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  • Peak Calculations versus Peak Opinions

    Originally posted by JJackson View Post
    I am probably a little less sanguine about the peak being reached next week than Dr. Evans. Christmas and the New Year bring a significant change in the interactions between people switching from work/school interactions to family and back again. This is a shake-up that I would expect to cause significant reseeding in new areas.
    We're with you, JJackson.

    Neither the clinical nor genetic data indicates these 7 Day "Best Case" scenarios for THE peak that are being painted by those considered experts / thought leaders. Perhaps a slowing in cases in one city / hospital has caused the speakers to miss the dozen that are increasing down the street and over the dale. Mini-cycles are common, especially geographically, when dealing with zoonoticly driven Influenza strains.

    Little new information has been published since the ICU count acceleration (100 -> 182 -> 302 -> 460 cases) was last reported on December 23rd? Five days have passed during an accelerative phase without significant data sharing?

    Last year, the Ukraine Ministry of Health managed to provide daily updates throughout a strikingly difficult influenza crisis. The <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" /><st1:country-region w:st="on"><st1:place w:st="on">UK, in contrast,</st1:place></st1:country-region> has given us a few numbers here and there, alongside 4 sequences taken prior to the severe wave onset with no clinical meta-data?

    If lucid data does, in fact, exist to support these opinions with backing calculations based on current viral dynamics, the public would be very keen to review those suppositions.

    After all, aren't these the same people who have repeated the chant, "flu is unpredictable, flu is unpredictable", in hundreds of press releases for the past 5 months? How are they suddenly able to predict influenza behaviour with such confidence?


    Have they stopped blaming the victims of their negligence long enough to actually undertake the feeding and evaluation of accurate models?
    • Where is that data?
    • What are their heuristics?
    • What are the assumptions?
    • Are those assumptions built on Seasonal Flu or Zoonotic Flu?
    Science is purportedly the process of knowledge discovery through observational evidence. A bedrock of the scientific method is reproducibility of experimental / decision outcomes based on data transparency and the surfacing of techniques.

    The public would like to see this rich bed of observational evidence related to zoonoticly active Influenza that is the foundation for these 7 Day Single Peak predictions.

    Or perhaps the speakers would be willing to properly couch their "suggestions", their opinions, in specific language defining their imprecise methods reliant on an experimental testbed that is less than robust. At any rate, the public needs more than this incessant chanting about ?under control?, ?within normal limits? and ?peaking in 7 days?.

    <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p>
    <o:p></o:p>
    More data, more transparency, more action.

    Less chatter.
    Last edited by NS1; December 28, 2010, 09:59 PM. Reason: Format

    Comment


    • Data Transparency and Collaboration

      Collaboration requires data sharing, sometimes when the data is uncomfortably rough or even inexplicable. But that's the purpose of collaboration, right?

      We collaborate to discover something that we did not already know. We collaborate when world health is in question.

      UK_December_Emerging_Genetics_v0.xls


      This GeneWurx Version Zero Excel spreadsheet represents an effort to externalise to the public our current rough lab notes on the 4 published UK HA gene segments and worldwide HA sequences that we've ascertained may be related. UK titles and UK polymorphisms are color-coded green wherever they are found.

      Each column represents a sequence of interest. The rows are filled with change data ordered by the amino acid position. This presentation of detailed data obviously required some careful editing for brevity. Even so, the reviewer will be inclined to scroll and / or hide columns in order to fully review relationships.

      The materials demonstrate the flow of genetic data from the Southern Hemisphere 2010 into the Northern Hemisphere today. For example, investigate the various similarities from columns AQ to AZ. The UKWhiteChapel4880374_2M_2010_11_28 sequence in column AX is our primary interest due to patterning suggestive of a capability to carry 156E / 158E and / or 225G.

      The authors are grateful to GenBank and GISAID for making their depository of valuable genetic material accessible and to those from many countries who have shared their sequences for the sake of public health. We also are thankful to a certain physicist who initiated the concept and layout for public presentation of this detailed genetics data.

      As always, any errors are those of the authoring team. Please provide errata via private message as you discover required corrections.
      Last edited by NS1; December 29, 2010, 02:22 AM. Reason: Format

      Comment


      • Re: UK: Reports of Approximately 31 Deaths and 460 Patients in intensive care (27 deaths confirmed by HPA as for Dec. 23 2010) due to influenza

        Originally posted by sharon sanders View Post
        New swine-flu discovery by Wales-based panel

        Dec 23 2010 by Madeleine Brindley, Western Mail



        PUBLISHED research has confirmed the first cases of person-to-person spread of a strain of swine flu resistant to the drug Tamiflu.


        A study by Public Health Wales experts has analysed an outbreak of the resistant strain in patients being treated at the University Hospital of Wales, Cardiff, last year.


        Eight patients of 11 who contracted swine flu while being treated on the hospital?s haematology unit were found to have infections resistant to Tamiflu (oseltamivir).


        snip


        The article is by Dr Catherine Moore, principal clinical scientist, regional epidemiologists Dr Roland Salmon and Dr Meirion Evans, and Dr Eleri Roberts, who is director of the Welsh Healthcare Associated Infections programme.

        snip


        Read More http://www.walesonline.co.uk/news/wa...#ixzz19S9dEzHC

        For this reason the updated guidelines for antiviral drugs treatment in the UK clearly states that immunocompromised patients have to be treated with zanamivir and not with oseltamivir at first instance. See the document at: http://www.flutrackers.com/forum/sho...d.php?t=157221

        Comment


        • Re: UK: Reports of Approximately 31 Deaths and 460 Patients in intensive care (27 deaths confirmed by HPA as for Dec. 23 2010) due to influenza


          Hospital patient in swine flu death



          A woman suffering from swine flu has died in the West Midlands as hospitals battled rising cases of the disease, it emerged today.

          The victim was in her 70s and had been a patient at New Cross Hospital in Wol-verhampton for over a week when she passed away in Intensive Care on Monday.

          The unnamed woman was showing symptoms of the disease on her admission last week and tests later confirmed that she was a sufferer.

          But she had other underlying medical conditions that could have caused or contributed to her death.

          The woman who died, and is believed to have lived in Wolverhampton, was also showing signs of pneumonia and a potentially serious lung condition.

          The hospital?s chief executive David Loughton said: ?We would urge people, especially those at risk chronic lung condition, asthma, heart problems, the elderly and pregnant women, to have the flu jab as a matter of urgency.?

          Mid Staffordshire NHS Foundation Trust said it was treating seven people with flu, including swine flu cases.


          Read more: http://www.expressandstar.com/news/2...#ixzz19VRgqYOr

          Comment


          • Re: UK: Reports of Approximately 31 Deaths and 460 Patients in intensive care (27 deaths confirmed by HPA as for Dec. 23 2010) due to influenza

            29 December 2010 Last updated at 08:05 ET

            GPs report flu cases rose again last week

            By Helen Briggs Health reporter, BBC News

            Flu cases have risen again in England and Wales, but have not reached epidemic levels, according to figures from GPs.


            The flu tally reached 124 per 100,000 of the population in the week ending 26 December, from 86 cases in the previous week.


            Health officials in England define an epidemic as 200 cases per 100,000.

            snip

            The latest figures show the incidence of flu has risen by about 50&#37; in the past week.

            snip

            Flu cases have risen steadily in England and Wales from 32.8 per 100,000 in week 49, to 85.8 in week 50, to 124.4 in week 51.



            more at...


            Flu cases have risen again in England and Wales, but have not reached epidemic levels, according to figures from GPs.

            Comment


            • Re: UK: Reports of Approximately 31 Deaths and 460 Patients in intensive care (27 deaths confirmed by HPA as for Dec. 23 2010) due to influenza

              The royal college's figures show an increase in illness all age groups except schoolchildren. The worry is that flu will take off among them when schools reopen. The numbers still fall short of epidemic level, which is 200 cases per 100,000. The peak of the present outbreak has not yet been reached, however.

              In London the pressure group Health Emergency claimed that intensive care beds were already under pressure and warned of problems in the new year if flu continues to spread. Geoff Martin, the group's chairman, accused the coalition of wasting money on NHS reorganisation instead of increasing intensive care capacity. "We are getting reports of intensive care units in London where up to a quarter of the beds are filled with swine flu cases and the crisis is getting worse by the day," he said, adding that "there is no doubt that many ITUs [intensive therapy units] will soon have to close to new admissions, putting hundreds of lives at risk".

              The Department of Health denied there was a problem. "Our latest data shows that the number of people with confirmed or suspected flu in critical care beds is 460," said a spokesman. "This represents less than one in seven of the total critical care beds available.

              "The NHS is coping very well and only a small percentage of the intensive care capacity is being taken up with patients with flu."


              Department of Health says outbreak is within normal range of season flu, even though main strain in circulation is H1N1 swine flu

              Comment


              • Re: UK: Reports of Approximately 31 Deaths and 460 Patients in intensive care (27 deaths confirmed by HPA as for Dec. 23 2010) due to influenza

                Source: http://www.walesonline.co.uk/news/wa...1466-27904461/

                Flu cases continue to rise in Wales
                Dec 29 2010 By Madeleine Brindley, WalesOnline


                CASES of flu are continuing to rise in Wales as experts have warned the virus has not yet peaked.

                Figures published tonight (Wednesday) by Public Health Wales show the number of people contacting their GP with flu-like symptoms increased to 92.14 per 100,000 population.

                This is equivalent to more than 2,700 people, although the real number who are ill but haven't sought medical help will be much higher.

                It is thought the majority of these patients are suffering from swine flu, the same virus as that responsible for last year?s pandemic.

                The Welsh figures represent a modest increase on last week?s position...

                Comment


                • UK Potential 90% Increase of Influenza Cases to Total ICU Beds

                  ** Caveat **

                  Due to data scarcity, apparently sanctioned by officials, this evaluation is forced to extrapolate from media reports.

                  The factor used to fill the gap is defined clearly as to source and the calculations are presented via a reusable Excel spreadsheet.

                  ** End Caveat **

                  Total case count officially increased by 44.9% in the UK, but ICU beds with Influenza (London) appear to have potentially risen by up to 90%.

                  Notice also that official releases early today failed to provide a new count on total or district Influenza ICU cases.

                  The December 23rd official report (latest) showed that 1 of 7 ICU beds (~13%) were Influenza cases. Compare that figure to the 2009 pH1N1 Pandemic peak of roughly less than 1 of 12. The Health Emergency campaign group today claimed that London hospitals are reporting that up to 25% of ICU beds are Influenza cases.

                  For the purposes of least optimal projections, recasting the factors countrywide is a reasonable evaluation due to the fact that London appeared to be trailing in cases and severity until this report. Based on the 25% number and 3500 beds nationwide, a practical doubling is indicated of the Influenza cases percentage of ICU / ITU over 5 to 6 days and brings the total cases at this time to potentially ~875 people in Intensive Care at one time for Influenza, a 90% increase in 5 to 6 days.

                  GeneWurx_UK_ICU_Categories_v0.xls

                  Again these factors are recast from London across the entire nation due to lack of data reporting and, as such, the results may be heavily skewed in either direction. Understanding the assumptions behind the calculation allows a guidepoint to be reached. If the results prove solid, then the case count rose by ~45% while the ICU percentage, at least in one major city (London), may have increased by 90% or more.

                  These extrapolations suggest a severe wave that is continuing.

                  GeneWurx and the concerned public would be more than pleased to have these calculations invalidated by actual official reports of current information from the public health officials, alongside genetic sequences tagged according to mild, severe and fatal cases with clinical progression meta-data.

                  Comment


                  • 2010-12-30 Epidemic Threshold Reached, 1 to 4 Year Old UK Age Bracket

                    Shiloh has opened a thread discussing the fact that an epidemic threshold has been reached officially in the UK for the age range of 1 to 4 years old, the very young children.



                    The epidemic threshold is also being approached for the entire under 5 year old group, but has not been reached due to the low count in the under 1 year old category. The obvious question of whether these low results in the baby age bracket are accurate or due to failure to diagnose is not satisfied at this time.

                    Comment


                    • Re: UK: Reports of Approximately 31 Deaths and 460 Patients in intensive care (27 deaths confirmed by HPA as for Dec. 23 2010) due to influenza

                      Swine flu fears give NHS 24 its busiest four-day period ever

                      Calls about flu have helped health service helpline NHS 24 record its busiest-ever festive period, new figures have revealed.

                      More than 44,000 people contacted the service between Saturday, December 25, and Tuesday, December 28, when GP surgeries across Scotland were shut.

                      The surge in patients comes amid concern about the growing toll swine flu is taking this winter.

                      Latest figures show 83 confirmed cases in Scotland, including 11 people who needed treatment in intensive care and two patients who have died. A further update is expected today.

                      Figures for England and Wales just released by The Royal College of General Practitioners (RCGP) revealed cases of flu rose by almost 50% last week. An RCGP spokesman said there had been a general increase in people falling ill across all age ranges, apart from children, with the middle-aged being particularly badly hit.

                      Experts believe the number of children catching flu could change when they return to school following the festive break.

                      Dr George Crooks, medical director of NHS 24, said flu was one of the main reasons patients were calling their service.


                      ...


                      Dr Crooks added: ?NHS 24 will again have hundreds of staff available over the New Year weekend and we expect to receive thousands of calls over the coming days.

                      ?Over the whole period of the festive holidays, we have planned for call demand in excess of 130,000.?

                      ..

                      The latest headlines and breaking news from Scotland and beyond in The Herald - the longest running national newspaper in the world.

                      Comment


                      • Re: UK: Reports of Approximately 31 Deaths and 460 Patients in intensive care (27 deaths confirmed by HPA as for Dec. 23 2010) due to influenza

                        Number Of Flu Hospital Patients 'Rises Again'


                        The number of people in intensive care with flu has risen again, weekly figures from the Health Protection Agency are expected to reveal.

                        Although the Royal College of General Practitioners said cases rose by 50% last week, the increase is still short of epidemic levels.

                        But that is not the experience of all doctors.

                        "I think we're in the middle of a flu epidemic" say Dr David Lloyd, who has seen his workload double at his surgery in Harrow, northwest London.



                        "I think everyone needs to be aware that, if they have a very high fever and aches and pains, they're likely to have flu or swine flu and should be keeping away from others and isolating themselves so as not to spread it around and infect more people."

                        ...

                        Comment


                        • Re: UK: Reports of Approximately 31 Deaths and 460 Patients in intensive care (27 deaths confirmed by HPA as for Dec. 23 2010) due to influenza

                          Prince William in dramatic rescue bid of tragic swine flu mum

                          PRINCE William played a key role in a dramatic attempt to save the life of a new mum diagnosed with swine flu.

                          The Prince, 28, was flying a helicopter from his RAF base in Anglesey, North Wales, when he was diverted to pick up a life support machine from Leicester and take it to a hospital in Manchester. It was hoped the machine would help critically-ill Sarah Bowden, 20, from Manchester, who was suffering from the illness but she died earlier this month, 11 days after the birth of her son Harry.

                          Stepmum Kelly Sarginson, 38, said: ?William gave her a chance of survival and we will always be grateful.?


                          Read more: http://www.mirror.co.uk/news/top-sto...#ixzz19ZxkQdZD

                          Comment


                          • Re: UK: Reports of Approximately 31 Deaths and 460 Patients in intensive care (27 deaths confirmed by HPA as for Dec. 23 2010) due to influenza

                            Winter flu at highest level for a decade

                            Official figures showed that children under the age of five had the highest rates of flu of any age group, with 184 cases per 100,000.


                            Young children have overtaken those aged five to 14 after rates dropped among older children because of the school holidays.


                            The figures will increase the controversy about whether young children should have been offered the seasonal flu vaccine.


                            Last winter, all children under five were offered the swine flu vaccine on the NHS, but a government advisory committee did not recommend that this should be repeated this winter.


                            Yesterday's figures from the Royal College of GPs showed that the sharpest increase in cases had been in adults aged 45 to 64, with the number of consultations almost doubling to 108 per 100,000 of the population.

                            Related Articles



                            Overall, cases of flu increased by almost half in the week to Boxing Day, with 124 people reporting symptoms per 100,000.

                            The last time seasonal flu cases were this high was during the 1999-2000 flu epidemic, when an estimated 22,000 people died.


                            snip

                            Rates were also higher than last week's levels during the 2008-9 swine flu pandemic,


                            snip


                            Officials are releasing batches of the antiviral drug Tamiflu left over from the pandemic to ease shortages of the medicine.


                            Officials said flu rates remained within expected levels for this time of year but cases could surge after the new year as children go back to school.


                            snip


                            Up to one in four intensive care beds in some parts of the country is being used for flu patients as NHS services come under increasing pressure.


                            Norovirus cases also peak at this time of year, leading to ward closures and staff shortages as patients and nurses fall ill.


                            snip

                            Pregnant women have been offered the seasonal vaccine this year for the first time because they are at greater risk of complications if they contract swine flu. But under-fives, who were also hit hard by last year's pandemic, were not included in the groups offered the seasonal jab.


                            The weekly report from the Royal College of GPs said: "Compared with last week's equivalent rates the incidence of influenza-like illness has increased by about 50 per cent.


                            "The increase was evident in all age groups except schoolchildren (for obvious holiday reasons). There has been a substantial increase in age groups 45-64. Increased incidence of other respiratory illnesses are small."
                            Flu consultations doubled in the North to reach 118 per 100,000 and there were smaller increases elsewhere. Flu rates remain highest in the South at 136 per 100,000 people.

                            snip

                            Health Emergency claimed there was a lack of capacity and specialist nurses that they said could put lives at risk if the flu outbreak gathered momentum.


                            Geoff Martin, the chairman of Health Emergency, said: “We are getting reports of intensive care units in London where up to a quarter of the beds are filled with swine flu cases and the crisis is getting worse by the day.

                            snip

                            The Department of Health said the NHS was coping well nationally and around one in seven intensive care beds was being used for flu patients. A spokesman added: “These figures are in keeping with what we would expect during a winter flu season.


                            more....

                            Comment


                            • Re: UK: Reports of Approximately 31 Deaths and 460 Patients in intensive care (27 deaths confirmed by HPA as for Dec. 23 2010) due to influenza

                              From Week 50 FluNet virological surveillance page: http://apps.who.int/globalatlas/data....asp?rptType=3

                              United Kingdom of Great Britain and Northern Ireland
                              Seasonal A/H1N1 - 0
                              Seasonal A/H3N2 - 1
                              Avian Influenza A(H5N1) - 0
                              Influenza A not subtyped - 417
                              Influenza H1N1 (2009) - 234
                              Influenza B - 162

                              -
                              ------

                              Comment


                              • UK White Chapel Sequence Hybrid with animal H7N7 and Human Adapted Seasonal Polymorphisms

                                An inspection of the final syn529L polymorphism on the White Chapel sequence from the 2 year old boy, noted here and previously, demonstrates a change unique to pH1N1 even at this late stage.

                                Though 2 different additional versions (CCa, tTG) of this silent polymorphism at aa529 have been found in the reservoir in rare quantities, the change at the third base of the codon (CCt) for the White Chapel sequence appears to have propagated from an entirely separate origin, a human-adapted seasonal H1N1 strain circulating in 2007. With a total of 37 HA syn529L instances in human Pandemic H1N1 2009 on record for the earlier CCa and tTG codings, this novel change (CCt) may demonstrate new behaviour for this virus.

                                Consider that human-adapted changes from seasonal H1N1 2007 also share extensive homology with the NA for this White Chapel sequence.

                                Frequent change has been noted on emergent 2010 pH1N1 strains after amino acid position 500 and in some cases has been associated with fatality (502K and syn542S). In a domain briming with recent diversity, these 38 changes of three variant silent codings at a single position, aa529, offer a block of data that may interest keen investigators.

                                GeneWurx has prepared a rough estimation for public review in an Excel spreadsheet detailing the findings as of December 25, 2010 for syn529L as related to the current emerging epidemic in England, Wales and Scotland.

                                GeneWurx_UKWhiteChapel_Unique_syn529L_Variation_v0 .xls

                                . . . . UKWhiteChapel4880374_2M_2010_11_28 (
                                . . . . . . . . 0A (gCC) [1918 (GCT), S7 (GCT), S5 (GCA)]
                                . . . . . . . . syn55L [S9, H5N1],
                                . . . . . . . . . . . . . . [Darwin47_2010_08_09 with syn529L,
                                . . . . . . . . . . . . . . Iran16273_2009_11_22 with 226R
                                . . . . . . . . . . . . . . NZ_Waikato2_2010_01_04 with 233H,
                                . . . . . . . . . . . . . . tkOntarioFAV117_1C_2009_12_07 mult domain matches,
                                . . . . . . . . . . . . . . et al],
                                . . . . . . . . 188T [H6N1, H7N7],
                                . . . . . . . . syn338G [H3N8, H4, H5, H6, sw],
                                . . . . . . . . . . . . . . . [OzBrisbane209_51F_2010_08_09
                                . . . . . . . . . . . . . . . . . . . . with 156E & 225G,
                                . . . . . . . . . . . . . . . Arizona05_2010_05_11 with 0A,
                                . . . . . . . . . . . . . . . Swine Asia 2005 with 0A, et al]
                                . . . . . . . . 377K,
                                . . . . . . . . 454N [H7N3, H7N7, H9N2]
                                . . . . . . . . . . [Florida14_24M_2010_08_05
                                . . . . . . . . . . . . . . . . . . with 188T, 454N,
                                . . . . . . . . . . FL_Pen210_2009_11_10
                                . . . . . . . . . . . . . . . . . . with 225E,
                                . . . . . . . . . . SouthCarolina18_2009_09_16_VxX
                                . . . . . . . . . . . . . . . . . . with 159D, 224K, et al],
                                . . . . . . . . syn529L (CTt) [Unique to PF11]
                                . . . . . . . . . . . . . . . . . . . . [S7 (CTt), tn with syn338G (GGg)]
                                . . . . . . . . . . . . . . . . . . . . [PF11 32 Worldwide (CTa),
                                . . . . . . . . . . . . . . . . . . . . PF11 5 North America (tTG)],
                                . . . . . . . . . . . . . . . . . . . . [swThailandCU_CHK4_2009_01 (tTG)
                                . . . . . . . . . . . . . . . . . . . . . . . . . . with 0A, syn338G, 189T, 377G, syn451K, syn456L])

                                Comment

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