Swine Flu

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Re: Swine Flu

Post #41by t00fri » 29.06.2009, 08:28

Hi all,

as of today (June 29th, 2009) the registered number of infections has risen to 71 578 in 106 countries with 320 fatalities. But, Anne Schuchat, MD, the head of CDC (Centers for Disease Control), has estimated that the real number of A/ H1N1 infections is MUCH higher, namely about 1 million in the US alone!!

In contrast, the officially registered cases in the US only amount to about 27 700 as of June 20th. Here is the link to the weekly CDC updates for the US:

http://www.cdc.gov/h1n1flu/update.htm

Today, 5 days after my last H1N1 plots, some qualitatively new features can be observed from the latest data on infections and fatalities. They are somewhat disquieting...

First, consider the meanwhile familiar semi-logarithmic plot, where we see clearly that the exponential growth law for the infections (blue dots) continues without change, with a doubling of cases about every 14 days. But as to the fatalities (red dots), a clear increase of the exponential slope has taken place since about day 45:

Image

The blue line that I drew through the red fatality points after day 30 to guide the eye, now has the same exponential slope as the infections curve! Before day 45, the slope was considerably flatter for the fatalities (black line)!

In the following linear ratio plot of [tex]\frac{\rm fatalities}{\rm infections}[/tex] (now in percent) you see this recent dramatic change quite clearly. While until day 45 the ratio of fatalities decreased linearly with time (early visits to doctors,...), it now oszillates around and towards a constant fraction of fatalities of about 0.44 %

Image


++++++++++++++++++++++++++++++++
Is this change of behaviour a first quantitative sign that the
virus has mutated and is becoming more agressive now??

Remember that since about day 45 it is winter in the southern hemisphere
and the seasonal flu has started there, interfering with the Swine flu...

If this somewhat steeper growth of fatalities persists, the prediction for the
number of fatalities by the Swine flu worldwide
is at least:

  • today: 320 (OK),
  • in 3 months from now: 28 367,
  • in 6 months from now: 2 516 220 worldwide (<=> 8.2 % of US population killed!)

Here is the best fit exponential formula (= blue line through red fatality data in my first plot above):

#fatalities = 161 * exp((t-47) / 20.4)

where t = 61 days <=> today June 29th 2009, and one month is
taken to have 30.5 days (on average).
++++++++++++++++++++++++++++++++

Last not least the same data in a linear plot as usual, where you can appreaciate the very strong growth...
Image

Fridger
Last edited by t00fri on 30.06.2009, 15:57, edited 2 times in total.
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Re: Swine Flu

Post #42by Reiko » 29.06.2009, 15:55

Here is an interesting article on it. Not scientific but interesting anyways.

Apocalypse Not: Behind the Swine Flu Hysteria

At the height of the swine flu pandemic this spring, when the US Centers for Disease Control and Prevention was recommending that schools with cases of H1N1 be closed for 14 days and Mexico was still on lockdown, the epidemiology community already suspected the world wasn't ending. Why? The numbers came in: case fatality rate (how many infected people are dying) and replication rate (how many others an infected person will transmit the illness to — "R-zero," in disease-speak). H1N1 had an R? of about 1.3, high enough to spread the virus but low enough that a strong isolation program could break its back. Its case fatality rate was a wussy 1.9 percent in Mexico and 0.1 percent worldwide. By comparison, the 1918 Spanish flu had an R? of 2.7 and a case fatality rate of up to 5 percent, making it far more deadly. A real apocalypse, like the killer flu in The Stand — Stephen King's opus of epidemiologic eschatology — would be off the chart, with an R? of 5 to 6 and a case fatality rate of 99 percent. So, don't panic ... unless H1N1 surges this fall. Where did we leave that hand sanitizer, again?

Link to full article. http://www.wired.com/special_multimedia ... oporn_1707

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Re: Swine Flu

Post #43by t00fri » 29.06.2009, 16:17

Reiko,

honestly I think hysteria is absolutely NOT at stake here. The real thing (and part of my motivation to update this Swine flu thread regularly) is that MOST people without solid math training can simply not imagine the "devastating" effects of exponential growth laws, as typically appropriate for worldwide virus infections.

It is NOT easy to grasp intuitively that for ANY exponential growth law, it takes exactly the same amount of time from the first fatality to just 1000 killed people, as it takes from 1000 to 1 million killed in the population... A slow start with hundreds of jokes about hysteric people is typical, until the rate virtually explodes some time later...and no one remembers a single joke. :o

See also my predictions for the fatality rate above, based on the present data! Another point: unlike the familiar, seasonal H1N1 virus, the spread of the Swine flu does not seem to be inhibited by warm summer temperatures... Hence the exponential growth of the number of infected/killed people may well be expected to go on for quite a while until it will merge with the additional harm from the upcoming seasonal flu this fall.



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Re: Swine Flu

Post #44by Reiko » 29.06.2009, 22:58

Ok I'll see you in six months and you can explain to me why your projections didn't come to pass. :blue:

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Re: Swine Flu

Post #45by t00fri » 30.06.2009, 09:01

Reiko wrote:Ok I'll see you in six months and you can explain to me why your projections didn't come to pass. :blue:

Reiko,

my present projections simply assume that the present trend continues without changes. It's nothing but a mathematical extrapolation which can be incorrect, of course. The present trend is purely empirical, but was extracted over a period of as much as 2 months from the daily official WHO data. No further assumptions were made.

Unfortunately, the chances seem higher that without an application of a widespread vaccination during the coming 6 months, the actual numbers will even exceed my projections substantially. :o

Today, the first case was reported from Denmark, where the A/H1N1 virus proved resistant against the so far effective antiviral drug Oseltamivir (trade name Tamiflu). The patient had to be treated with the second known antiviral drug Zanamivir (trade name Relenza)

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Re: Swine Flu

Post #46by Reiko » 30.06.2009, 15:24

I know your projections are based on current trends but I don't think this virus will stay that trend. This flu has already shown a low mortality rate compared to the season flu. The yearly flu hits about 1% each year and this one has yet to reach 1/2%. To put that into perspective the Spanish flu of 1918 reached around 2.5%

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Re: Swine Flu

Post #47by t00fri » 30.06.2009, 15:50

Reiko wrote:I know your projections are based on current trends but I don't think this virus will stay that trend. This flu has already shown a low mortality rate compared to the season flu. The yearly flu hits about 1% each year and this one has yet to reach 1/2%. To put that into perspective the Spanish flu of 1918 reached around 2.5%

Reiko,

I would be happy if your optimism eventually appears to be justified.

Yet, as my above extrapolations show, also that A/H1N1 virus with a mortality rate of ONLY 0.44% can easily kill 2.5 million people in 6 months from now. It's NOT the (initial) mortality rate that counts, but rather the amount of time over which the above growth law persists!

Finally, the Spanish flu of 1918 also started off with a low mortality during its first wave, but then -- after mutation during the seasonal flu period-- it returned in much more agressive form with the high mortality that you quoted.

This may well happen with the Swine flu virus as well this fall / winter, and we will be VERY lucky if it doesn't ...

But please note that my above projection of 2.5 million fatalities in 6 months from now, does NOT yet take into account any increased agressiveness compared to now. It's merely based on a constant mortality rate of 0.44%, together with an extrapolation of the present trend!

Fridger

PS: In Argentina (its winter now!) the mortality has reached 1.65% as of today which is not all that far away from 2.5%. All schools are now closing for weeks down there...
Last edited by t00fri on 30.06.2009, 20:32, edited 2 times in total.
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Re: Swine Flu

Post #48by t00fri » 30.06.2009, 16:15

Hi all,

find below a graphical extrapolation of the present trend in a semi-logarithmic plot with enlarged ranges. The fat purple line marks 1 million. Today corresponds to the last blue and red dot, respectively. From that plot you can read off, how long it's gonna take until 1 million of infections and 1 million of fatalities are reached, respectively (assuming the present trend persists):

Remember this extrapolation is for the present very low mortality rate of only 0.44%! Note also that we have strong evidence already that the Swine flu virus does NOT make a "summer break" (like the seasonal flu)

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Re: Swine Flu

Post #49by t00fri » 03.07.2009, 12:27

Hi all,

5 days after my last plots, it's time for an update today (July 3rd 2009).
The virus is spreading precisely according to my exponential predictions, as displayed in the new plots below.

Note in particular: 100 000 officially infected people will be exceeded in just a few days!
Image

The predicted trend of a constant mortality ratio of 0.44 percent is now much clearer borne out by the additional data.

Image

+++++++++++++++++++++++++++++++++++++
On a longer time scale you can see that 1 million of infected and killed people, is predicted from my extrapolations of the present trend on August 21, 2009 and December 9, 2009, respectively!! These frightening numbers are based on a constant mortality ratio of ONLY 0.44%.
+++++++++++++++++++++++++++++++++++++

Image

Finally, here's the plot on a linear scale, demonstating the "explosive" exponential spreading of the virus!

Image

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Re: Swine Flu

Post #50by t00fri » 13.07.2009, 17:11

After a 10 days break with my plot updates, find below my meanwhile familiar diagrams as of today (July 13, 2009)

The reason for my longer break was that right after the last update, the countries with the highest number of infections, US, Mexico, Canada, GretBritain,..., have announced that they cannot handle this regular counting anymore. Thus a large proportion of the cases was missing as of then. One can also easily see this distortion in my curves (see e.g. first figure, blue dots!).

Since today it seems that they are providing numbers again, but only on a weekly basis at best. No idea how accurate this is now. Therefore I made an update today. Meanwhile we have way above 100000 registered cases, precisely 114 569 infected and 572 deaths as of today. The Swine flu has now completely superseded the seasonal flu occurrences in the Southern hemisphere...

Here are the usual plots.

Image

At the top end of the infections (blue dots) you can see clearly the depletion for reasons I have described. The counting of fatalities (red dots) is more reliable, of course. Correspondingly, you can see that the trend continues without change! So still without a large-scale vaccination ASAP, we can expect 1 million deaths worldwide by beginning of December!

Image

The ratio of deaths to infected cases has risen in the last bin, but this is because the numbers are too small for the infected cases:

Image

Finally, see everything on a linear scale plot and appreciate the "explosive" growth of the infections. The purple line corresponds to 100 000!

Image

Fridger
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Re: Swine Flu

Post #51by LordFerret » 15.07.2009, 18:20

Just the other day our local radio station announced over 80 cases of it in our county, mostly kids. I was surprised because just a few weeks back the count was only 2. I'm not sure of the fatality count, I'll have to check on that.

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Re: Swine Flu

Post #52by t00fri » 15.07.2009, 18:31

LordFerret wrote:Just the other day our local radio station announced over 80 cases of it in our county, mostly kids. I was surprised because just a few weeks back the count was only 2. I'm not sure of the fatality count, I'll have to check on that.

Well the US is again a "world leader" by far ...

The last official CDC info is of July 10th: 37 246 cases and 211 fatalities for the US.
While the fatality count should be about realistic, the number of infections must be much much higher than that...

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Re: Swine Flu

Post #53by LordFerret » 15.07.2009, 18:42

I do believe there is an issue regarding the reporting / identification which accounts for the count discrepancy you mention.

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Re: Swine Flu

Post #54by t00fri » 18.07.2009, 20:12

Hi all,

today (July 18th, 2009) I probably will present my last update of my familiar Swine flu diagrams, since the WHO has announced today the end of their regular publication of H1N1 cases. They simply cannot handle the strongly increasing numbers anymore in a reliable manner. Instead, the various countries have been asked to monitor carefully, whether any changes in agressiveness of the virus are becoming apparent...

Since the number of infections is not reliable anymore since a week or so, I took it out of the following semi-logarithmic plot. I only show the growth of the number of fatalities, which is obviously much more reliable.

Image

This display at relatively large scale forms the basis of the following prediction of mortality ...There is no change in the growth visible. On the basis of a straight extrapolation, one still arrives at 1 000 000 fatalities by about Dec 10 2009 (ignoring the effects of vaccinations).

Image

Here is the familiar "explosive" plot in linear scale

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Re: Swine Flu

Post #55by Reiko » 30.08.2009, 14:44

(CNN) -- Brazil has confirmed 557 deaths caused by H1N1 flu, the highest total in the world, the nation's Health Ministry says.

The United States has counted 522 fatalities through Thursday, and nearly 1,800 people had died worldwide through August 13, U.S. and global health officials said.

http://www.cnn.com/2009/HEALTH/08/28/br ... index.html


This won't go away. :(

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Re: Swine Flu

Post #56by Fenerit » 21.09.2009, 11:34

Hey Fridger, just for your information, in Italy (in which there are the first deceases) the media's debacle isn't on to prevent diffusion, but on how to prevent people from thinking at its exponential diffusion! Because, they says, "it's unclear, and the mathematical models are under analysis". "Should be avoided the diffusion of false news" they says as conseguence; but they doesn't says which would be the "true news", since their math is still "under analysis". Does they have read this thread? :wink:
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Re: Swine Flu

Post #57by t00fri » 21.09.2009, 12:07

Fenerit wrote:Hey Fridger, just for your information, in Italy (in which there are the first deceases) the media's debacle isn't on to prevent diffusion, but on how to prevent people from thinking at its exponential diffusion! Because, they says, "it's unclear, and the mathematical models are under analysis". "Should be avoided the diffusion of false news" they says as conseguence; but they doesn't says which would be the "true news", since their math is still "under analysis". Does they have read this thread? :wink:

Massimo ,

firstly, I had to stop accounting/plotting the growing number of global infections in this thread of mine, since that number was just not generated anymore...

A significantly more accurate number is (for obvious reasons) the number of deaths. Meanwhile, the official figure is 4041 as of today. While this is getting high, the (exponential) growth of that number has slowed down, because quite clearly we are now seing the end of the first flu wave in the northern hemisphere.

Image

Here is a plot clearly showing the decrease of the daily new infections in Germany as function of time:

Image
In Germany this number is still reasonably well kept track of by the RobertKoch institute and thus is a good indicator of the end of the first wave.

While the flu was still in normal "expansion" mode, it was clearly an exponential law. Exponential growth laws are actually quite general in Nature (not only with plants), including the global spread of Aids. Yet, in case of Aids things are proceeding on a longer timescale and thus are getting less well noticed by many.

Still, I know of two people of our Celestia community that caught the Swine flu already...
There is surely a much higher dark figure.

Fridger
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Re: Swine Flu

Post #58by BobHegwood » 21.09.2009, 20:54

Just curious here...

Is the Swine Flu preventable with a pre-flu injection?
Or, is this not the case? Got a shot at the VA today, so I was just wondering if this
would actually do any good or not. :wink:

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Re: Swine Flu

Post #59by selden » 21.09.2009, 21:18

My understanding is that it is *not* included in the current multi-strain vaccine.
I've heard that a vaccine for H1N1 is expected to be available in the U.S. in late October, although the CDC web site just says "fall".

http://www.cdc.gov/h1n1flu/vaccination/ ... qa_pub.htm

p.s,

Yup: limited release early October, general release late October.
http://www.cbsnews.com/stories/2009/09/ ... 3104.shtml
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Re: Swine Flu

Post #60by t00fri » 21.09.2009, 21:42

Bob, Selden,

after an extendend (international) discussion on vaccine safety, the Swine flu vaccine has only been admitted officially in the US for mass application a short time ago.

I agree that the main vaccinations will take place in the US and in Europe during the months October and November. It is advised strongly to take a shot against the seasonal flu first in September and leave 3-4 weeks before the Swine flu vaccination.

It is still debated whether 1 shot might be enough, but originally 2 shots with a month intervall was supposed to be the "canonical" procedure.

Fridger
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