Current WHO phase of pandemic alert is 5

UPDATE :: Make that 5 – that is, The world health organization has confirmed a pandemic is imminent.

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The current world health organizations phase of pandemic alert is still at 4 but I wouldnt be surprised if they raise this to level 5 before the end of the week – Level 5 means theres evidence of human-to-human spread in two different countries, like the US and Mexico, for example.

http://www.who.int/csr/disease/avian_influenza/phase/en/index.html

Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.

Filed under: Health, Science

1 fatality out of 66 cases in the US

My wife said she’d die if she were the mom - I can’t imagine the horror and tragedy this family just experienced.

UPDATE :: The CDCs 11 oclock update is up.
http://www.cdc.gov/swineflu/

Which makes my attempt at a CFR look hasty indeed.

UPDATE :: Our first death was a patient originally infected in Mexico and brought to the US for treatment, not originally infected here in the US and maynot be statistically appropriate include if youre trying to estimate an effective CFR for the US.  I need to read m0r3.

A CFR is an extremely difficult value to get
See this post at “Effect Measure” for more information 

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A rough, very rough, CFR (case fatality ratio) of 1/66, about 1.51%, or 15 fatalities for every 1000 infections is possible.  In statistics one of the most important things you learn is how to look at the sample number and data of the statistic to analyze its usefulness, a sample number of 66 out of a potential population of 305 million may not be a good idea.  The actual CFR for this strain of H1N1 maybe end up being way off this initial value.  I should try to construct an error estimate.  But I wont.  Im not a statician, Im not a medical expert, I just felt like writing down what worries me about this new flu.

A gross approximation of the potential of such a virus can now be done, if you allow a number of assumptions, in the absence of much more valuable, real data.  

If the spanish flu infected 25% of the population and killed 2.5% of those effected, and this virus seems milder but its ability to be transmitted between humans is still unknown even if we know its happening.  Lets assume this aspect of the virus will also be milder.  Say 10% of the population infected 30.5 million out of which 462000 could be serious, fatalities could be reduced in this group if promtp and appropriate action is taken, and antiviral medications like tamiflu and relenza remain effective against it, reduced by about 2/3rds to about 154000 fatalities in the US.  Of course this gross estimate ignores a lot of factors like not being in flu season and if this will reduce the potency of the virus and how much and how fast it spreads, if it does effect it.  We still dont know why there even is a flu season.  And more importantly we don’t know much at all about this very new virus to expect an estimate like this from anybody who knows anything about disease and epidemiology.

Maybe this number isn’t useful – maybe I took a number and ran too far with it.  Kinda like forest gump catching the football and running off the field, down the street, …and what.  You didnt see the movie?!  Its a blog not a news source, you want safe and reliable analysis?  Wait a few years for the CDC to cruch the data.  But this is my number and I hope im wrong I hope its another flu we just deal with every year – makes us miserable for a week and we shrug it off then get the regular flu – and shrug it off.  But Im worried that we’ll be lucky to see only 154000 fatalities at the end of this.

Remember if you’ve seen one flu pandemic – you’ve seen, one flu pandemic.

Filed under: Health, Science

If you’ve seen one flu pandemic – You’ve seen one flu pandemic.

UPDATE 04.29.2009 :: At least 66 cases in the US with our first fatality – a 23 month old baby in Texas. 

http://www.msnbc.msn.com/id/30471035/ 

Germany Confirmed its first 3 cases.

UPDATE 04.28.2009 :: Statement issued Tuesday by the state health department:

INDIANAPOLIS – State health officials report test results from the Centers for Disease Control and Prevention have confirmed a case of North American Human Influenza A (H1N1) in northern Indiana.

This case does not appear to be included in the latest CDC update meaning there are at least 65 confirmed cases in the US now.

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Snipped from Effect Measure at scienceblogs.com

http://scienceblogs.com/effectmeasure/

QUOTE

Posted on: April 28, 2009 11:07 AM, by revere

It would be nice to think that the 28 cases at the NY Prep School are it for the city and that the virus has been contained there. But that was always more a wish than a plausible reality:

CBS 2 HD has learned of a confirmed case of swine flu at the Ernst & Young headquarters in Times Square.One of the staffers became ill over the weekend after coming into contact with a family member who had been exposed to the virus.

The staffer is said to be resting at home and the company believes, due to the virus’ 24-hour incubation period, that no one else at Ernst & Young was exposed. The company released a statement on Monday night:

“An employee in our offices at 5 Times Square was diagnosed on Sunday with swine flu, which she contracted from a family member. The individual had not been in offices since last Thursday. According to the Center for Disease Control, the disease has a 24-hour incubation period. Given the timeframe, we believe that it is unlikely that any other of our people have been infected.

“The health of our people is our foremost priority. Since learning of the diagnosis, we have followed the procedures outlined by the Center for Disease Control, including closing the offices on the floor where she worked and retaining a skilled sanitation service to clean the area. We have alerted our people and have told them to feel free to work from home if they would be more comfortable doing so. We have also notified the appropriate authorities.” (CBS2, NY)

 

As we keep looking, we will find cases, so the total will rise, probably on a daily basis. Like poll numbers, it is probably wise not to pay attention to daily fluctuations but look at the big picture. Right now the big picture isn’t visible, but with the passage of days or a week, it should become clearer. The current spate of cases could burn itself out as warmer weather ensues. Flu is a highly seasonal disease, for reasons we don’t understand. That wouldn’t mean we were home free, however. Wherever flu hides in the “off season” (flu does find work in the southern hemisphere’s winter), it can come back the following year. Those familiar with 1918 know there seems to have been a milder “herald wave” the previous spring which came back like a freight train in August. CDC is well aware of this possibility and should this outbreak wane will clearly urge and engage in continued preparation in the event this evolves in the same way.

If it evolves the same way. Influenza is a virus full of mystery and surprises. The more we study it the more complicated it becomes. Remember the adage: “If you’ve seen one flu pandemic, you’ve seen one flu pandemic.”

Filed under: Health, Science

unprecedented commitment to science

Missed in yesterdays headlines was Obamas announcement to increase R&D funding to a new high of 3% of GDP.  And attempt to reverse losses in our nations ability to lead in education and innovation.

Highlights of the speech by the American Institute of Physics here.

Full transcript of the speech here

Filed under: Economics, Education, Science

a new influenza A/H1N1 virus has emerged in our modern world

Update :: CNN’s Sanjay Gupta in Mexico City says the rate of deaths from this outbreak seems to be decreasing.

Update :: 50 confirmed cases in the US – 82 world wide, and the world health organization upgraded this situation to a phase 4, that is confirming sustained human-to-human spread.

Update :: Mexicos Health Minister just announced there have been 149 fatalities out of 1995 cases of severse flu, which they are investigating weather it is in fact Swine Flu.  776 patients remain hospitalized.

I just saw on CNN that the number of confirmed cases has just doubled from 20 to 40, although these were already suspect days ago and only confirmed now.  It was intriguing to follow this developing story over the weekend where on Saturday I learned there was a family in Texas and a half dozen cases in southern California with the same virus that shut down schools and public events in Mexico.  Thru to this morning where there are confirmed cases in New York, Kansas and Ohio – as well as New Zealand, Nova Scotia, Scottland, Spain and France.  This morning in Mexico the numbers a saw were 103 dead out of 1614 cases, although these have not all been confirmed to be the new strain, and there may have been more than the reported 1600 cases.  Saturday the number of fatalities in Mexico was 68, the day after 81.  Something I want to see over the next few days is weather the number starts to top off or if the rate continues to grow.

The fatality rate is extremely disturbing if the vast majority of those cases and fatalities can be confirmed to be the new virus, especially since the pattern of infected indicated the young and middle aged rather than the typical elderly and children who are more affected by this new strain of influenza.  This is a hallmark of previous pandemics like the spanish flu of 1918 – which was also an H1N1 virus, but now extinct – where it is believed most fatalities came quickly due to a sort of over reaction of a healthy immune system, a positive feedback loop they call a cytokline storm, or hypercytokinemia.  Although realiable, solid information and analysis is slow to emerge – and the flu and epidemics are difficult to predict.  What we know for sure if that there is a human-to-human transmitted new influenze A virus out there.  We know that the confirmed cases in the US have so far been mild to date – and pending the nature of the rest of the cases just reported in the US by the world health organization.

Its something of a paradox that our modern age of quick and easy transportation can spread a virus like this to distant and diverse populations, but other advances in medicine and our knowledge of these diseases can save us from a catastrophy similar to 1918s influenza, or hopefully mitigate its effect, hopefully not repeat a grim chapter in history.

There is a lot of noise out there and some exageration of the threat as we can scientifically confirm it to date, but one site Ive found helpful in clearifying some things is a blog at Effect Measure - http://scienceblogs.com/effectmeasure/

another useful link is the CDC site on the topic http://www.cdc.gov/swineflu

Filed under: Health

Ares I vs Ares III

Jupiter Direct update

Jupiter Directs latest itteration of a replacement for the shuttle will look something like the space shuttles external tank with 3 RS-25Cs under it ( the same engines that have reliable taken the space shuttle to orbit without fail, SSME – space shuttle main engines ), 2 current & unmodified 4 segment SRBs at the sides in the traditional configuration and a payload fairing or shroud covering the Crew Exploration Vehicle.  This is the J-130 or Ares III.  And if given a green light by the new NASA administrator could be ready to go far sooner, a whole 5 years sooner than the Ares I, and by saving billions of dolars by eliminating the need for expensive new engine development programs, or re-engineering RS-68s for man-rated flight, its can put the constellation program and the VSE back on schedule.

Heres the new chart provided by the DIRECT team

Notice the IOC ( initial operational capability ) of the Ares I vs the IOC of the J-130 ( Ares III ) is in 2017 by current NASA estimates, a full 7 years after they expect to retire the space shuttle – while the IOC for the J-130 is before the end of 2012, just 2 years post shuttle retirement.  Even if the delays can be reduced and the original development scheduel for the Ares I is attained it’ll still be a 5 year gap between the retirement of the space shuttle and the launch of a new vehicle.  Also notice how the Ares V isn’t even on the Map – it couldnt even be compared.  Its replaced by the J-246, or Ares IV with an IOC of 2016 and FOC or Full operational capability before the end of 2017.  Thats right – we can be on the moon before the Ares I is even ready to ship cargo and crew to low earth orbit if we went with the Jupiter Direct proposal.  And it would save thousands of jobs across 3 states by almost eliminating the shuttle-gap and going with a real shuttle derived launch vehicle that fully utilizes known practices, skill sets, infrastructure and hardware.

Are the words – no contest – useful here?

 

 

Filed under: Space

The Dream is alive and well

“I like the dreams of the future better than the history of the past. “

- Thomas Jefferson

 

My two year old son loves this, “Mars movie” he calls it.  Well at least the parts with the rockets!  The future belongs to them.

“The Case For Mars” by Dr. Robert Zubrin is recommended reading for anybody interested in the future of human spaceflight.

Enjoy The Mars Underground

Filed under: Mars, Space

Jupiter Direct update

A new version maybe worked out and released soon – one that relies more heavily on space shuttle derivatives.
Using currently man rated and tested engines the new plan if opted by NASA would give us a vehicle capable of delivering crew and cargo to the ISS even sooner by using 3 SSME( space shuttle main engines ) instead of the Delta vehicles RS-68 (2) which would not work due to base heating by the Solid rocket boosters. The only way they could use RS-68s is if an entirely new regenerative nozzle were engineered and man rated cost millions of dolars and which the airforce is not inclined to do without this specific demand from NASA. By going with the shuttles main engines this saves in developement cost and is potentially safer than developing and testing a brand spanking new rocket engine.

The current iteration will be a J-130 with 3 SSMEs to get the orion CEV to the International Space Station and with a Delta IV Heavy Derived upperstage a lunar flyby mission can be launched. Secondly by using SSMEs in the core stage the can use RL-10s on the Jupiter Earth Departure Stage another already man rated and extensibly tested engine reducing developement cost further and allowing a manned Lunar mission as early as 2015 depending on the developement time needed for the LSAM ( lunar surface access module ) the Altair. Instead of the 2020 date given for the as of yet undesigned, unworked and untested Ares V heavy lifter. Using RL-10s allow developement funding and time to be spent on more science missions insetad of developing the new J-2X engines that would be required for the Ares I and Ares V upperstages. Funding that could go towards a Near Earth Object or Mars Sample Return mission. Or both. More science from NASA, how about that? Going with the Jupiter direct proposal could now reduce the impending shuttle gap – the time between shuttle retirement in 2010(NEXT YEAR) and the first crewed flight to the ISS on an Ares I – from 2017 on an already overbudgetted and delayed Ares I to 2012 aboard a J-130( or an Ares III if youre so inclined ) thats a 5-7 year gap reduced to 2 if the new NASA administrator investigates the Jupiter proposal and gived it a green light now.

Itll also preserve thousands of Florida, Alabama and Texas hightech jobs – maybe even a politically good thing to do, politics AND space given a win – win – choice, How about that?

http://www.directlauncher.com

Jupiter Direct v2.0 PDF without the new improvements

From the NASASpaceflight.com forums
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http://forum.nasaspaceflight.com/index.php?topic=15541.2750

 

 

 

Filed under: Space

academic disaster

Ive had a rough time keeping up with multivariable calculus. I must say the how annoying it is to goto a lecture and not understand half of whats discussed sometimes – annoying is not it – its more like torture, its personally unbearable to approach this topic unprepared, and I wasnt able to dedicate enough time to prepare for the material covered in lectures or the exams. I will be repeating this course even if I could recover my grade before the end of the semester – I feel I’ve glossed over too much material that will be important in the rest of my course of study in mechanical engineering and in practice upon graduation.

On the upside of this mess – towards the end of this semester Ive discovered this interesting resource at the MIT’s website. MIT OpenCourse ware – where you can get a sort of second opinion of sorts or even go thru a semesters worth of lectures at your own pace and attempt to work out examples yourself before registering for the class yourself, or while youre in the class in need to hear a lecture on the material covered again, maybe a decent review tool. Although most of the courses with a full list of video lectures are introductory maybe theyll add more to thier openCourseware list as time goes on.

http://ocw.mit.edu/OcwWeb/web/courses/av/index.htm

Multivariable Calculus Here
Or here on youtube

Filed under: Education