Ok, for dramatic effect here, I'll make my final point:

Kendall pointed to discrimination based on Asian/Middle Eastern lineage.  In
the flu scenario it will be the folks who have the best chance of recovery
based on prima facie evidence.  That's going to leave out the disabled.  Is
there empirical proof that folks with disabilities as a whole have poorer
respiratory functionality than folks without? No, but this is how things are
going to fall out.  Epidemiology will be used to determine treatment--not
the doctor/nurse in the triage room.

Am I the only one that sees a parallel here?

On Mon, Nov 3, 2008 at 7:38 PM, KE Cleveland <[log in to unmask]> wrote:

>  OK, something serious to think about vis-a-vis how the world-at-large
> will deal with a pandemic and how this just might play out in socialized
> settings of which we speak.
>
> The following article/opinion piece is from the UK Telegraph.  I can't
> speak to the Telegraph's journalistic veraacity, but they're not very far
> off the mark on projections of influenza infection and mortality.
>
> So, let's say best case scenario we have a 30% CFR.  That's a little low
> from the modelling I've seen, but it's a start.  Now with this particular
> round of the flu, you'll have not one, but three surges of infection with
> about a 60% infection rate.  Let's have a round number of 100 people in a
> given population.  Over the 9 months of active pandemia, 60 people will
> become infected, some 20 will die.
>
> Now, let's multiply our scale and add 4 zeros to our population, giving us
> 1,000,000.  Of those, 600,000 will contract active infections, 200,000 will
> perish--without intervention.  So what do we have for intervention?  Ah,
> yes, we have the golden bullet oseltamivir (Tamiflu).  Our collective
> governments pat us on the head and tell us no worries because we'll have
> prophylaxis for all!  Oops... what they forgot to tell us is that news from
> Vietnam is indicating that viral suppression is incomplete in that nation's
> clinic (the most comprehensive H5N1 treatment facility in the world, oddly
> enough).  That means...resistance.  Kind of like antibiotic resistant
> bacteria--same idea.  Tamiflu is quickly becoming old news on the flu front
> and that's not good because the World Health Organization has invested a lot
> of capital (human and otherwise) in advising nations to stockpile Tamiflu.
> The golden bullet turns out to be brass after all.
>
> Here's the catch: NO ONE has immunity (yet) to this virus.  And it's not
> whacking the old and the babies this time around.  It's a repeat of the 1918
> scenario where the population with the highest morbidity and mortality is in
> the 20-40 year-old range.  Why?  Well epidemiologists think it will be due
> to something called "cytokine storms" (look it up, it's windy).
>
> Ok, lets lowball and say we have a few 10K infections in our 1M
> population.  The majority of these folks will be really sick, but "stay home
> from work" sick, not deathly sick.  There will, however, be a fairly large
> cohort of young adults who will get very, very ill.  They will require
> intensive supportive care as they transition into full-blown pneumonia.
> Let's say out of our 1M populatiion, 1,000 are critically ill (these figures
> are wa-a-a-y below expectations) and need ventilation.  Our city of 1M has
> 50 vents, max (I'm dreamin' here), so that means 950 people are going to die
> without intervention--which is not available.  Who is going to triage those
> 1000 patients who have an equal chance of living or dying with treatment?
> The government?  What makes the local Health Department or the CDC the
> authority on who lives or who dies?  Because they "are".  The government
> appoints itself the authority, and once it has the authority it ain't coming
> back.  That's the plan and that's Socialism.
>
> Read the following.  I think it's foretelling.
>
> Kyle
>  ------------------------------
> *From:* [log in to unmask] on behalf of Tim
> *Sent:* Mon 11/3/2008 9:41 AM
> *To:* [log in to unmask]
> *Subject:* How would Britain cope with a pandemic?
>
>   How would Britain cope with a pandemic?
>
> Via *The Telegraph*, : Flu epidemic anniversary: How would modern Britain
> cope with an influenza pandemic?<http://www.telegraph.co.uk/news/newstopics/politics/health/3330052/Flu-epidemic-anniversary-How-would-modern-Britain-cope-with-an-influenza-pandemic.html>Excerpt:
>
> "So many were ill that only the worst could be visited," recalled a GP's
> son from Lancashire. "People collapsed in their homes, in the streets and at
> work... All treatment was futile."
>
> The symptoms of the 'Spanish' influenza – so-called because Spain, as
> opposed to countries involved in the conflict, did not censor reports of the
> spreading plague - included a hacking cough, projectile nose bleeds, and a
> condition known as heliotrope cyanosis, a dark-blue discoloration caused by
> shortage of oxygen to the lungs.
>
> Unlike most strains, it did not just strike the very young and old but also
> the 20-40-year-old age group. Around 228,000 Britons perished, and
> worldwide, it killed at least 50 million – ten times as many as had died in
> the war.
>
> Now, as the world faces the prospect of a new pandemic - mostly likely
> triggered by the bird flu virus H5N1 - the question has to be asked: how
> would Britain cope with a similar outbreak today?
>
> In the event of a repeat of 1918, the Department of Health calculates that
> a quarter of the UK population could fall sick over a fifteen-week period
> and 375,000 people could die. But the Armageddon scenario is that a new
> avian virus could have an even worse impact - resulting in more than 450,000
> deaths.
>
> One of the last Britons still living who remembers the'Spanish Lady,' is
> Ada Darwin, a 98-year-old who lives in Chester. She was seven when influenza
> killed her younger brother and both her parents.
>
> "There were black horses with plumes made from ostrich feathers, then the
> gun carriage with my dad's coffin covered with the union flag," she recalls.
>
>
> "My mother's coffin was in a big glass hearse with Noel's coffin under the
> driver's seat. My grandma told us my mother had gone to Jesus, but I said,
> 'Jesus has got plenty of people, I want my mummy.'"
>
>  Britain's Monty Python, of course, long ago taught us always to look on
> the bright side of life. But we really have no reason to suppose the case
> fatality ratio in the next pandemic will fall into the 2% range experienced
> by most industrial nations. (The CFR seems to have been much higher in
> countries like India, and approached 100% in small Native communities in
> Alaska and northern Canada.)
>
> We've had a welcome respite from human cases for several months, but the
> case fatality ratio remains around 60% worldwide and 80% in Indonesia. We're
> often told that when H5N1 becomes easily transmitted between humans, it will
> lose much of its virulence.
>
> Well, maybe. If someone can cite evidence for this assertion, please send
> it to me. But we should at least consider the possibility of H2H avian flu
> with its present CFR. As Dr. Samuel Johnson, another wise Briton, famously
> observed, "Depend upon it, sir, when a man knows he is to be hanged in a
> fortnight, it concentrates his mind wonderfully."
>
> November 02, 2008 at 04:51 PM | Permalink<http://crofsblogs.typepad.com/h5n1/2008/11/how-would-brita.html>
>
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