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And maybe think about avoiding those airplanes...

This is from my friend momwolf. I belive the doctor who wrote this lives in the Texas Hill Country, and I know that the incidence of cases of 'flu south of there have grown pretty astronomically in the last 24 or so hours. This thing is going to get a lot worse before it gets better, unless the warmer weather starts to kill it.

I pointed out to someone yesterday that I'm probably pretty prone to this bug, though I've been lucky so far. I was in a hospital, both as an inpatient and as an emergency patient, at the time it first started showing up. I was at a doctor's appointment in a building attached to the hospital that the child who died in the US was in, on the day he died. I work in a healthcare setting, and patients come in and out of my building every day, many of them to the general clinic two floors above mine. I live in Texas, where lots of people come to and from Mexico on a very regular basis. I'm likely slightly immunosuppressed, given that a lot of my body's resources are currently dedicated to fixing me from my surgery.

My main advantage is that aside from Graham, some friends, and my healthcare providers, my contact with the outside world for almost ten days was entirely eliminated. That ended, though, when I came back to work on Wednesday, and yesterday, we went to a party with 900 other people.


The following swine flu update is from Dr. XXXXXXX Doctor at XXXXXX
Center and director of emergency medical services at XXXXXXX
Hospital in XXXXXXXXXX). It is provided for your

After I returned from a public health meeting yesterday with community
leaders and school officials in XXXX A Texas CountyXXXX, XXX suggested I send an
update to everyone, because what we are hearing privately from the CDC and
Health Department is so different from what you are hearing in the media.
Some of you know some or maybe all of this, but I will just list what facts
I know..

- The virus is infectious for about 2 days prior to symptom onset

- Virus sheds more than 7 days after symptom onset (possibly as long as 9
days) (this is unusual)

- Since it is such a novel (new) virus, there is no "herd immunity," so the
"attack rate" is very high. This is the percentage of people who come down
with a virus if exposed. Almost everyone who is exposed to this virus will
become infected, though not all will be symptomatic. That is much higher than
seasonal flu, which averages 10-15%. The "clinical attack rate" may be
around 40-50%. This is the number of people who show symptoms. This is a
huge number. It is hard to convey the seriousness of this.

- The virulence (deadliness) of this virus is as bad here as in Mexico, and
there are folks on ventilators here in the US, right now. This has not been
in the media, but a 23 month old near here is fighting for his life, and a
pregnant woman just south of San Antonio is fighting for her life. In
Mexico, these folks might have died already, but here in the US, folks are
getting Tamiflu or Relenza quickly, and we have ready access to ventilators.
What this means is that within a couple of weeks, regional hospitals will
likely become overwhelmed.

- Some of the kids with positive cases in Comal County had more than 70
contacts before diagnosis.

- There are 10-25 times more actual cases (not "possible" cases -- actual),
than what is being reported in the media. The way they fudge on reporting
this is that it takes 3 days to get the confirmatory nod from the CDC on a
given viral culture, but based on epidemiological grounds, we know that
there are more than 10 cases for each "confirmed" case right now.

- During the night, we crossed the threshold for the definition of a WHO,
Phase 6 global pandemic. This has not happened in any of our lifetimes so
far. We are in uncharted territory.

- I expect President Obama will declare an emergency sometime in the next
72-96 hours. This may not happen, but if it doesn't, I will be surprised.
When this happens, all public gathering will be cancelled for 10 days.

- I suggest all of us avoid public gatherings. Outdoor activities are not as
likely to lead to infection. It is contained areas and close contact that
are the biggest risk..

- Tamiflu is running out. There is a national stockpile, but it will have to
be carefully managed, as it is not enough to treat the likely number of
infections when this is full-blown. I don't think there is a big supply of
Relenza, but I do not know those numbers. If I had to choose, I would take
Relenza, as I think it gets more drug to the affected tissue than Tamiflu.

- You should avoid going to the ER if you think you have been exposed or are
symptomatic. ER's south of here are becoming overwhelmed -- and I mean that
-- already. It is coming in waves, but the waves are getting bigger.

- It appears that this flu produces a distinctive "hoarseness" in many
victims. The symptoms, in general, match other flu's; namely, sore throat,
body aches, headache, cough, and fever. Some have all these symptoms, while
others may have only one or two.

- N-Acetyl-Cysteine -- a nutritional supplement available at the health food
store or XXX Pharmacy, has been shown to prevent or lessen the
severity of influenza. I suggest 1200mg, twice a day for adults, and 600mg
twice a day in kids over 12. It would be hard to get kids under 12 to take
it, but you could try opening the capsules and putting it on yogurt. For 40
pounds and up, 300-600 mg twice a day, for less than 40 pounds, half that.

- Oscillococinum, a homeopathic remedy, has been vindicated as quite
effective in a large clinical trial in Europe, with an H1N1 variant. You can
buy this at XXXXXXX Natural Foods, or the XXXX Pharmacy.

I will try to keep everyone posted if I have any new information. Meanwhile,
don't be afraid just avoid infection. The fewer people infected the easier
it will be for our public officials to manage it.




( 11 comments — Say something )
May. 1st, 2009 05:54 pm (UTC)
That really sounds like an irresponsible email for any doctor to send out. Implying fudging on the part of the CDC, saying there's going to be a state of emergency declared and public gatherings shut down? Claiming there are deaths that have been covered up (when, indeed, plenty of deaths have been reported, even in the US)? This is sensationalism at its finest.

Perpetuating the Tamiflu myth? Prescribing supplements without seeing patients first? What kind of doctor does these things? Whipping up public panic benefits no one and can hurt the people who actually need help by making it harder for them to get it.
May. 1st, 2009 06:24 pm (UTC)
I don't think he said that deaths were covered up, just that there are some pretty severe cases in Texas that would imply virulence. The numbers in South Texas grew pretty fast in the last 24 hours, so it doesn't surprise me that an infant and a pregnant lady would be in the hospital. Nor that the media wouldn't report that.

The link above, by badrahessa above has a partial retraction by the doctor and an apology. I suspect that he never thought it'd go out beyond close friends that he sent it to.
May. 1st, 2009 07:02 pm (UTC)
I don't really see much of a retraction in the statements on that news link, although he does say that the letter was edited and twisted, we don't know what version he was looking at when he said that, and he didn't specificy any particular parts.

I'm guessing the original letter is probably true, and he was comfortable making the recomendation for supplement because he was making it to only a few people that he already knew their medical histories for. (that might be the twisted part)

I also don't see anything that says that things were covered up.

I heard on the radio that the rockets game was canceled, but I was working yesterday and there were an aweful lot of people going it to.

What bothers me is that I've heard several times that if we think we might have this flu, we need to go to the doctor and get checked ASAP. Now, most of the people I know don't have insurance. They don't go to the doctor, because even for a small issue the doctors bill frequently cost more than their food budget for the month. If the CDC wants the working class to go to the hospital to get tested so they can track the virus when it's not nearly killing people, they need to test us for free. I mean, think about it. They can't *do* anything for you really, so you might as well save your money. Either you'll recover or you'll die - either way, the $$ is needed more not going to the doctor. Also, these are the people more likely to go to work when sick - and unless their bosses pay attention and send them home, they'll infect people throughout their shift. Yesterday, I went to work with a flu that I believe is *not* part of this pandemic, but quite frankly, almost everyone I work with is showing symptoms of a minor flu bug. But we're still up and kicking, so we're going to work. I'm working in a parking garage and interacted with over 100 customers yesterday alone. The boss brought us hand sanitizer, which I tried to smear on some of the surfaces that people touch a lot, but it didn't seem to work so well. My last paycheck was so small, I can't even afford to buy a can of lysol to spray on the elevator buttons, etc.

Pandemics like this are the main reason we need universal affordable health coverage. Maybe people will see that because of this and that will be our silver linning.

hrm, that's a bit of a ramble and a rant. I'm making more tea and going back to bed now.
May. 2nd, 2009 07:51 pm (UTC)
It's not really much of a retraction. And, never thinking that it would go out beyond close friends is in fact irresponsible behavior on the part of a doctor. Surely in this day and age, being cognizant of the way people forward email around , and not causing a panic, is part of being a responsible doctor.

The coverups are implied in this line:
The virulence (deadliness) of this virus is as bad here as in Mexico... This has not been in the media

Also, the bit about it being a phase 6 pandemic is false; according to the WHO website we're at phase 5:

Wash your hands, cover your mouth, those are good advice anyway. But I don't think that doctor's letter is anything more than the ravings of a scared man who even now isn't speaking or behaving rationally. I'm glad he's not my doctor.
May. 1st, 2009 07:03 pm (UTC)
reading the retraction now... my first reaction, pre-retraction, was that this sounds pretty alarmist. in fact, I see it as directly contradicting the scientific research reported today in the New Scientist that suggests that the H1N1 virus is pretty weak in comparison to say H5N1...
May. 1st, 2009 07:07 pm (UTC)
also heard yesterday an interview with some scientists (i was driving, looking for the citation now) who suggested that older folks may already have some immunity to the virus simply by virtue of having been exposed to so many different strains of flu over the years.
May. 1st, 2009 07:17 pm (UTC)
ok, so the "retraction" really isn't... doctors are no more immune to fear and panic than anyone else, really, and that's what this strikes me as.

in looking for that citation, i came across something else of interest: "Another CDC official, Dr. Anne Schuchat, said preliminary studies suggest that in U.S. households with an infected person, about a quarter of other family members are getting sick as well. That's consistent with what happens with seasonal flu, she said." (source)

that being said, your subject header for this post is still perfectly appropriate. why people don't do this anyway is beyond me.
May. 1st, 2009 08:33 pm (UTC)
My recommendations would be the same with this letter or without it: Wash hands, cover your mouth when you sneeze/cough, don't get too close to people who are sick (this one is hard in my group of friends because everyone is a hug and kisser), and eat chicken soup when you do get sick. I sent an e-mail to all of my friends basically saying that.

Over the last 24 or so hours, that part of Texas has had 118 suspected cases show up in one county. I'm not surprised that local resources are a bit strained and that a physician would write to his close circles explaining his thoughts given what he's seen/heard.

I am a little concerned about Flipside, though. Those sorts of events are already infectious cess pools and everyone comes back coughing up a lung.
May. 1st, 2009 09:57 pm (UTC)
I think it's just a sign my moontime is due that I promptly checked my email and burst into tears when there wasn't anything, right? 'Cause you still love me, too?
May. 2nd, 2009 03:45 pm (UTC)
Eh, I work with kids. If I were afraid of viruses I'd have a different job. I'm not losing any sleep over the swine flu.
( 11 comments — Say something )