Misinformation caused by those who complain of misinformation

This journalist make a silly assumption that the infection, if 30,000
per week, will maintain at this rate for the next week.

For infectios disesase, each one of the 30,000 will infect more than
one person.
If the previous week there was only one, it gives an impression that
this one person has infected 30,000, so similarly for the next week.

The next week infection will be 30,000 x 30,000, which is 900 million,
higher than the population of Taiwan.

The observed death rate is 10 per month, so the infection rate should
also be similar, i.e. about 10 per month.

I.e. you multiply the number of infections of the previous months with
10, in order to get the number for the present month.

Of course, you can reduce this infection rate if you take special
precautions such as closing schools as what Mexico had done, but once
you return to normal, this rate will return because the infection is
already embedded in the society.

http://www.chinapost.com.tw/print/222681.htm

www.ChinaPost.com.tw

Misinformation can be as dangerous as the virus

Monday, August 31, 2009
The China Post news staff

Recently, the front pages of many newspapers and the main segments of
many TV news programs have featured scary numbers: 7 million Taiwanese
people may contract the A(H1N1)) influenza, also known as swine flu,
and 7,000 may die as a result.

It is understandable why the media tends to rely on numbers: they are
concrete, they are concise and precise. They are neat enough to put
into the headlines. Numbers are also good indicators of the "late-
breakingness" of news: The biggest ones make for the latest updates.

The problem with numbers is that while a number may be worth a
thousand words, these words can be misleading when the number is taken
out of context.

7,000 deaths is apparently a significant number, almost three times
the 2,416 casualties of the Sept. 21 Earthquake that occurred a decade
ago. Such number inevitably adds a tone of emergency to the pundits'
proclamations which in turn instills a sense of fear in the people.

While the seven-million estimation, made by Taiwan's former top health
official, Chen Chien-jen, based on the calculations of the World
Health Organization (WHO) and the 7,000 deaths based on his
"conservative" assumption of the A(H1N1) flu's death rate (0.1
percent) are sound, they can present a distorted picture of the
situation when they are used without one key piece of information:
over how long?

As the current health minister Yaung Chih-liang pointed out in a rare
press conference to rebuff the abundance of misinformation in the
media, even if the A(H1N1) virus maintains a high infection rate of
30,000 per week, which is unlikely, it would take over four years for
the number to reach 7 million. The 7,000 death rate is therefore a
four year tally at most.

According to the WHO, 250,000 to 500,000 people in the world die from
seasonal influenza, the "normal" flu, every year. According to
Taiwanese data, seasonal flu kills about 2,000 people per year. In
four years, the statistical death toll of seasonal flu in Taiwan has
been 8,000.

That does not mean that the A(H1N1) flu should be taken lightly. While
seasonal flu-triggered pneumonia generally causes death to infants and
the infirm, the new strain is most fatal for adults in their 30s to
50s.

It is exactly because the A(H1N1) flu is a challenge to reckon with
that the media should handle high numbers with great care. The
contention that it is passable to run sensational information as long
as it helps raise people's attention to the pandemic is false because
misquoted information only distracts people from learning the right
facts about flu prevention.Research by Common Health Magazine found
that despite wide coverage of the flu-related news, only 6.8 percent
of Taiwan's people fully understand the mechanisms of transmission of
the A(H1N1) virus. The A(H1N1) flu can only be transmitted through
droplets or contact inflection. The virus is not transmitted through
airborne means.

According to the research, more than 30 percent of people mistakenly
believe that the flu is spread through airborne or droplet
transmission while nearly 20 percent wrongly thought that they can be
infected with A(H1N1) through the air, droplets and contact.

Research has shown the counter-intuitive yet clear truth that
sometimes massive media coverage does not equal comprehensive
education of the people.

This is not a uniquely Taiwanese problem. U.S. President Barack Obama,
widely recognized as one of the best communicators in recent U.S.
history, has found himself greatly challenged in his health care
reform campaign by raging misleading information such as that his new
health care bill will encourage euthanasia and sponsor abortion.

With its credibility severely eroded in the aftermath of Typhoon
Morakot, President Ma Ying-jeou's administration is facing a crisis of
confidence. The government was determined to go all out to regain its
popularity, no matter the cost. The President was even quoted as
saying that the post-Morakot rebuilding process has to be done ASAP
"or else the government will be scolded again by the people."

The job of the government is not to obey the wishes of the masses, or
to avoid the heat of public denunciations. The government should be
first and foremost the protector of the people. As the health
minister, Yaung demonstrated his leadership and that he valued the
people's welfare beyond his personal career by standing up to fear
mongering and misinformation. However, the bravery of Yaung should not
be the end of it.

If the Ma administration truly wishes to redeem itself, it should not
focus only on the belated admission that it can "listen to the people"
and "feel their pain," it should take the lead in protecting people
from painful disasters in the future. Sometimes that means having the
courage to do the right thing, not the popular one.

Copyright © 1999 – 2009 The China Post.

Swine Flu is not Common Cold, Idiot

Many people think that Swine Flu is just like Common Cold, as this
report suggests. They are just a bunch of ignorant idiots.

Americans are getting serious about swine flu
Posted 23h 28m ago | Comment | Recommend E-mail | Save | Print |
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SWINE FLU: H1N1 VIRUS
Interactives: Track with U.S. time-lapse map; view world actions; how
strain emerged
Photos: People worldwide try to protect themselves
Q&A: Seasonal vs. swine flu vaccine | Video | Answering readers on
source, treatments | Handwashing 101: 3 steps
Schools: New guidelines | School nurses in short supply | Nurses are
front lines vs. flu
Oink oink: USA will wash its hands of swine flu humor when pigs fly
Looking ahead: ERs may not be pandemic-ready | Tamiflu, Relenza
resistance feared
Twitter, '76 flu, Your Health, biz impact

HEALTH UPDATES ON TWITTER

o Yahoo! Buzz
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o What's this?

By Steve Sternberg, USA TODAY
Americans are taking swine flu more seriously now than they did last
spring, when the emerging pandemic began causing widespread illness
and shuttering schools in several states, the latest USA TODAY/Gallup
Poll shows.

The poll of 1,007 adults Wednesday found that one in three people
believe they or a family member probably will contract H1NI flu, up
from one in five in May. Seventeen percent say they worried yesterday
that they would get flu, up from 8% in June. Sixty-one percent now
accept the government's reckoning of swine flu's risks, up 5% since
May. A majority of people, 55%, say for the first time that they will
get vaccinated, up 9%.

The poll's margin of error is plus or minus 4 percentage points.

"I'm not surprised to see that worry is increasing," says Kristine
Sheedy, who heads the H1N1 vaccine communication task force for the
Centers for Disease Control and Prevention. "When your kids go back to
school, you naturally think more about the possibility that they'll
get sick."

Despite the rising concern, the poll found that 62% of people believe
it's unlikely that they or a family member will get sick. Sheedy says
the finding may be the result of a misperception of just how many
people are susceptible to flu.

"People recognize that influenza's out there and that it can be
severe, but they say, 'I'm not personally worried,' " Sheedy says.
"That's one of the big challenges we face. Take seasonal influenza.
When we add up the high-risk groups and their close contacts, that's
the majority of the population."

The risk groups for swine and seasonal influenza differ, research
shows; more swine flu cases are concentrated among children and young
people.

A Chicago Department of Public Health study of 1,557 cases of swine
flu released Thursday by the CDC shows that children ages 5 to 14 had
14 times the infection rate of adults 60 and older.

Swine flu also has taken a toll among pregnant women, who have a death
rate of 6%. "People think of flu as the common cold," Sheedy says.
"It's not the common cold. It can be deadly."

An American Red Cross poll of 1,002 adults released Thursday shows
that more people are taking precautions against flu: Two-thirds said
they make an effort to cover coughs and wash their hands.

"Clearly they're taking the threat seriously," says Sharron Silva, the
Red Cross research director.

The margin of error of the Red Cross poll is 3.1 percentage points.

Politically sanitised report but good WHO report

What is missing is the research results from French researcher who
confirmed that Swine flu is 100 times deadlier than Common Flu when it
comes to ARDF.

WHO only admits to Swine Flu being not the same as Common Flu,
probably out of fear or respect for the stupid opinions in many health
authorities that Swine Flu is milder than Common Flu.

Swine Flu may be milder than Common Flu but it affects Younger people
much more and therefore spread rapidly and affects more people.

Despite the availability of Tamilfu which can cure Swine Flu with
certainty provided given within 48 hours, many had been hospitalised
and subsequently require ICU treatment. The death rate is 10 per
month, and had been true to the last 3 months, i.e. 1000.

In the 4th month(August), it is more than 2,500 but it is more due to
the slowing down of testing than to actual deaths. Malaysia is a very
clear case. They can't even speed up the testing of patients who are
in the risky groups.

At the end of September, it will be 100,000 so it will tax most health
care systems all over the world. By October, it will be 1 million.

The second wave has nothing to do with mutation. Even in 1918, it is
more due to the natural exponential rate that swamp the health care
system in those places. At the end of the day, the death rate remain
low at 0.67% the most, i.e. in Wales, UK.

If ever, Swine Flu were to mutate into virulent forms, you can see the
large death rates immediately, and will prompt world health
authorities to close borders, effectively stopping its spread.

The danger with Swine Flu is that authorities are lax in enforcing
quarantines resulting in the slow but exponential rate that will
eventually overflow the health care systems.

Global Alert and Response (GAR)
Country activities | Outbreak news | Resources | Media centre
WHO > Programmes and projects > Global Alert and Response (GAR) >
Diseases covered by GAR > Pandemic (H1N1) 2009 > Briefing notes
Main content
printable version
Preparing for the second wave: lessons from current outbreaks
Pandemic (H1N1) 2009 briefing note 9

28 AUGUST 2009 | GENEVA -- Monitoring of outbreaks from different
parts of the world provides sufficient information to make some
tentative conclusions about how the influenza pandemic might evolve in
the coming months.

WHO is advising countries in the northern hemisphere to prepare for a
second wave of pandemic spread. Countries with tropical climates,
where the pandemic virus arrived later than elsewhere, also need to
prepare for an increasing number of cases.

Countries in temperate parts of the southern hemisphere should remain
vigilant. As experience has shown, localized "hot spots" of increasing
transmission can continue to occur even when the pandemic has peaked
at the national level.
H1N1 now the dominant virus strain

Evidence from multiple outbreak sites demonstrates that the H1N1
pandemic virus has rapidly established itself and is now the dominant
influenza strain in most parts of the world. The pandemic will persist
in the coming months as the virus continues to move through
susceptible populations.

Close monitoring of viruses by a WHO network of laboratories shows
that viruses from all outbreaks remain virtually identical. Studies
have detected no signs that the virus has mutated to a more virulent
or lethal form.

Likewise, the clinical picture of pandemic influenza is largely
consistent across all countries. The overwhelming majority of patients
continue to experience mild illness. Although the virus can cause very
severe and fatal illness, also in young and healthy people, the number
of such cases remains small.
Large populations susceptible to infection

While these trends are encouraging, large numbers of people in all
countries remain susceptible to infection. Even if the current pattern
of usually mild illness continues, the impact of the pandemic during
the second wave could worsen as larger numbers of people become
infected.

Larger numbers of severely ill patients requiring intensive care are
likely to be the most urgent burden on health services, creating
pressures that could overwhelm intensive care units and possibly
disrupt the provision of care for other diseases.
Monitoring for drug resistance

At present, only a handful of pandemic viruses resistant to
oseltamivir have been detected worldwide, despite the administration
of many millions of treatment courses of antiviral drugs. All of these
cases have been extensively investigated, and no instances of onward
transmission of drug-resistant virus have been documented to date.
Intense monitoring continues, also through the WHO network of
laboratories.
Not the same as seasonal influenza

Current evidence points to some important differences between patterns
of illness reported during the pandemic and those seen during seasonal
epidemics of influenza.

The age groups affected by the pandemic are generally younger. This is
true for those most frequently infected, and especially so for those
experiencing severe or fatal illness.

To date, most severe cases and deaths have occurred in adults under
the age of 50 years, with deaths in the elderly comparatively rare.
This age distribution is in stark contrast with seasonal influenza,
where around 90% of severe and fatal cases occur in people 65 years of
age or older.
Severe respiratory failure

Perhaps most significantly, clinicians from around the world are
reporting a very severe form of disease, also in young and otherwise
healthy people, which is rarely seen during seasonal influenza
infections. In these patients, the virus directly infects the lung,
causing severe respiratory failure. Saving these lives depends on
highly specialized and demanding care in intensive care units, usually
with long and costly stays.

During the winter season in the southern hemisphere, several countries
have viewed the need for intensive care as the greatest burden on
health services. Some cities in these countries report that nearly 15
percent of hospitalized cases have required intensive care.

Preparedness measures need to anticipate this increased demand on
intensive care units, which could be overwhelmed by a sudden surge in
the number of severe cases.
Vulnerable groups

An increased risk during pregnancy is now consistently well-documented
across countries. This risk takes on added significance for a virus,
like this one, that preferentially infects younger people.

Data continue to show that certain medical conditions increase the
risk of severe and fatal illness. These include respiratory disease,
notably asthma, cardiovascular disease, diabetes and
immunosuppression.

When anticipating the impact of the pandemic as more people become
infected, health officials need to be aware that many of these
predisposing conditions have become much more widespread in recent
decades, thus increasing the pool of vulnerable people.

Obesity, which is frequently present in severe and fatal cases, is now
a global epidemic. WHO estimates that, worldwide, more than 230
million people suffer from asthma, and more than 220 million people
have diabetes.

Moreover, conditions such as asthma and diabetes are not usually
considered killer diseases, especially in children and young adults.
Young deaths from such conditions, precipitated by infection with the
H1N1 virus, can be another dimension of the pandemic's impact.
Higher risk of hospitalization and death

Several early studies show a higher risk of hospitalization and death
among certain subgroups, including minority groups and indigenous
populations. In some studies, the risk in these groups is four to five
times higher than in the general population.

Although the reasons are not fully understood, possible explanations
include lower standards of living and poor overall health status,
including a high prevalence of conditions such as asthma, diabetes and
hypertension.
Implications for the developing world

Such findings are likely to have growing relevance as the pandemic
gains ground in the developing world, where many millions of people
live under deprived conditions and have multiple health problems, with
little access to basic health care.

As much current data about the pandemic come from wealthy and middle-
income countries, the situation in developing countries will need to
be very closely watched. The same virus that causes manageable
disruption in affluent countries could have a devastating impact in
many parts of the developing world.
Co-infection with HIV

The 2009 influenza pandemic is the first to occur since the emergence
of HIV/AIDS. Early data from two countries suggest that people co-
infected with H1N1 and HIV are not at increased risk of severe or
fatal illness, provided these patients are receiving antiretroviral
therapy. In most of these patients, illness caused by H1N1 has been
mild, with full recovery.

If these preliminary findings are confirmed, this will be reassuring
news for countries where infection with HIV is prevalent and treatment
coverage with antiretroviral drugs is good.

On current estimates, around 33 million people are living with HIV/
AIDS worldwide. Of these, WHO estimates that around 4 million were
receiving antiretroviral therapy at the end of 2008.

More deaths due to no Tamiflu

This report is from Thailand. A blogger has difficulty in getting
Tamilflu treatment despite having high fevers and flu symptoms.

Doctors may be right. After 48 hours, Tamilflu is useless so it is
better not to give it to the patient but to let him just die.

Even hospitals cannot be blamed if they don't prescribe Tamilflu after
48 hours because it is clearly stated by the instructions that come
with the Tamilflu pack.

You just have to wait for your chances to survive. 10 000 to 1
against ARDS but combined with other complications such as pneumonia,
your chances of survival will be lower than this.

Ministry faces complaints on treatment of H1N1 victims
Web blogger dies after complaining

Writer: APIRADEE TREERUTKUARKUL
Published: 29/08/2009 at 12:00 AM
Newspaper section: News

Health authorities have been dogged by delayed diagnosis and treatment
of H1N1 victims at private hospitals after a patient complained about
the problems and described his severe flu symptoms on a mobile
community network prior to his death.

Nattawut Pajai, better known as "Day iPhone" for his creation of a
Thai font for the iPhone communications device, died on Tuesday.

The 28-year-old web blogger posted his message on Smart-Mobile.com by
using the pseudonym "Creative 7419", saying he had a high fever and
suspected he might have contracted the flu.

But he said he visited three different private hospitals before
doctors could confirm that he was carrying the virus.

Doctors at the first two hospitals he visited checked his blood but
the test results proved negative and they sent him home after giving
him painkillers.

A doctor at Ramkhamhaeng Hospital, the third hospital where Nattawut
sought medical treatment for his illness and later died, said it was
not H1N1 but a viral infection of the heart which had taken his life,
said his relatives.

It took nearly five days for lab tests to confirm the presence of H1N1
in his body. Hundreds of bloggers have forwarded his mail through
online communities and blamed health authorities for his death.

Suphan Srithamma, a Public Health Ministry spokesman, said Nattawut
was not listed among the confirmed H1N1 cases. Private hospitals
taking care of flu patients are not obliged to report new flu cases or
casualties to the ministry despite being asked to do so.

Meanwhile, relatives of another H1N1 victim lodged a complaint with
the ministry yesterday, accusing two private hospitals of negligence,
saying they should be held responsible for the death of Peerawee
Tuangsinkulbodee, 28, for not treating him in time.

The Department of Medical Service Support is looking into the matter
and will rule in the case next week.

Peerawee was hospitalised at two private hospitals for two weeks after
developing flu-like symptoms but was not treated with the anti-viral
drug oseltamivir.

After his condition deteriorated, he was transferred to a third
private hospital, where his family claims to have paid three million
baht in treatment costs, but he died on Aug 3.

It is estimated that over one million Thais are now carrying the H1N1
virus, said Public Health Minister Witthaya Kaewparadai.

So far 14,976 H1N1 cases and 119 deaths caused by the virus have been
confirmed, says the Bureau of Epidemiology's latest report released on
Wednesday.

A second batch of pandemic flu vaccine viruses has already been
harvested. The result of the yield rate is to be released on Monday,
which would determine how soon Thailand would be able to develop a
vaccine for H1N1.

Sudden turn for the worst in Swine Flu

This sudden turn to the worst is common among those hospitalised with
Swine Flu.

It is OK if you are willing to risk lives because those with ARDS,
even in ICU, only 50% survive. Just imagine those that stay at home in
the belief that they are previously healthy.

Overall the article reflects the facts but the present of the 2nd wave
due to mutation is not supported by any facts, or even mathematical
modelling. Even it it mutates, not all viruses mutate at the same
time.

Once it mutates, it will spread slowly, taking 6 months before it its
effect is seen due to the exponential growth. It is already seen with
the current trend of 10 per month. In just 3 months, the number of
deaths is already 1,000. By the end of this month, the number of
deaths should be 10,000 but testing is now burdened to the point that
it won't record this number.

The worst case scenario is already happening. Varients of Tamil-flu
resistant Swine Flu has already appeared but it was behind by a few
months. Until now, it is still very rare and will take 6 months before
its damage become visible.

Let alone a mutation in winter. It will take another 6 months for it
to be visible through sheer number.

Better use up the Tamilflu stock first while waiting for the
inevitable Tamilflu resistant virus to appear. When it became
widespread in 3 months, time, Tamilflu will become as useless as junk.

**********Pandemic virus could get nastier in year two

(AFP) – 20 hours ago

PARIS — The swine flu is unlikely to become more virulent as it
spreads through the northern hemisphere this winter, but could re-
emerge a year later in a more deadly form, a top expert said Thursday.

"We should get through the winter relatively easily, I don't think the
virus will mutate before then," said John Oxford, a professor of
virology at Britain's St Bartholomew's and the Royal London Hospital.

"There will be more people in hospital and more deaths, but
essentially it will be the same virus we have experienced in the
summer, just more of it," he told AFP in an interview.

After winter has passed, however, the pressures of natural selection
could favour the emergence of more deadly strains of the A(H1N1)
virus, Oxford explained.

"For the moment, the virus is running around the world finding lots of
young people and infecting them. It is doing very nicely, thank you,
why should it change?", he said by phone.

"But once the virus has infected about a third of the world's
population -- which is what we expect -- it will find less
'susceptibles'. That is when mutants will have a selective advantage."

It would be a serious mistake to think that once the impending flu
season is over, the danger will have passed, he added.

Oxford said he had just returned from Australia, where he met front-
line doctors who were concerned about an emerging pattern in swine flu
patients.

Whether they are people in high risk groups -- the obese, pregnant
women, asthmatics -- or young adults with no underlying conditions, an
alarming number of patients wind up in intensive care units.

"One minute they are OK in a hospital bed, the next minute they are in
intensive care," he said.

There have been more than 100 confirmed deaths from the pandemic H1N1
strain in Australia, which is just emerging from the southern
hemisphere winter.

Epidemiologists sifting through data from other countries have also
found similar -- and disquieting -- patterns.

French epidemiologist Antoine Flahault reported a 100-fold increase,
compared to seasonal flu, in the number of swine flu deaths in
Mauritius and New Caledonia attributed directly to the virus itself
rather than secondary bacterial infections or underlying conditions.

Many of those deaths were caused by acute respiratory disease syndrome
(ARDS), which requires intensive-care treatment for an average of
three weeks. Only 50 percent of ARDS patients survive.

Copyright © 2009 AFP. All rights reserved. More »

3 days to get 38 C

It is true that Swine Flu will cause 38 degree fever but it will take
more than 3 days to get this consistently, but by this time, it is too
late to take Tamilflu. In fact it is illegal to use Tamiflu by that
time as shown by the Tamilfu instruction.

All fevers start with a low temperature. Only idiots expect it to
suddenly jump to 38 degrees, just because he/she does not realise it.

Why wait for the treatment if you know for certain that 95% is Swine
Flu?

Why wait when you know that the patients should not get normal flu
when he already had flu vaccinations?

It is this waiting that had resulted in deaths and wasting of valuable
resources, i.e. Tamilflu.

August 27, 2009 18:05 PM

No New Deaths, 259 Patients Positive H1N1

KUALA LUMPUR, Aug 27 (Bernama) -- No new deaths due to Influenza A
(H1N1) have been registered today, leaving the death toll at 71, with
patients confirmed positive with the virus at 259 cases.

Director-general of Health Tan Sri Dr Mohd Ismail Merican said of the
259 cases, 53 were in Intensive Care Unit (ICU) with 41 risk factor
cases like those with chronic illness, obesity, children or babies,
pregnant women, new mothers and Down's Syndrome.

He said 260 new patients with influenza-like illness (ILI) had been
admitted to hospital for treatment while 312 had been discharged,
leaving 1,394 ILI patients at 94 hospitals, including five private
hospital.

"Those with ILI should rest at home and wear masks at all times when
in public places," he said in a press statement on the H1N1 situation
nationwide.

Dr Mohd Ismail urged the public to understand the difference between
normal flu and H1N1.

"Those infected with H1N1 normally have high fever (temperatures of
over 38 degrees Celcius) for three to four days, headache, sore
throat, tiredness, body aches and cough without phlegm during the
early stage.

"While those with normal flu rarely have fever or light fever
(temperatures of less than 38 degree Celcius), running nose and often
sneezes," he said.

-- BERNAMA

Tamilflu cannot be taken after 48 hours

Refer to the instruction sheet that I scanned and posted at my blog:
othmanahmad.blogspot.com

It is clearly stated that Tamilflu:
"Treatment should commence as soon as possible but no later than forty-
eight hours after the onset of the initial symptoms of infection."

When the symptoms start is not clear.

My sons, all start with watery nose but no fever. On the first day,
they all start with mild fever, 37.2 degree C, but in 8 hours, their
temperatures will rise to 38 degree C. A doctor's comment that it
immediately got to 38 degree C does not make sense but she vehemently
made that statement because she had the confirmed Swine Flu.

I should call the onset of fever as the start of the symptom.

On the second day, almost 48 hours, my 13-year old son, had developed
heavy coughing but only once but he felt his inner throat itchy. A
doctor later confirmed that there is mucus inside his lung.

After taking Tamilflu, it took him a few hours to get fully well.

My 11-year old son took the Tamilflu within one day after arguing with
the doctor that we cannot wait for the second day in view of what had
happened to his elder brother. Luckily he agreed.

He developed slight fever, 37.2 degree C, at 4 am yesterday. By 10 am,
at Putatan Government Clinic, his temperature was only 37.6. That was
where the doctor stated that the fever should be 38 degree but I agree
with her. I was hoping that he only got tonsil as a previous doctor
had confirmed that his tonsil was swollen and he was given Augmentin
antibiotic.

By 4 PM, his temperature had gone up to 38 degree so after breaking
fast, I went to SMC to request for Tamilflu which I got.

After taking Tamilflu, within half an hour, his temperature dropped to
normal.

Now I don't understand the research result that stated that Tamilflu
only slowed down symptoms by 1.5 days for healthy individuals
suffering from normal flu. The evidences of my son proved them
completely wrong, or is it the way the data were interpreted but if
that were the case, the intention is not sincere.

Tamillfu is to save lives, but to put it on display for any emergency
that will never come or useless to be used because it is too late or
not strong enough to stop death such as in individuals suffering from
acute diseases.

WHO or any doctor or authority who ordered to delay the prescribing of
Tamilflu beyond 48 hours is responsible to all deaths that may occur,
unless they are obviously not healthy to begin with. People should sue
them for damages as had been done in New York and probably in Pune.

The case in New York is not clear because the patient suffer from high
blood pressure and therefore are taking additional drugs but my
brother who suffer from high blood pressure insist that high blood
pressure is not in the list of risky individuals.

But cases in Pune is ignorance but in Lancaster is just utter
irresponsible but in line with WHO guideline. So WHO and British
health authority can be sued for gross negligence knowing full well
that 50% of those who are admitted to hospital wards and 20% of the
deaths are those without any underlying diseases, while Tamilflu is
extremely effective against Swine Flu and especially so for healthy
individuals as proven by my children.

It is not as effective in cases where the patients have underlying
diseases and especially when taken after 48 hours. It is just a waste
of resources and a potential emergence of Tamilflu-resistant Swine
Flu.

Although doctors can quote rumours that Tamilflu can be effective
after 48 hours, it is just rumours and unsubstantiated, and can be
explained to just random occurrence, or "luck". There is no reason for
the manufacturer to lie about the effectiveness of Tamilflu. It could
easily claim that it can be effective even afer 48 hours but in this
particular case, it is very strange indeed that it strongly states
that it is not to be taken after 48 hours. I have never come across
any drug company advertising this limitation openly.

By common sense, most drugs are no longer effective after a certain
days on the onset of symptoms, but the reduction in effectiveness may
be low enough that the drugs may still function as advertised, but in
the case of Tamilflu, it is completely forbidden.

In light of this information, WHO or other doctors should read this
instruction sheet, if they have not done so, and obey its instructions
to the letter. There is no excuse not to read them because Tamilflu is
easily available now and all come with the instruction sheet. If you
still haven't seen it, you can always read it in my blog at
othmanahmad.blogspot.com

Tamilflu instruction

Swine Flu vaccine only effective 1 month after

A good article on vaccines. I am surprised that it should take 1 month
before a 2 dose Swine Flu vaccine can be effective.

http://www.theleafchronicle.com/article/20090826/LIFESTYLE/908260309

theleafchronicle.com

August 26, 2009

Experts answer questions about flu vaccines

USA Today

The novel H1N1 flu strain, commonly known as swine flu, circling the
globe has prompted the U.S. government to order 195 million doses of
vaccine and prepare for a widespread vaccination campaign that would
be carried out along with the already scheduled effort to vaccinate
people against seasonal flu. USA Today reporter Steve Sternberg asked
vaccine experts to address questions about the pandemic vaccination
program and the vaccine.

Q: What makes the new flu vaccine different from seasonal vaccines?

A: The regular flu vaccine always has three different influenza
viruses in it, says Baylor College of Medicine vaccine expert Carol
Baker, a member of the government's Advisory Committee on Immunization
Practices (ACIP). That's both the nose spray vaccine and the
injectable vaccine. The three strains are the ones that are going to
be around in the fall and winter, she says. The H1N1 vaccine will be
made of one virus.

Q: How many shots will people need?

A: Seasonal vaccine can be given in a single dose, Baker says. That's
because the three strains in the seasonal vaccine have been around for
awhile and most people have been exposed to them, she says. Once
you're exposed to a virus, your immune system is primed to fight it
off once it turns up again. Vaccine ramps up that protection. Children
under 9, who have never received the flu shot before, typically need
two doses of seasonal vaccine, according to the American Academy of
Pediatrics.

Q: What about the swine flu pandemic vaccine?

A: We anticipate that everybody's going to need two doses of the
pandemic vaccine, Baker says. That's because the swine flu virus is so
different from typical viruses that very few people - except maybe the
elderly, who have been around longer and may have encountered a virus
like it - have been exposed to it, she says. That makes most of us
like children, lacking immunity and needing a booster dose.

Q: Who should get vaccinated for seasonal flu? What about pandemic
flu?

A: Seasonal flu vaccine campaigns usually focus on the elderly and
people of all ages with chronic diseases that can put them at higher
risk of potentially dangerous complications, Baker says. Pandemic flu
is striking a much younger population, including pregnant women, so
the ACIP recommended that it be given to pregnant women, people who
live with or care for children younger than 6 months old, health care
workers, people ages 6 months to 24 years and people 25 to 64 who have
chronic illnesses or immune problems.

Q: How long will it take for the vaccine to provide protection?

A: At least a month, because the two shots will come a week apart and
the immune system will not be fully armed until a week or so after
that booster shot, Baker says.

Q: Is the vaccine safe?

A: It's expected that it will be just as safe as seasonal flu vaccine,
Baker says. It's a new vaccine, so she understands why some people
worry about safety, but as a vaccine expert she doesn't share that
concern, she says. Each year, the strains in the old vaccine are
swapped for new strains, and there have never been problems, other
than the usual side effects of minor fever, aches, pains and soreness
at the injection site.

Q: What about thimerosal? Is that safe?

A: Thimerosal is a preservative used in vaccines. People worry about
thimerosal because it's a form of mercury, which can be toxic,
especially for pregnant women and young children, Baker says. What
complicates things more is that pregnant women are considered a
priority group for vaccination, because their death rate has hovered
around 6%. But thimerosal, made of ethyl mercury, is different from
the methyl mercury found in fish, she says. Methyl mercury can cause
congenital problems in fetuses. The ethyl mercury used in vaccine
isn't thought to pose a problem, especially because it's used in trace
amounts.

Q: I've heard researchers may need to use an immune booster, called an
adjuvant, for flu vaccine. What's that?

A: For reasons that aren't clearly understood, certain substances
significantly increase the potency of vaccines, says immunologist
Philippa Marrack of National Jewish Health in Denver. These adjuvants,
as they're known, are widely used in children's vaccines, and they're
a reason why measles, mumps, rubella and diphtheria vaccine work as
effectively as they do, Marrack says. Adjuvants aren't typically used
in flu vaccines in the USA, though they are in Europe, she says.
Adjuvants boost potency, lower the cost of vaccination and make
vaccines more widely available.

Because researchers are concerned about the potency of the H1N1
pandemic flu vaccine, they've begun testing versions made with
adjuvants. Canada has gone even further, buying millions of doses of a
vaccine-adjuvant combination from GlaxoSmithKline. Tests of adjuvanted
flu vaccine in the USA probably will begin soon, says Anthony Fauci,
director of the National Institute of Allergy and Infectious Diseases.
U.S. public health authorities have been reluctant to use adjuvants in
flu vaccine in the past because they don't want concerns about their
safety to stand in the way of persuading people to get the vaccine.

Q: When will the vaccine be available?

A: Studies have just begun to determine the dose and to make sure the
vaccine is safe. Jesse Goodman, deputy commissioner at the Food and
Drug Administration, said 45 million to 52 million doses of vaccine
are expected to be available by mid-October. More vaccine will then be
made available weekly, up to about 195 million doses by year's end.

Q: Where can I get it?

A: The same place you can get seasonal vaccines. Also, some states
will be providing vaccines through schools and health departments.

Contributing: Elizabeth Weise

Idiotic WHO advice on the use of Tamilflu

Tamilflu is only effective within 48 hours on the onset of symptoms
which means fever or runny nose.

After 5 days patients may turn to the worst suddenly. On then should
Tamilflu be given, according to WHO. This makes Tamilflu ineffective
and will create Tamilflu-resistant Swine Flu virus.

50% of patients admitted to hospitals have no underlying diseases, but
75% of those who survived were previously healthy.
So why give priority to patients who have underlying diseases where
Tamilflu is not as effective?

Tamilflu is designed to save lives, not to waste it on people who do
not benefit from it the most, i.e. those who are late and with serious
underlying diseases. As long as there is stock of Tamilflu, it should
be given to all those where lives need to be saved and have the
greatest chance of making full use of it.

Using Tamilflu for cases that are already more than 5 days is just
ridiculous and a waste of resources. It is similar to vaccinating old
people that only have effectiveness of less than 10%.

WHO must be filled with a bunch of idiots.

http://www.thestarphoenix.com/health/issues+caution+over+monitoring+swine+cases/1924069/story.html

The World Health Organization is warning that underlying health
problems "will not reliably predict all or even most cases" of severe
H1N1 influenza.

Worldwide, around 40 per cent of severe cases are now occurring in
previously healthy children and adults, usually under the age of 50,
WHO said Friday in issuing new guidelines on the use of antivirals
developed by an international expert panel.

In Canada, among cases where information is available, about 46 per
cent of those hospitalized so far with human swine flu had no
underlying medical condition. Among those who have died, 75 per cent
had a pre-existing health problem, according to the Public Health
Agency of Canada.

Most patients infected with the pandemic virus have mild symptoms and
recover fully within a week, even without any medical treatment, WHO
says.

But patients with severe H1N1 infection can experience "a sudden and
very rapid deterioration in their clinical condition", WHO said,
usually on Day 5 or 6 after the onset of symptoms. H1N1 can cause
viral pneumonia, which destroys lung tissue and is a leading cause of
death for H1N1 and seasonal flu, and multi-organ failure, including
failure of the heart, kidneys and liver.

"Clinicians, patients and those providing home-based care need to be
alert to warning signals that indicate progression to a more severe
form of illness, and take urgent action, which should include
treatment with oseltamivir," or Tamiflu, the world health agency says.

Serious cases should be treated immediately, ideally within 48 hours
of the beginning of symptoms, but treatment should be provided, even
if started later.

The recommendation applies to all patients, including pregnant women,
and all age groups, including young children and infants.

In children under age 1, recent Canadian data show higher rates of
hospitalizations, admissions to intensive-care units and death,
compared with all H1N1 cases in Canada.

WHO says anyone with an underlying medical condition should also get
Tamiflu as soon as possible, without waiting for lab test results, and
doctors should consider using higher doses than normal in severe
cases.

But healthy people with mild or "uncomplicated illness" don't need the
drug, the agency says.

Neither do otherwise healthy children older than five, unless their
illness persists or worsens, WHO says.

As of Aug. 15, a total of 1,422 cases of people hospitalized with
swine flu had been reported to the Public Health Agency of Canada.
This week, four new deaths were reported, for a total of 71 deaths
since the beginning of the pandemic.

Canada has a national antiviral stockpile of 55 million doses of both
Tamiflu and Relenza, another flu drug. The Public Health Agency of
Canada has recommended the drugs be reserved for those at high risk of
complications of the flu, and for people with more severe illness, and
not people who are only mildly sick.

If Tamiflu is overused, the H1N1 virus could adapt and develop
resistance.

Since the start of the outbreak, the official messaging has been
people with underlying health problems, such as asthma, diabetes and
heart disease, are among the most vulnerable to getting severely sick
with H1N1.

"That is still one of the groups that we need to identify, and that's
what we're doing — identifying new students on campus who have those
problems," says Dr. Pierre-Paul Tellier, director of student health
services at McGill University in Montreal.

But the warning that 40 per cent of cases are occurring in otherwise
healthy people "also then tells us that we need to maybe be a little
bit more vigilant at looking for other individuals who may be
deteriorating a little more rapidly," he says. "It does indicate there
is a change."

The Public Health Agency of Canada's national microbiology laboratory
in Winnipeg is working with intensive-care units across Canada to
investigate why severe infections are occurring in certain people.
More than 100 cases are under review.

Tellier says federal reports that overall H1N1 activity is decreasing
across Canada "is a bit of a false picture."

"If we speak to our colleagues who work in the hospital, they're just
not testing like they used to. We don't really know how common the
infection is in the population, at this point."

The World Health Organization says medical attention should be sought
when any of the following danger signs appear in someone with
confirmed or suspected H1N1 infection:

- Shortness of breath, either during physical activity or while
resting

- Difficulty breathing

- Turning blue

- Bloody or coloured sputum

- Chest pain

- Altered mental state, including drowsiness and confusion

- High fever that persists beyond three days

- Low blood pressure

In children, warning signs include fast or laboured breathing, lack of
alertness, difficulty in waking up, and little or no desire to play.
© Copyright (c) Canwest News Service

WHO wants to kill 50% more Swine Flu patients who are healthy

REsearch shows that up to 50% of the previously healthy patients died
of Swine Flu but these only occur when they are not given Tamilflu.

The figure used to be low, e.g. 20% in Malaysia, but it is more due to
wrong diagnosis of prior illnesses, as most humans have a slight
medical conditions which do not prevent them from being physically
active to the point of being a Soldier and Fireman, as shown by a
swine flu fatality case in UK.

The fatality used to be low as well because they were treated well
with Tamilflu, as had been done by UK in the early stages but lately
there was a lot of advice for healthy patients not to take tamilflu.
As a result the number of Tamilflu prescriptions go down, but the
number of deaths go up.

The good news is that the number of deaths didn't follow the
exponential pattern as monitored by ECDC. There appear to be a drop 2
weeks ago, but this is due to the school holidays in Australia and UK,
more than 2 weeks ago. As the students return, it peaked up again but
only to the level of the previous 2 weeks.

This supports the vaccination plan that the best way to protect the
whole population is to vaccinate the children, which has the highest
vaccination effectiveness instead of old people that have low
vaccination effectiveness.

The reported number of deaths didn't match up to the predicted 10,000
despite following the pattern of 10 per month, up to last month, which
was 1000. This month should be 10,000 but so far only 2,450. These are
confirmed swine flu after weeks of testing. As the number of deaths
grows large, up to the 10,000 number worldwide, it will be difficulat
to undergo all the Swine Flu confirmation phase. It does not mean
that there are no 10,000 deaths, but burials will not tell lies.

The worst will be in the next month, when it approaches 100,000
worldwide. It will certainly tax the health care of many nations,
thereby increasing the rate to more than 10 per month. Small but
wealthy nations like New Zealand and Australia have already ordered
more lung machines. What hope is there for large but poor nations like
Indian have?

The rate in India is more than 20 per month, so by the second month it
should be more than 400, but their medical authorities are still
sleeping, thinking that 20 per month is not as bad as 30,000 in 30
years.

China has to be commended for still having ZERO fatality, due to its
over zealousness in enforcing quarantine procedures. Despite China's
large confirmed Swine Flu cases, it still has zero fatality which is
surprising because it achieves a fatality rate that is lower than the
10,000 to 1 for ARDS fatality observed by a French researcher.
Probably the low microbe exposure causes less fatality as our bodies
can ward off a smaller number of microbes.

That is why my son's wearing of masks in the classroom helps somehow
despite him taking it off just before going out of the classroom. With
the surgical mask not entirely foolproof against airborne microbes,
the lack of any mask, even in the short duration while still inside
the classroom had exposed him to swine or other flu virus.

So strict quarantine is still the best practise because it is
economical in life and monetary terms, but failing that, we all should
wear masks in enclosed places.

http://www.thestarphoenix.com/health/Keep+swine+drugs+serious+cases+says/1916898/story.html

GENEVA - Healthy patients who get H1N1 swine flu without suffering
complications do not need to be treated with antivirals like Tamiflu,
the World Health Organization (WHO) said on Friday.

But the drugs are strongly recommended for pregnant women, patients
with underlying medical conditions and children under 5, since they
are at increased risk of more severe illness.

However, judging who will need antivirals is not easy for doctors
since the risk of developing severe illness from the new flu strain is
not restricted to people who have chronic conditions such as heart
disease, diabetes or asthma.

"Worldwide, around 40 percent of severe cases are now occurring in
previously healthy children and adults, usually under the age of 50,"
the U.N. agency said in its latest guidelines on drug use.

"Some of these patients experience a sudden and very rapid
deterioration in their clinical condition, usually on day 5 or 6
following the onset of symptoms," it said.

Despite the WHO's conclusion that underlying medical conditions do not
predict a severe infection, the fact that 6 out of 10 patients
suffering serious bouts of swine flu do have previous conditions
chimes with other medical research.

A study published on Thursday by France's Institute for Public Health
Surveillance concluded that about half the people dying from swine flu
were pregnant or had other health conditions, especially diabetes or
conditions linked with obesity.

The WHO said doctors should give Tamiflu to patients with severe
illness or whose condition deteriorates, or to high-risk groups
including pregnant women, but not to healthy people with no
complications, as most of these recover fully within a week.

International experts who reviewed the latest evidence found that
Tamiflu, made by Switzerland's Roche, "can significantly reduce the
risk of pneumonia," a leading cause of death for both pandemic and
seasonal flu, it said.

Viral pneumonia, which does not respond to antibiotics, can lead to
the failure of multiple organs, including the heart, kidneys and
liver, so patients will require intensive care and additional
treatment to antivirals.

"Studies show that early treatment, preferably within 48 hours after
symptom onset, is strongly associated with better clinical outcome,"
the WHO said.

The recommendation applies to all patients, including pregnant women
and all age groups including infants.

When oseltamivir, the generic name for Tamiflu, is not available or
cannot be used for any reason, zanamivir, made by GlaxoSmithKline
under license from Biota and sold under the brand name Relenza, may be
given, it said.

The WHO said it has been notified of 12 cases where the H1N1 virus had
been resistant to treatment with Tamiflu, as a result of a mutation.
There was no evidence of onward transmission of the virus in these
cases, it said.

The H1N1 strain has now spread to 177 countries, causing at least
1,799 deaths, the WHO said in a separate statement.
© Copyright (c) Reuters

120kg man given the same dose as a 40kg

I'm reading the instruction manual for Osmivir, from Royce, Malaysia
that is is equivalent to Tamilflu, or Oseltamivir phospahae.

Adults and adolescents 13 year of age and older, is 75mg twice daily
for 5 days.

My son is older than 13 years although weighs at 39kg and he prefers
pills instead of syrup that is too messy for me to administer.

If you weigh 120kg, i.e. obese, you'll be given the same dose.

A very important message is that treatment for influenza should be no
later than 48 hours after the onset of the initial symptoms of
infection.

Note that it is for all types of influenza, except that for Swine Flu,
it is 100 times life saver compared to normal flu that Tamilflu only
relieves symptoms from 3 days to just 1.5 days. For Swine flu,
Tamilflu can be a 100 times life saver indeed, compared to normal flu.

3-day antiviral treatment is too late

August 25, 2009 17:16 PM

Death Of Child Raises H1N1 Flu Death Toll To 70

KUALA LUMPUR, Aug 25 (Bernama) -- A three-year-old child has died of
Influenza A(H1N1), raising to 70 the death toll from the disease in
the country.

Director-General of Health Tan Sri Dr Mohd Ismail Merican said Tuesday
the child died on Aug 18 of encephalitis with cerebral odema and multi-
organ failure.

He also said that 52 new cases of Influenza-like illness (ILI) were
admitted to hospitals while 162 ILI patients were discharged, leaving
1,354 ILI patients still under treatment in 82 hospitals nationwide.

Dr Mohd Ismail said in a statement that treatment was first
administered to the child on Aug 12 after suffering from fits and
cough for two days.

However, the following day, the child's condition worsened, requiring
admission to the intensive care unit and treatment with the anti-viral
drug, Tamiflu, he said.
This is another evidence that after 48 hours, Tamilflu is not longer
effective in preventing death.

It should be administered within 2 days on the onset of fever. This is
what I had requested for my son, and fortunately I got it.

In the first 2 days, the fever was mild I noticed that on the second
day, he coughed heavily, like never before, for the first time.

Because I was worried, I went to SMC immediately. I think it should be
before the 48 hours. I argued that my 13 year old son shouldn't get
the normal flu because he was already vaccinated at SMC with normal
flu vaccine, more than 2 weeks ago, at least with 99.9% probablility
that he should not be getting any normal flu.

Also I argued that my wife is suffering from SLE, and used to be
treated with steroids, and all this is recorded at SMC where she was
treated.

On doctor's inspection, the fever was confirmed although still light,
and his lung has evidence of puss(kahak in Malay).

And I know him quite well and this Tamilflu is provided free of
charge, although I was more than willing to pay for it.

Today, my son is alright. His red eye has disappered as well his puss
in his throat, his runny nose and cough. He may not have suffered from
Swine Flu, but Tamilflu is surely effective, which is further evidence
that what he got was Swine flu.

It was mild and my son had no underlying diseases, but based on death
cases even in Malaysia, in 5 days, it could turn suddenly worse and
cause death within 2 days after that. And in Lancaster, UK, a 50 year
old with no underlying diseases died, because he was advised by
authorities to just stay at home and not get any Tamilflu. It led to
his death, but a reduction in the prescriptions of Tamilflu.

At the cost of RM120, is it worth the life of a human being? And
despite having evidences that only 10% of those given Tamilflu were
really Swine Flu cases in UK, those other 90% are still better served
by Tamilflu by reducing their sufferings, just as my son is at the
moment.

The reduction in symptoms studies due to Tamilflu by just 1.5 days for
healthy people, but for these people, they only need to suffer for at
most 3 days even without Tamilflu. A reduction of 1.5 days is a
reduction of suffering of 50%, a significant contribution.

The study didn't cover not so healthy people who may suffer deaths if
not given Tamilflu. This was not studied so cannot be relied on to
stop the prescription of Tamilflu for even healthy people for
suspected Swine Flu cases. The consequences is heavy, i.e. deaths for
even healthy people, because statistics shows that 50% of the deaths
in UK have no underlying diseases, while it is only 20% in Malaysia.
Even 20% is siginicant, especially when it is you family that is
affected, all for the saving of RM120?

http://www.bernama.com/bernama/v5/newsgeneral.php?id=435558

Dr Mohd Ismail said that of the 1,345 patients in hospital, only 202
or 15 per cent had been confirmed as H1N1 positive, and 42 of these
cases were under intensive care.

"Of the 42 cases under intensive care, 38 are in the risk category,
having chronic illnesses (15), being obese (nine), suffering from
diabetes (six), being children or infants (three), women who were
pregnant or in the post-delivery period (three) or suffering from
Down's syndrome (two)," he said.

Dr Mohd Ismail said the World Health Organisation (WHO) had reported a
total of 239,397 H1N1 cases with 2,578 deaths worldwide as of today,
indicating that the pandemic was still active.

-- BERNAMA

Swine Flu 100 times more lethal than Common flu

Directly lethal means without any comparison with health care.

This is due to ARDS which will make a person be kept in ICU for 3
weeks and only 1 in 2 will survive.

Cases of ARDS among Swine Flu is 1 in 10,000 which is 100 times more
than normal flu.

Malaysia that has a population of 25 million may have 2500 cases of
ARDS if they are not treated early with Tamilflu. Fortunately Tamilflu
is now provided free of charge.

http://www.google.com/hostednews/afp/article/ALeqM5g9K3Z8fvmvpOUBWlmjQZDxnscXQg

Swine virus more directly lethal than seasonal flu: scientist

By Marlowe Hood (AFP) – 6 hours ago

PARIS — People who die after getting swine flu are up to 100 times
more likely, compared to seasonal flu, to have been killed by the
virus itself rather than secondary causes, a top French researcher
said Monday.

The findings -- published on a research-sharing platform, PLoS
Currents: Influenza, vetted by flu experts -- could help health
officials manage critical care resources if infection rates climb in
the Northern Hemisphere's autumn and winter.

It could also provide important clues as to the new swine flu's
potential virulence, said author Antoine Flahault, a leading
epidemiologist and director of France's School for Advanced Studies in
Public Health.

"The direct lethality due to viral pneumonia probably gives the best
estimate of an influenza strain's virulence, since it may vary from
strain to strain and is not due to a country's level of health
development," he said.

With regular seasonal flu, which claims up to 500,000 lives each year
worldwide, most deaths are attributed either to secondary bacterial
infections such as pneumonia, or pre-existing chronic conditions that
boost vulnerability.

Only about one-in-a-million infections result in death due to a rare
condition known as acute respiratory disease syndrome (ARDS).

"ARDS is frighteningly lethal -- it is like drowning," Flahault told
AFP by phone. The condition requires intensive-care treatment for an
average of thee weeks. "Statistically, only one in two patients
survive."

The risk factors for ADRS are poorly understood, though recent studies
in the United States suggest that, among people infected with swine
flu, pregnant women and the very obese are particularly at risk.

Both seasonal influenza and the new A(H1N1) virus that has swept the
globe since May appear to have roughly the same mortality rate of one-
to-five per 1,000 infections, though figures for the swine flu remain
very sketchy.

Experts also caution that the pandemic flu could become more lethal as
it continues to mutate.

But preliminary analysis of infection and mortality statistics from
the French territory of New Caledonia and the Indian Ocean island
nation of Mauritius suggest that the new A(H1N1) virus directly caused
an ARDS fatality for every 10,000 cases, Flahault told AFP.

In New Caledonia, local health authorities have reported 30,000
infections and two deaths attributed directly to the pandemic virus.

Flahault said that some 70,000 persons have been infected in
Mauritius, with seven reported deaths from ARDS, five of them
confirmed.

"These surveillance data allow for a first estimate of direct
lethality due to H1N1 of one-per-10,000 infections, about 100 times
more than regular seasonal flu," he said.

Flahault cautioned that these are only "preliminary and rough
estimates," and acknowledged that his findings -- based on a limited
number of cases on two isolated islands -- may not extend to much
larger, continental countries.

"But we have a terrible lack of data," he said.

"It may be useful to deliver such estimates ... as early as possible
so health authorities can check availability of intensive care units
and artificial ventilation devices in case of a wave of similar
virulence this autumn in the northern hemisphere," he said.

Copyright © 2009 AFP. All rights reserved.

Those who died of Swine Flu should sue the authorities

Instead of just attacking, they should sue the authorities, just as
the 1st death in USA. It was needless when it can be treated with
Tamilflu and Relenza.

Letting someone with no previous illness defenseless, when it is well
known that 50% of the dead were those with no underlying illnesses, is
just plain murder, but doctors are so used to seeing deaths that just
one more death is not important to them.

http://www.lep.co.uk/news/Grieving-brothers-attack-health-bosses.5576652.jp

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Grieving brothers attack bosses over swine flu death

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Published Date:
21 August 2009
By Aasma Day, Health Reporter
The grieving family of a Lancashire man killed by swine flu has
attacked the authorities for their handling of the crisis.
Godfrey Armstrong, 55, who lived in Penwortham near Preston, with his
brother Julien, became ill with a flu-like illness a few weeks ago.

As he had no underlying health conditions, he did not go to his doctor
or to hospital, but tried to recover from the illness at home. But the
disease took hold and he died on August 2.

His brothers Rodney and Julien said a pathologist's report confirmed
Godfrey died of swine flu.

He is believed to be the first person in Lancashire to have died of
the disease – one of 59 to die nationally during the pandemic.

Julien, 45, who believes he also suffered a milder form of swine flu
but recovered, found his brother dead.

He said: "Godfrey was late getting up that morning and when I called
him, I was not getting a response.

"I went into the bedroom and found him lying there dead on the floor.
"The health advice is that if you are relatively fit and healthy and
get swine flu, you should get better in a few days.

"But even though Godfrey was in good health, he died of it.

"You just don't expect something like that to suddenly happen to
someone in your family."

>> Lancashire man dies from swine flu

After his brother's death, Julien became concerned about his own
illness being swine flu and called his GP surgery for advice.

He said: "I was told to ring the National Flu Line and when I did, I
just seemed to get an advice line telling me to make sure I disposed
of tissues after blowing my nose and to make sure I washed my hands
regularly."

Rodney said: "The health people are trying to sweep the whole issue
under the carpet.

"I think they are trying to play it down so they don't frighten
people, but they are being deceitful about it. Health bosses are
discouraging people from going to doctors or hospital if they think
they have swine flu and say it is mild unless you have an existing
health condition.

"Godfrey did not have any underlying health conditions and he died.
Swine flu is a nasty, aggressive, illness and Godfrey's death was
rapid.

"The health professionals let Godfrey down as they are supposed to
save people."

Conservative shadow health secretary Mike Penning told the Lancashire
Evening Post: "It's vitally important for Mr Armstrong's family and
the country as a whole that we can have confidence in the processes
put in place to deal with swine flu."

South Ribble MP David Borrow said: "The family have not contacted me
but if they were to I would demand answers from the PCT and would
ensure as much information as possible was in the public domain. I
need the permission of the family before I can start asking questions
about a particular individual."

Dr Terry O'Connor, NHS Central Lancashire clinical executive chairman,
said: "There is nothing new that we can add about whether or not this
was a death due to swine flu until we have heard from the coroner,
which we anticipate will be in the next few days.

"Whether or not the death was due to swine flu, we would like to offer
our sympathy."

The funeral was at Kingsfold Methodist Church in Penwortham on August
12, followed by burial at Hill Road Cemetery.

>> Vote in our latest web poll

Another example idiotic doctors and their statistical analysia

Even I was a fool but I had my doubts but this article cleared it all.

If we remote infant mortality from the statistics, the men's age at
which they die, remain remarkably constant. No wonder my observations
that my grand parents die at much higher ages than the statistics
indicate, although many of their relatives die at much earlier ages.

In fact, many of my grand parents believe that they are more healthy
then the people nowadays because they eat and live healthily. Less
pollution and poison in their diet and enivironment and they use
physical force more.

http://www.livescience.com/health/090821-human-lifespans.html

Human Lifespans Nearly Constant for 2,000 Years
bradford-columnist-153x65.jpg

By Benjamin Radford, LiveScience's Bad Science Columnist

posted: 21 August 2009 03:26 pm ET
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Comments (13) | Recommend (4)

The Centers for Disease Control and Prevention, often the harbinger of
bad news about e. coli outbreaks and swine flu, recently had some good
news: The life expectancy of Americans is higher than ever, at almost
78.

Discussions about life expectancy often involve how it has improved
over time. According to the National Center for Health Statistics,
life expectancy for men in 1907 was 45.6 years; by 1957 it rose to
66.4; in 2007 it reached 75.5. Unlike the most recent increase in life
expectancy (which was attributable largely to a decline in half of the
leading causes of death including heart disease, homicide, and
influenza), the increase in life expectancy between 1907 and 2007 was
largely due to a decreasing infant mortality rate, which was 9.99
percent in 1907; 2.63 percent in 1957; and 0.68 percent in 2007.

But the inclusion of infant mortality rates in calculating life
expectancy creates the mistaken impression that earlier generations
died at a young age; Americans were not dying en masse at the age of
46 in 1907. The fact is that the maximum human lifespan — a concept
often confused with "life expectancy" — has remained more or less the
same for thousands of years. The idea that our ancestors routinely
died young (say, at age 40) has no basis in scientific fact.

Yet this myth is widespread, and repeated by both the public and
professionals. A few examples:

* An article on Egyptian pyramid builders in the November 2001 issue
of "National Geographic" noted, "Despite the availability of medical
care the workers' lives were short. On average a man lived 40 to 45
years, a woman 30 to 35."

* In a 2005 press release for the TV show "Nightline," a producer
wrote, "I am 42 years old. I live in a comfortable home with my
family.... I'm lucky. If I were in Sierra Leone, the poorest country
in Africa, chances are I'd be dead at my age. The life expectancy
there is 34 years of age."

* A Dec. 18, 2003, Reuters news story on the impact of AIDS in Africa
reported that "A baby girl born now in Japan could expect to live 85
years, while one born in Sierra Leone probably would not survive
beyond 36."

Such statements are completely wrong; most people in Sierra Leone are
not dropping dead at age 34. The problem is that giving an "average
age" at which people died tells us almost nothing about the age at
which an individual person living at the time might expect to die.

Again, the high infant mortality rate skews the "life expectancy"
dramatically downward. If a couple has two children and one of them
dies in childbirth while the other lives to be 90, stating that on
average the couple's children lived to be 45 is statistically accurate
but meaningless. Claiming a low average age of death due to high
infant mortality is not the same as claiming that the average person
in that population will die at that age.

Of course, infant mortality is only one of many factors that influence
life expectancy, including medicine, crime, and workplace safety. But
when it is calculated in, it often creates confusion and myths.

When Socrates died at the age of 70 around 399 B.C., he did not die of
old age but instead by execution. It is ironic that ancient Greeks
lived into their 70s and older, while more than 2,000 years later
modern Americans aren't living much longer.

Benjamin Radford is managing editor of the Skeptical Inquirer science
magazine. His books, films, and other projects can be found on his
website. His Bad Science column appears regularly on LiveScience.

The idiot that is causing all the deaths in Malaysia

I have been reading comments on the statements made by this idiotic
doctor this week but this is the original word made by him.

They are indeed idiotic and full of conjectures, devoid of any fact at
all.

What figure does he have to use 20 times as the estimate for the
number of cases of swine flu? If this estimate were used, then the
same estimate should also be used for normal flu that does not have
any formal testing at all, so the rate for normal flu is only 0.02/20,
i.e. lower than 0.001% for the whole year which is consistent with the
US inflated estimate(0.01%) of Normal Flu deaths, where 50% of
pneumonia deaths were attributed to Flu using a special unproven and
unsubstantiated model. In 2001, only 257 were confirmed to have died
of flu, instead of thousands.

BAsed on the early confirmed results, it was 0.4% for Malaysia. It was
more reliable in the early days because tests were actually conducted
on suspected cases and deaths. It was still under reported but so were
the deaths.

Many unnecessary deaths that will not happen if it were not for the
Swine Flu, were not reported as swine flu induced deaths as this
stupid doctor had suggested, but wrongly indeed. Almost all deaths
reported all over the world are not due to swine flu. The 15 figure
quoted by him here is just a stupid guess. But all over the world had
the sense to indicate that swine flu is the contributing factor
leading to their deaths because without swine flu, they will not have
died.

With such idiotic doctors being widespread in Malaysia, it is not
surprising to note that many deaths were under reported. In fact, I
have just heard a rumour that a suspected swine flu patient were put
next to patients that mysteriously died one after the other.

These deaths were never diagnosed as being due to Swine Flu because
they were hospitalised for other diseases, but will become fatal if
exposed to swine flu.

http://www.sun2surf.com/article.cfm?id=37200
Don't spread the panic, too

THERE has been much alarm over the rising number of cases and fatality
rates and rightly so, because influenza A(H1N1) is a very infectious
disease.

While alarm and widespread panic is not necessary, there exists the
pressing need to restrategise and implement mechanisms and Standard
Operating Procedures (SOP) for the prevention of secondary bacterial
pneumonia. A(H1N1) spreads by droplets and so is easily transmitted.
The director-general of Health calls it a high attack rate.

For a country of 27 million, struggling with this crisis since April
this year, and with national and international transport being so
widely used, 4,200 reported cases so far is severe under-reporting.

There are probably 20 times the number of cases out there that are not
reported. Because of this, many countries have stopped trying to
report the number of new cases.

Unfortunately, 67 have died in Malaysia. But if you were to be
objective, 67 deaths, out of a possible 70-80,000 cases, gives a death
rate of 0.08%. Still a bit higher than the usual seasonal flu death
rate of 0.04%, but surely not anywhere near panic proportions.

A closer look at the deaths revealed that 80% were A(H1N1) associated,
or were incidentally found to have contracted the virus, the virus by
no means causing the death.

We can call this A(H1N1) associated death or death with incidental A
(H1N1) infection. So, if the certification of death is proper, it may
be that only 15 deaths were actually due to A(H1N1), giving a fatality
rate of 0.02%. This is why we need to consolidate measures that are
already in place.

This should include a national level SOP whereby all affected patients
with secondary bacterial pneumonias would be immediately triaged for
intensive tertiary level care.

There is no cause for panic but we should all be vigilant.

Dr Ng Swee Choon
Committee member
Medical Affairs Committee,
Federation of Private Medical
Practitioners' Associations Malaysia.

Australia's death could be 10,000 by 19/Nov/2009

REad the article carefully. One point is very clear here but may be
missed by idiots. The number of confirmed deaths is much lower than
those what is actual.

"There will be many more deaths out there that were caused, or
precipitated, by this flu that are not diagnosed of it," she said,
adding the 30,000 cases would be just the tip of the iceberg."

In 2 months, the number of deaths, i.e. by 19 August, was 100. So in
another 2 months, it should be 100x100=10,000 by 19 Nov, 2009.

By this time, the official number of deaths will not be reliable any
more because testing and confirmation will be of a lower priority.

It is fortunate that vaccination will be rolled out by October. If it
were successful, it will reduce the number of fatalities
significantly.

Queensland winter school holiday:
Saturday 27 June to Sunday 12 July 2009 (incl.)

It is significant that the number of deaths occur when Australian
schools are having a school holiday. Children were the main agents to
spread flu. It will be even worse in August and September.

http://www.chinadaily.com.cn/world/2009-08/21/content_8600803.htm

Australia confirms over 33,000 A(H1N1) flu cases
(Xinhua)
Updated: 2009-08-21 15:03
Comments(0) PrintMail

CANBERRA: Australia's officially confirmed A(H1N1) flu cases reached
33,179 Friday, with 131 deaths. But experts believe this number is
just "the tip of the iceburg".

NSW is the hardest hit with 36 deaths, followed by Queensland with 28
deaths and Victoria with 24. The national capital of Canberra is
least affected with only two deaths.

Professor Raina MacIntyre, who is head of the School of Public Health
and Community Medicine at the University of New South Wales, said on
Friday retrospective studies are likely to raise Australia 's death
toll from the new flu.

"There will be many more deaths out there that were caused, or
precipitated, by this flu that are not diagnosed of it," she said,
adding the 30,000 cases would be just the tip of the iceberg.

However, she believed that the more people get infected the more
immune they get and so the epidemic will go down.

Full Coverage:
Australia confirms over 33,000 A(H1N1) flu cases A (H1N1) Influnza
Outbreak
Related readings:
Australia confirms over 33,000 A(H1N1) flu cases Mainland H1N1 flu
cases exceed 2,700
Australia confirms over 33,000 A(H1N1) flu cases Sinovac bets big on
flu vaccine
Australia confirms over 33,000 A(H1N1) flu cases WHO reiterates advice
on use of flu drugs for H1N1
Australia confirms over 33,000 A(H1N1) flu cases 774 new A/H1N1 flu
cases confirmed in Europe
Australia confirms over 33,000 A(H1N1) flu cases WHO: First flu
vaccines to be licensed in September
The vaccination program -- to be rolled out next month and on a scale
never before seen in Australia -- is expected to put a significant
dent in the future spread of the A(H1N1) virus.

Australia recorded its first case of the flu on May 9 but proof of its
community-level transmission was not seen until May 22.

The new flu claimed its first victim on June 19 when a 26-year- old
Aboriginal man with a chronic medical condition died from the virus-
related complications in Royal Adelaide Hospital.

Many flu like deaths were not confirmed as Swine Flu

This is the 2nd evidence that I know of that clearly shows that flu-
like deaths were not confirmed as Swine Flu death. With 95% of all flu-
like diseases are most likely to be Swine Flu, and only Swine Flu has
a much greater chance of killing victims below 65 years old, no matter
what the test result says, it is most probably swine flu.

Of course the deaths are not due to Swine Flu directly. All Swine Flu
deaths are pneumonia or some other organ failures, but without Swine
Flu, these people will not have to die.

As testing and confirmation costs too much money, prevention is still
the best chance. Hiding the incidences of Swine Flu, thinking that
swine flu is milder than common flu is just irresponsible. If you
believe that Swine Flu is milder, why are you so worried of telling
the truth. Let the other parents decide for themselves.

For me, I won't take any chance at all. I won't let my children to go
to school where the school authorities lie about Swine Flu incidences
and do not take any measure at all to stop its spread.

http://www.mmail.com.my/content/11334-parents-shocked-usj-12-school-kept-open

Parents shocked USJ 12 school kept open
Submitted by pekwan on Friday, August 21st, 2009

* influenza A (H1N1)
* Local
* Sekolah Menengah Kebangsaan USJ 12

Friday, August 21st, 2009 07:37:00

PARENTS of students at Sekolah Menengah Kebangsaan USJ 12 are aghast
the Subang Jaya school
has remained open despite the death of a teacher from suspected
Influenza A (H1N1) infection.

A parent, whose son attends the school, said measures should be taken
by the headmistress to restore the confidence of parents.

Declining to be named, he said: "The Health Ministry did say that it's
now up to school heads to take measures and decide what would be good
for the students, staff and the school.

"It's natural for us to be concerned. With this fastspreading virus,
as it's better to do something quickly to prevent its spread, so as to
avoid seeking a cure later."

He noted that many parents had already stopped their children from
attending school, fearing they could pick up the infection.

The school's science and mathematics teacher, Chai Mee Feng, 39, died
at the Intensive Care Unit of Kuala Lumpur Hospital at 7.46am on
Tuesday, from severe pneumonia and multiple organ failure - symptoms
that are very similar to H1N1 infection.

Another parent, who only wished to be known as Carmen, said: "As a
parent, I would appreciate if we are
not kept in the dark. This is serious, I wouldn't want to gamble with
my children's lives by sending them to a
school with cases of H1N1 and refuses to share this information."

A former member of the school's parent-teacher association, Sabrina
Abdullah, said: "Since there's only one day left until the school
closes for a weeklong break, this shouldn't really be a problem or an
issue, since the death has not been confirmed as due to H1N1.

"I understand that parents are concerned over the safety of their
children. But, since the death has not been confirmed as a H1N1 case,
we need not worry too much.

"If it's a H1N1 case, I doubt the Health Ministry will allow the
school to remain open. H1N1 is a serious matter."

Malay Mail was unable to get the any comment from the headmistress.

Vaccinate Children FIRST!!!

I agree especially when it is researched by a mathematical biologist.
I just don't trust doctors who can't count properly.

Also vaccines don't work properly for older people which is why many
of them died of normal flu even though they were vaccinated in USA.

So no need to vaccinate older people, just younger people, especially
the school children.

Since Malaysia is most likely to receive the vaccines late and in
short supply, they should target schools that are in hotspot areas.
With all the secrecy about Swine Flu hotspots, do we really know where
the hotspots are? They will just waste resources vaccinating their own
children first.

http://www.southcoasttoday.com/apps/pbcs.dll/article?AID=/20090821/NEWS/908210327/-1/NEWSMAP

Study: Vaccinate school kids to stop flu
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WASHINGTON — New research says the best way to protect society's most
vulnerable from the flu: Vaccinate school-age children and their
parents.

Kids already top the government's priority list for swine-flu shots
this year because that new influenza strain targets the young. That's
unusual, as flu usually is most dangerous to older adults.

But Thursday's study, in the journal Science, says vaccinating
students should be a priority every year — because schoolchildren are
influenza's prime spreaders and their parents then are the virus'
bridge to the rest of the community. The idea: Inoculating spreaders
could create something of a cocoon around the people most at risk of
flu-caused death.

Clemson University mathematical biologist Jan Medlock modeled what
would happen if a virus like the ones that caused the 1918 and 1957
pandemics struck today. He tested multiple vaccination strategies
against viruses of varying virulence to see which would give the best
outcome for the least vaccine.

In typical winters, the U.S. has 85 million to 100 million doses of
flu vaccine. If at least 40 million doses are available, then
vaccinating children ages 5 to 19 and adults in their 30s — their
parents' average age — gives society the most protection, Medlock and
co-author Alison Galvani of Yale University reported.

In just one example, using a hypothetical flu strain as deadly as the
notorious 1918 virus, the model predicted that deaths could be cut by
more than half if just those ages are vaccinated, compared with
vaccinating only the more usual targets — people over 50 and under 5.

Flu specialists increasing are focusing on children.

The research is "very much in line with the evidence" that schoolkids
in crowded classrooms act as flu factories, said epidemiologist John
Brownstein, of Harvard and the Children's Hospital of Boston.

Brownstein has tracked Boston-area influenza cases and found that
neighborhoods with the most kids are where flu strikes first and
worst: Every 1 percent increase in the child population brings a 4
percent increase in adult emergency-room visits.

And just last year, the Centers for Disease Control and Prevention
started recommended routine flu vaccination for children of all ages.
While shots had long been recommended for babies and preschoolers who
are at higher risk for flu complications, healthy school-age children
typically spend an achy, sneezy week and bounce back.

The change came as scientists began realizing flu vaccine doesn't work
as well in people over 65 — who account for most of the 36,000 flu-
caused deaths each winter — as it does in the young. While flu vaccine
protects 75 percent to 90 percent of young healthy people, some
research suggests the protection may plummet to 30 percent among their
grandparents.

But excluding other ages from vaccination, like in Medlock's model,
would be "obviously a very difficult decision" rather than vaccinating
schoolchildren in addition to the usual high-risk groups, Brownstein
said.

The Associated Press

Malaysia must order Lung Machines

Scientifically named:
extracorporeal membrane oxygenation, or ECMO,

It is just an artifical lung. If Malaysia does not order more, there
will be more deaths especially when Malaysia has followed Australia
and New Zealand in treating swine flu as milder than normal flu.

It is mild, as long as there is sufficient medication and life support
machines, but it still kills lots of people as shown in Australia and
New Zealand, and now rapidly in Malaysia.

Of course if Malaysia had followed China and Japan, no need for such
expensive treatment and no need for any loss of life.

http://www.bloomberg.com/apps/news?pid=20601081&sid=a9vKlznnyeQ4

Swine Flu Pandemic Paradox Kills Few, Overwhelms Hospital ICUs
Share | Email | Print | A A A

By Jason Gale

Aug. 21 (Bloomberg) -- Swine flu filled up Geoff Shaw's intensive care
unit in Christchurch, New Zealand, last month, forcing some surgeries
to be canceled as the hospital struggled to cope. As winter moves to
the Northern Hemisphere, health officials from Chicago to London brace
for a similar overload.

"We have run out of bed space, we have run out of nurses," Shaw, 47,
said after working in the ICU and being on- call for 185 hours over 11
days. "There will be people who die because they were denied access to
other treatments."

Health officials call it the swine flu paradox. As the new H1N1 strain
spreads, the majority of patients recover within days and the number
of deaths is a fraction of the seasonal flu toll. Those statistics
mask an alarming reality: the pandemic has strained intensive care
units and a resurgence of the virus in the fall could bring a public
health disaster, experts say.

"We have largely been fortunate," said Simon Towler, an intensive care
specialist at the Royal Perth Hospital and Western Australia's chief
medical officer. "If we had a severe flu of a different type we would
be in massive trouble. The systems really don't have the capacity to
cope with a surge."

Last weekend, a quarter of Western Australia's 105 adult intensive
care beds were occupied by swine flu patients who needed ventilators
to breathe, according to Towler.

The experience in Australia and New Zealand offers clues about what
North America, Europe and Japan may see when winter moves in.

Artificial Lung

"The Northern Hemisphere medical care requirements for the next six
months are a train wreck waiting to happen," said Michael Osterholm,
director of the University of Minnesota's Center for Infectious
Disease Research and Policy in Minneapolis. "In the fall, even if
nothing else changes in terms of the virus's severity and our
preparedness, it's going to be a real challenge."

While fewer than 0.5 percent of swine flu sufferers may need
hospitalization, those who do can remain in intensive care for up to
three weeks, occupying a bed that could be used for 15 heart bypass
patients. Christchurch Hospital, the biggest on New Zealand's South
Island, postponed non-emergency procedures requiring an ICU stay such
as heart bypass as flu patients -- three-quarters needing mechanical
ventilation -- filled up the 12-bed unit and nine other hastily
created intensive-care beds, according to Shaw.

What's more, a 10th of those critically ill patients needed their
blood pumped through an artificial lung, a procedure known as
extracorporeal membrane oxygenation, or ECMO, that only one hospital
in New Zealand offers.

Life Support

"I've seen nothing like this," said John Beca, head of pediatric
intensive care at New Zealand's national children's hospital in
Auckland. Five of Beca's six ECMO units have been used simultaneously
this winter. He's ordering three more.

Maquet Cardiopulmonary AG, a subsidiary of Sweden's Getinge AB, has
received a 50 percent jump in orders for the life- support system in
Australia, Clinical Director Juergen Boehm said. The German company is
doubling production of the units, which cost as much as 60,000 euros
($85,000) apiece, and plans to increase its inventory of tubes,
artificial lungs and other disposable ECMO equipment to about 500
sets, from 100 usually.

"We will have to see what comes over the next weeks and months from
other areas," Boehm said in a July 27 interview.

Orders for ECMO accessories are up about 20 percent in Australia and
New Zealand, said Joseph McGrath, a spokesman for Minneapolis-based
Medtronic Inc., which also makes the devices.

Vaccine Hopes

Sanofi-Aventis SA, GlaxoSmithKline Plc and Novartis AG are racing to
prepare millions of inoculations against the new virus and test them
before the weather turns colder in the hope of blunting the pandemic.
Paris-based Sanofi began vaccine trials on Aug. 6 and needs "two to
three months" to complete them. London-based Glaxo has said it began
testing this month. The U.S. expects the first shots to be delivered
mid-October.

"Hopefully the vaccines will get out and the Northern Hemisphere's
experience will be dramatically mitigated," Towler said. "But there
will be some people who either won't get vaccinated or won't be
protected, and the lessons from the Southern Hemisphere, particularly
countries like Australia and New Zealand, will be important."

More than a dozen flu patients were entering intensive care units
daily in Sydney a month ago, compared with five at the peak of a
regular winter flu season, said Tim Smyth, deputy director general of
health for New South Wales.

Health officials in the state, home to one in three Australians, are
equipping a helicopter with the lung bypass machine to retrieve
patients from remote hospitals.

'Stress'

The average age of patients in intensive care is 40 years, according
to Smyth, and most have an underlying condition such as diabetes or
heart disease, or are pregnant or obese.

In some patients, the virus causes such a severe assault on the
respiratory tract that the lungs become inflamed and the grape-like
sacs where gas is exchanged are injured, causing bleeding and a
critical loss of oxygen supply.

"We are all concerned given the severity of this disease and the
significant critical care support and resource utilization required
for the successful treatment of these patients," said Lena Napolitano,
chief of acute care surgery at the University of Michigan Health
System at Ann Arbor.

Studies in the U.S. show that the group of patients requiring
mechanical ventilation for at least four days is growing six times
faster than the rest of hospitalizations, said Marya Zilberberg, a
scientist with the Amherst EviMed Research Group at the University of
Massachusetts.

The pandemic will only add to that demand, Zilberberg said. "My sense
is that it may stress our capacity to its limit and beyond," she said.

Young Victims

Worldwide, the H1N1 virus has killed about 1,800 people as of Aug. 13,
according to the World Health Organization. The median age of death in
Australia is 56 -- compared with 83 years for seasonal flu fatalities.

"It's striking young people down," said Shaw, the intensive care
specialist in Christchurch. "We are seeing people largely between the
ages of 20 and 50. That really is quite different from anything else
we have ever had."

Australia shows how the pandemic has confounded expectations:
Intensive care accounts for about a quarter of hospital stays, Jim
Bishop, Australia's chief medical officer, said last week. The
government had anticipated only 10 percent of those hospitalized would
need critical care, yet expected more deaths: its modeling predicted
6,000, and 121 have died so far.

"There is something very different about this virus," said Heath
Kelly, head of epidemiology at Victoria state's infectious diseases
reference laboratory in Melbourne. "In ICUs, it looks worse" than
expected, he said. "But everywhere else you look, it looks better.
That's the interesting paradox."

To contact the reporter on this story: Jason Gale in Singapore at
j.gale@bloomberg.net.
Last Updated: August 20, 2009 10:01 EDT