outbreak! (ebola, sars, coronavirus, etc)

sorry to hear Brad.

My parents went on a very stupid vacation and my dad “got a cold” in the middle of it— when I asked them whether he had Covid, they told me he hadn’t tested since he’d been sick! I… uh… well, I had some words with them, but despite being intelligent people, a lot of the Boomers I know seem to know little and care less about the facts of epidemiology.

They’re both up to date with vaxes and boosters too. A few months ago my dad said “well we’ll be dead soon anyway, might as well take the risk now” and threw his hands up in the air. I couldn’t even really believe it tbh.

The Food and Drug Administration is proposing a crucial change in the way the coronavirus vaccine is handled: Switching to a once-a-year shot that targets the strain expected to pose the greatest threat during the following winter — a system akin to what is used for the influenza vaccine.

The agency, in briefing documents released Monday for a meeting this week with its vaccine advisers, said evidence suggests that “moving forward, most individuals may only need to receive one dose” of a coronavirus vaccine “to restore protective immunity for a period of time.” The change in strategy will be one of the topics discussed at the meeting, scheduled for Thursday.

The proposed change is designed to reduce the complexity of the vaccine regimen for the public, doctors and manufacturers. It also reflects a view that “chasing variants” with ever-changing booster formulations is ultimately futile, in part because the public has little interest in getting repeated injections, according to a person familiar with the situation who spoke on the condition of anonymity because they were not authorized to speak publicly about it.

The FDA would choose the annual strain for the shots every June, in time for the updated shots to be manufactured and then administered in September, as part of a yearly inoculation campaign. The goal would be to select the strain most likely to be dominant in the winter, when people are indoors and covid cases typically rise.

Seems like this was always the way things were going -- lots of people a year ago were like "what, are you going to get a needle in your arm EVERY YEAR FOR LIFE, WHEN WILL THE MADNESS END???" and I've been like, well yeah, I already do that for flu, what's the big deal?

Yeah. I wouldn't mind it being every six months while it's still flaring up pretty regularly, but just making it part of a normal cadence instead of people being confused whether they've got the now-current vaccine or the last vaccine because the communication has been spotty would be nice.

Agreed.

This seems like the right time to make that switchover to treating it like the flu vaccine, especially now that the omicron strain has become so dominant that it will predictably become the basis for all future variants.

I'm going to get a second bivalent boost in late March/early April I figure -- it'll have been six months and that's right before I do some travelling later in April, so given that efficacy does seem to decay regardless, I'd rather be safe than sorry -- but after that I'd be content to just do what I did last September and get bivalent (or whatever) yearly with the flu shot if things seem to have finally turned a relative corner. (Still masking like heck regardless when prudent.)

When I got my second booster in June (pre-bivalent), I got mild resistance at CVS ("But you got the first booster in Sepember!") but I ended up lying about my health. I wonder if we'll see similar nonsense. Considering the pathetic response to the bivalents, I hope not.

Looks like wastewater reports in Florida and California are looking better.

The SF numbers are going down for sure -- my hospital is now finally back in the single-digit amount of patients in care for the first time in at least three months I think.

hospitalizations also dropping significantly in FL last two weeks

however XBB.1.5 is only a small percentage of FL's variant soup, and yet normally you see the increase in cases at the beginning of the variant's emergence as well as when it becomes dominant, so not sure if it's a short hiatus or if that really is 'it' for the wave.

Not an article I wanted to write.

The deadly H5N1 bird flu is spreading widely, including to mammals.

For the first time, it's now likely spreading mammal-to-mammal, among minks which are exceptionally well-suited conduits to humans.

We must act now.https://t.co/aqd2TIqE5V pic.twitter.com/DPpmupOtGo

— zeynep tufekci (@zeynep) February 3, 2023

ffs

Act now? I can’t even access the article.

It's almost as if she thinks that information that has appeared in a NYT article isn't already sufficiently known to public health officials, and the best way to inform them is to issue a public call to action on her Twitter account. Glad to know she's on the job!

It's a concern but one I have no ability to stop atm and one I have no energy to think about until there is an action I can actually take

It's almost as if she thinks that information that has appeared in a NYT article isn't already sufficiently known to public health officials, and the best way to inform them is to issue a public call to action on her Twitter account.

Government officials are often empowered to act (or prevented from acting) by public sentiment. It seems perfectly possible that public health officials went to Tufekci to ask her to publicize this stuff in order to generate public outcry enabling them to do their job.

RIP, birds.

Government officials are often empowered to act (or prevented from acting) by public sentiment. It seems perfectly possible that public health officials went to Tufekci to ask her to publicize this stuff in order to generate public outcry enabling them to do their job.

― Guayaquil (eephus!)

Aimless?

It seems perfectly possible that public health officials went to Tufekci to ask her to publicize this stuff in order to generate public outcry enabling them to do their job.

I can buy the idea that Tufecki was contacted by Thomas Peacock, the virologist she cited in her tweet, but I greatly doubt the theory that the public health apparatus as a whole needed Tufecki's assistance because otherwise they would be powerless to address the possibility of avian flu making the leap into the human population.

Public health officials have tremendous power which they are already using. According to numbers cited in an article from Jan 17 over 58 million domestic fowl have died because of the avian flu, but the vast majority of them were deliberately killed to prevent its spread within the poultry industry. Officials could easily do the same thing in mink farms and I don't think they'd hesitate if it were required. They've used this same power many times in the past to prevent epidemics among poultry, cattle and swine. It's a basic tool.

I'm not at all sure what additional actions are being suggested. Public health officials are essentially powerless over wild migratory birds. Sure, we could slaughter large numbers of wild birds, but it would not be an effective response, because wild birds are not confined and they can't all be killed, their bodies collected and burned and their habitat disinfected. If the virus jumps to wild mammals presumably we won't even know until it reaches a stage where the increased mortality is obvious. Then you're stuck with the same problem as with wild birds.

Bird Flu Specialist Thomas Peacock is further proof that the simulation is breaking down

!

But what about specialist Thomas Apple TV+?

xp

Not to mention bird flu expert Thijs Kuiken from Rotterdam (kuiken means chick in Dutch).

I'm not at all sure what additional actions are being suggested.

just fyi the column is essentially a list of actions being suggested, none of them include slaughtering wild birds, not sure how you missed that

I don't have a subscription to the NYT and so I don't click on links to the NYT that will just take me to a paywall. If you'd care to name one or two of them I'd be happy to find out what they are.

If you click the link and then put your laptop/phone/whatever into airplane mode you can read the whole article without the paywall popping up

Here's a free link

xp My 2012 Dell desktop running Win7 doesn't have an airplane mode. But thank you just the same.

ty Eazy

in all seriousness, though, Tom Peacock is one of the better resources for virology, he gets cited by just about everybody, and dude is humble and patient (sometimes to a fault) with just about everyone.

there was a while where people would be freaking out about some minor subvariant and tagging him and he'd just calmly say "ehh I don't think it's a big deal", whereas he'd be honest if he thought it was one to watch.

this is helpful
https://archive.ph/

xp to Aimless - just disable Javascript on the Times website to access all articles.

I get my Times off of Napster

The Tufecki article suggests many interesting actions that could be taken, but as I suspected almost all of them rely on truly massive expenditures of money and effort, the creation of entirely capacities that do not exist yet and the expansion of some existing capacities by many orders of magnitude.

This is precisely how an expert scientist would think about the problem and it's an accurate reflection of the scale of global commitment that would be required to most effectively address the prevention of an avian flu pandemic and to minimize its global impact if prevention efforts fail. It is also an accurate reflection of the narrow limitations of expert scientists when it comes to their specialty.

I agree that if all those suggested actions were taken then society would become as protected against an avian flu pandemic as human ingenuity could devise. And all those measures taken in concert still could fail drastically because attempting to control events on a global scale is almost impossibly complex. Or events could simply deliver an outcome where no pandemic happened regardless of our actions. Chance occurrences are outside the province of scientists. They will simply acknowledge them and then have nothing more useful they can say about them.

From that list it seems sensible and possible to shut down mink farming entirely and to expand vaccination and testing efforts among poultry workers. Also, working on an mRNA vaccine should be fully funded. I can't see any of the other actions happening at the scale suggested. But the very scale of those suggested actions are a good indicator of the near-futility of halting a novel and easily communicable pathogen from creating a global pandemic.

are you basing that take off the covid-19 pandemic, which by many measures did have a blunted impact due to mitigation efforts despite being eventually ubiquitous, leaving you skeptical, or the numerous other diseases that threatened to reach pandemic status that we successfully mitigated by taking steps similar to those outlined in the article?

I don't understand this "well, we really failed to contain this recent pandemic, I guess the system can't work" when it has worked numerous times in the past. It's akin to all the people saying, hey, this y2k thing was a whole lot of nothing! The computers kept working fine, when it was the work of millions of people updating and testing computers that ended in that result.

"the near-futility of halting a novel and easily communicable pathogen from creating a global pandemic" is blowing my mind, as if humanity hasn't done this a number of times, or successfully adapted so that contagions that *did* cause pandemics no longer do so

bird flu wouldn't be as easy to spread as COVID, and its IFR would be much higher than COVID (meaning many more deaths) - so there are most definitely things that can be done that don't include shutting down society to curb this. development of vaccine/utilization of existing vaccines also a much different scenario than COVID-19.

and let's be real, the US didn't even really try to fight COVID-19 at all, not even the first year.

like...these things may not require you and I to do anything yet, but our medical and science infrastructure could and should take action.

...there were relatively effective vaccines by the end of 2020, the ability to isolate/test was patchy at best and not equitably distributed across the populace, but large swaths of society were part of a partial shutdown

there's a pretty huge difference between "we could have done it a lot better" and "didn't even really try to fight COVID-19 at all"

as if humanity hasn't done this a number of times

The measures that, for example, halted SARS and MERS resulted from public health officials using well-known methods and pre-existing powers, such as quarantine, rigorous barriers between the infected and caregivers, and rapid communication of findings among public health officials. If those measures can be counted upon to halt pandemics, then we can discount most of the actions Tufecki mentions as unnecessary.

contagions that *did* cause pandemics no longer do so

Those aren't novel pathogens.

I should clarify that I'm mostly talking about the United States (though there were many other countries who did equally poorly). the partial shutdown was ended way too early (just one month) for just about every state, and not every state restricted things as strictly. few if any met the measures the White House put in place for re-opening, so the premature re-open caused the second wave/surge.

And the reason that testing was patchy was because the CDC refused the existing COVID test kits and decided to create its own and they turned out to not work, which caused us to lose a lot of ground in testing/isolation. This would not have solved the problem outright, as it still would have been a major challenge, but it would have lead to catching clusters faster in some areas and probably slowed the growth a little.

Trump's government pushed a narrative of 'freedom' and opening America up, and mask usage began fading significantly by 2021.

I agree the vaccines were pretty much a miracle. However, my point is, using COVID as an example to suggest that fighting avian flu is futile (which I know you're not doing - i'm speaking broadly to the thread) is flawed because we didn't do a very thorough job trying to fight COVID as a country in the first place. and yes, it will take more than America to prepare/take action for avian flu, but we have to step way the fuck up this time.

Globally speaking, there is plenty that can be done and needs to be. this won't spread like COVID will, but as I said upthread, epidemiologists are quick to say the IFR as it is right now is misleading because of the small number of cases, but even though it will certainly not be 56%, it could be 4% or higher, which means many dead people. so we have duty to do something even if right now that 'we' doesn't include you and I directly.

(and of course right now, whether this will actually be a thing, human to human transmission, remains to be seen. it may be a non-event, but part of that is taking these actions to ensure it is a non-event.)

xxp Well, I can't argue if the specific criteria is a novel pathogen that spreads from livestock to humans. If it's the culling of animals and specific testing of animals alone, you can look at BSE. If it's the transmission from human to human, you can bring up SARS (2002) or ebola. If you need validation that the things mentioned are not all possible in concert in order to build up a precautionary framework, then sure, act like it's all impossible.

Livestock testing and culls aren't a new thing, but the latter is done more often as an economic safeguard than a human health safeguard.

helpful response to Zeynep's article, which supports it, but highlights a perhaps missed area of it regarding potential death toll if this became a human-human pandemic (it'd be bad, likely, like, very bad, but not extinction level)

But we don’t think this is a Last of Us or Contagion movie mortality rate for humans. I’ve already seen tweets that it will cause “billions of people to die”, which isn’t correct.

If this thing jumps, communicating this nuance is going to be very important.

— Katelyn Jetelina (@dr_kkjetelina) February 3, 2023

btw thank you to whomever turned me onto her substack, I read it all the time now

the one annoying bit is the prevailing statement that mink to mink transmission definitely occurred. this is not known, this is speculated based on what was observed, but a lot more testing is needed. that doesn't make Zeynep's article premature though. problem is readers don't really understand nuance, like everybody talks about the Y2K 'hoax' but don't realize that a lot of why it was such a non-event was all of the work that went into Y2K preparation.

more and more people are saying this

It's almost as if she thinks that information that has appeared in a NYT article isn't already sufficiently known to public health officials, and the best way to inform them is to issue a public call to action on her Twitter account. Glad to know she's on the job!

― more difficult than I look (Aimless), Saturday, February 4, 2023 10:49 AM (three days ago)

I don't have a subscription to the NYT and so I don't click on links to the NYT that will just take me to a paywall. If you'd care to name one or two of them I'd be happy to find out what they are.

― more difficult than I look (Aimless), Tuesday, February 7, 2023 4:09 AM (seven hours ago)