals to make it less bad.  And if you fall into one of the high risk groups, it could be serious.  But other than that?  It’s not like 1918. There won’t be body laden carts driven by lackadaisical smartasses crying, “Bring out your dead!”

Having a country on lockdown seems counterproductive to me, especially in a bad economy.  Not all of us can work from home and some of our employers have made that pretty impossible these days anyway.  I suspect that such a directive could make the economic crisis exponentially worse.  But yesterday as I went into work, there were signs posted on the doors telling people to not enter the buildings if they had a runny nose, sore throat, fever or cough.  I considered for a moment whether my scratchy throat was due to spring pollen or some deadly plague and decided that going through the medical review team gauntlet was probably not worth the day off and went in.  But still, you have to wonder why we go to these extremes over a typical flu.  Maybe we’re just covering our asses.  Maybe we just can’t deal with illness these days when everyone expects a quick cure and a shot for everything.  Or maybe it’s just a perfect excuse to keep everyone scared and indoors.

I told you I was paranoid.

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Tuesday: Influenza as Infuence-ah

I waited for my mom to call yesterday.  Any minute now, I thought.  She was in hysterics over the bird flu epidemic that never materialized a few years back.  At the time, I had to patiently talk her off the ledge:  There are many steps from chickens to people.  First, it has to be virulent in the bird population.  Then it has to be transmissible to humans, no mean feat.  It helps if you live on a poultry farm.  Do you live on a poultry farm, Mum?  No?  Well, that’s a relief.  Then, when it jumps to humans, it could simply stop there.  That’s right, it doesn’t have to go any further.  To be transmissible *between* humans, it has to mutate again.  And to be really deadly, it has to be spread really easily.  More mutations.  I mean, Bush is jumping the gun but if you’re really worried, you can track the mutations of the virus sequence  on one of the federal health sites.

That calmed her down for about 2 days before the next *ping* from the department of homeland security.  She called yesterday afternoon at about 2:30pm with some chit chat about Memorial Day plans before she hit me up on the Swine Flu Panic of 2009.

This flu is different.  First of all, it helps if you keep swine in your backyard.  Boyfriends do not count.  It looks like it can be spread to people but in the end, it’s still just flu and despite the fact that it seems to be out of season and somewhat more debilitating, the standard rules apply:  Wash your hands, stay away from people who are sick, do not touch surfaces of things a sick person might have touched, if you get sick, see your doctor for any available anti-viral meds, blah, blah, blah.  The vaccine manufacturers are probably already on it.

So, it’s a health problem.  But a worldwide catastrophe of Armageddon like proportions with the horseman of death stalking the rolling green hills of central Pennsylvania?  Probably not.

What it may be is a way for Obama to get his HHS nominee appointed as quickly as possible without the Republicans sitting on the nomination and pointing out more culture war related inconveniences.  As the NYTimes reports in its editorial today:

While health officials scramble to keep up with the fast-moving virus, it is deeply disquieting that the Obama administration has few of its top health officials in place. The Senate, delayed by Republican objections, is finally scheduled to debate the confirmation of Kathleen Sebelius on Tuesday to be secretary of health and human services. And the White House has yet to announce a nominee for director of the Centers for Disease Control and Prevention. Those are two of the most important positions for dealing with an infectious disease epidemic.

Ok, this is ridiculous.  It is nearly May.  Obama was elected in November.  In six months, he hasn’t even got his cabinet in place?  He doesn’t have a head of the frickin’ CDC?    Please.  Do not tell me that this economic crisis has consumed so much of his time that he hasn’t put together a roster of people to fill the remaining slots.  He should have gotten that together back in June of last year.  What the hell is going on here?

So, this is what he’s reduced to: panicking the citizenry, just like Bush used to do, in order to get his way and leapfrog over the confirmation process.  Don’t get me wrong.  Republicans are reprehensible when they hold up nominations like this over trivialities and put us all at risk for a really serious problem.  But this is not a well run executive branch if its cabinet positions are still pending after 6 months.

Still, I’m only mildly surprised.  I never did have much faith in government by shmooze.

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Swine flu: here we go again

update below

The news is spreading everywhere: Mexico flu ‘a potential pandemic’. In the next few days we’ll probably have a replay of the bad old bird flu days. Tamiflu! Hide in your house! Shoot the postman! Or whatever level of idiocy we achieve this time.

I did one of my POPs (Pissed Off Posts) on that occasion, and I think it’s time for a rerun.

First, this newest flu strain, H1N1 (CDC info), sounds vicious. It’s communicable between people (in the US, as of this morning, there were 11 cases with no fatalities) but it’s already killed dozens of people in Mexico. This makes it a far more serious threat than bird flu, which was almost never caught from another person. So being worried about this new flu is not a mark of loopiness in the same way as setting your hair on fire over bird flu. But panic is still an intensely foolish reaction, and the points I’ll run through below are still valid.

Fiction 1: We’re all going to die. It makes for a good movie script, but this is not the way flu works. Even SARS, which had an exceptionally high rate, had about 15% fatalities. Obviously, the only good rate is zero. The point I’m trying to make is that exaggerating risk does not help anyone to deal with it.

Fiction 2. Quarantine will stop the disease. Imagine two different scenarios. You feel the first twinges of something that could be flu. In the first scenario, you go to the hospital, get tested, receive free medication, your whole family and all your contacts are tested and also receive any necessary medication. People who see how you were treated are also alert to any sign of flu and go to get treatment as fast as possible. In the second scenario, you go to the hospital, and get tested. Then you’re quarantined for an unspecified length of time, your family is quarantined and unable to go to work, pay the rent, go to school, or do anything they have to do. The money spent on finding and quarantining you and yours is not available to provide an adequate supply of drugs. Obviously, in the second case you’ll rush to the hospital at the first sign of flu. Not.