[Health] The Infectious Diseases Thread

[Kraken]

If anyone is going to take the blame for bird flu, it should be Trump. That would make him responsible for screwing up two major pandemics. We’re in the worst timeline, so it is of course inevitable.

But it may also be the quickest way to prove to the unintelligent the need for effective, fact-based government. And that Republicans deliver only chaos and failure.

I must reluctantly point out that the party currently in power is looking the other way. This will be a bipartisan pandemic.

Around here, there are still a small number of people masking up in public. I saw three at the grocer today. I presume that they're either infectious or immunocompromised, but there's no mask shaming to speak of.

[Blackhawk]

If anyone is going to take the blame for bird flu, it should be Trump. That would make him responsible for screwing up two major pandemics. We’re in the worst timeline, so it is of course inevitable.

But it may also be the quickest way to prove to the unintelligent the need for effective, fact-based government. And that Republicans deliver only chaos and failure.

I must reluctantly point out that the party currently in power is looking the other way.

I would posit that it's still on Trump, who was, more than anyone, responsible for making an official response such a partisan issue that it has become essentially impossible to take formal action.

[Kraken]

If anyone is going to take the blame for bird flu, it should be Trump. That would make him responsible for screwing up two major pandemics. We’re in the worst timeline, so it is of course inevitable.

But it may also be the quickest way to prove to the unintelligent the need for effective, fact-based government. And that Republicans deliver only chaos and failure.

I must reluctantly point out that the party currently in power is looking the other way.

I would posit that it's still on Trump, who was, more than anyone, responsible for making an official response such a partisan issue that it has become essentially impossible to take formal action.

If Covid-19 policies had beaten the virus we'd be all over this new, nastier threat. And the vaccines ultimately did tamp it down to background noise. But people forget the refrigerated trucks storing the corpses of people who died in hospitals, and remember how annoying it was being confined at home with their children for months. Forgetting the good and amplifying the bad is nonpartisan human nature. Or at least, American nature. I don't think they (we) needed trump to tell us that we should hate public health fascism. And for Smoove I have to add a .

[gbasden]

I must reluctantly point out that the party currently in power is looking the other way. This will be a bipartisan pandemic.

For sure. However, one party turned rational science-based disease response into a politicized jihad about people's rights not to give a shit about their fellow humans. And flogged the Democrats with it mercilessly. If they weren't so spineless they would do what needs to be done regardless, but I'll still put the majority of the blame on the Republicans.

[Blackhawk]

If anyone is going to take the blame for bird flu, it should be Trump. That would make him responsible for screwing up two major pandemics. We’re in the worst timeline, so it is of course inevitable.

But it may also be the quickest way to prove to the unintelligent the need for effective, fact-based government. And that Republicans deliver only chaos and failure.

I must reluctantly point out that the party currently in power is looking the other way.

I would posit that it's still on Trump, who was, more than anyone, responsible for making an official response such a partisan issue that it has become essentially impossible to take formal action.

If Covid-19 policies had beaten the virus we'd be all over this new, nastier threat.

COVID-19 policies were never fully implemented and/or enforced. We have no if they'd have worked. Instead, a few (under a Trumpian banner) turned loudly ignoring those regulations into a point of pride for a third of the country. That, in turn, so confused another half of the nation that they didn't know what was real and what was safe. Not knowing what the real truth was, they fell back on business-as-usual.

By the end, the message had successfully been flipped around as a political weapon against the Democrats: COVID-19 policies aren't just useless, they're openly harmful. They hurt the economy. They're destroying our children's educations. The vaccines don't work or are harmful. It's just the flu. Scientists are untrustworthy. And it's that message that has lasted, and that we're stuck dealing with going into a potential round two. How do you tell people to take measures when they're primed to do exactly the opposite as soon as you speak?

[Smoove_B]

Trying really hard to not get political here.

Disease outbreaks - epidemics and of course pandemics - are always going to be bad. I'm under no illusion COVID-19 would have been a super if we were in a different, bluer timeline back in 2016.

As Blackhawk has noted, it's a matter of degree and now public health and prevention are 3rd rail topics for politicians largely because of what's happened over the last ~5 years. They were difficult (and often ignored) topics at best, but now everyone has an opinion - and lots of people have indicated that do not like the seemingly "draconian" polices that help to maintain the fabric of society that we all enjoy.

If there is an H5N1 pandemic that unfolds in the coming months, the response will be on the next administration and I have no doubts it will be bad (based on 2016-2020). But political will and the expectations of the general public has likely been damaged for at least a generation, possibly longer, in part by the current administration. What's happening now is a culmination of decades of half-assing, underfunding and low-prioritizing public health.

[Blackhawk]

And again, deemphasizing education until the public has become unable to distinguish fact from fantasy.

And I think we're past the stage where public health can be discussed fully divorced from politics.

[Smoove_B]

And I think we're past the stage where public health can be discussed fully divorced from politics.

For a really long time, I genuinely believe public health was apolitical - because that's what I was taught. However, I'm now genuinely embarrassed by my naivety and all the assumptions I'd made about the general public for the last 20+ years. While I can't fix what was done or said in my early days, I can at least spend what time I have left trying to fix things in a more appropriate way.

[Smoove_B]

Another case confirmed in California:

The Centers for Disease Control and Prevention (CDC) has confirmed a human infection with avian influenza A(H5N1) (H5N1 bird flu) in a child in California. This is the first reported avian influenza H5 virus infection in a child in the United States. Consistent with previously identified human cases in the United States, the child reportedly experienced mild symptoms and received flu antivirals. There were low levels of viral material detected in the initial specimen collected, and follow-up testing of the child several days later was negative for H5 bird flu but was positive for other common respiratory viruses. The child is recovering from their illness. An investigation by the California Department of Public Health (CDPH) into the child's possible H5N1 exposure source is ongoing.

NOTE:

During CDPH's investigation, all household members reported having symptoms and specimens were collected from those people. All test results from members of the household were negative for H5 bird flu, and some family members were positive for the same common respiratory viruses as the child. Contact tracing continues, but there is currently no evidence of person-to-person spread of H5N1 bird flu from this child to others. To date, there has been no person-to-person spread identified associated with any of the H5N1 bird flu cases reported in the United States.

This case was detected through influenza testing and reported to CDPH through influenza surveillance. This is the second U.S. case identified through national surveillance. CDC continues to closely monitor available data from influenza surveillance systems, particularly in states affected by outbreaks in animals, including California, where widespread outbreaks of H5N1 bird flu have been detected in wild birds and domestic poultry since 2022 and dairy herds since August 2024 in that state.

Advice:

CDC's risk assessment for the general public is low. However, people with exposure to infected or potentially infected animals, such as birds, dairy cattle, or other animals (including livestock), or to environments contaminated by infected birds or other animals, are at higher risk of infection. CDC recommends avoiding unprotected exposures to sick or dead animals, including wild birds, poultry, other domesticated birds, and other wild or domesticated animals (including cows).

[Dogstar]

And I think we're past the stage where public health can be discussed fully divorced from politics.

For a really long time, I genuinely believe public health was apolitical - because that's what I was taught. However, I'm now genuinely embarrassed by my naivety and all the assumptions I'd made about the general public for the last 20+ years. While I can't fix what was done or said in my early days, I can at least spend what time I have left trying to fix things in a more appropriate way.

Because public health should, in theory, be apolitical. We just don't have a working model, no pun intended, for an economy that can run at even 50% with isolation/containment protocols in place. (Or maybe we do, and I haven't seen it. I would love to see it.) We definitely don't have an effective disease containment model, barring absolutely draconian measures enforced by law enforcement or the military, where a sizable chunk of the population flaunts health and containment measures. And while I hope Smoove will correct me, I'm guessing we once again don't remotely have enough PPE stockpiled.

I'm doing what I can to try to get our firm thinking of pandemic operation protocol again. The area in which I work is bound to get hit eventually if it continues to spread, as we have a contingent here that believes in raw milk.

[Smoove_B]

And while I hope Smoove will correct me, I'm guessing we once again don't remotely have enough PPE stockpiled.

It's likely even worse than you realize. There's current a vote pending at the CDC to lower infection protocols even more at health care facilities:

OSHA and NIOSH clearly state that surgical masks provide inadequate protection. OSHA says, "Surgical masks are not designed or certified to prevent the inhalation of small airborne contaminants." NIOSH concurs, concluding a surgical mask "is not considered respiratory protection." Yet HICPAC, with one exception, concluded that they were equivalent.

Wearing an N95 respirator will become even more critical as bird flu becomes more widespread, particularly if/when it mutates to be readily spread person-to-person.

...

There was considerable discussion about whether a health care worker (HCW) should have the flexibility and right to decide what level of respiratory protection they felt necessary, based on their own health and that of family members they might be exposing to disease.

In the non-binding vote, almost all members supported the idea that HCWs should not be given that voluntary right.

...

Before vaccinations, the mortality of patients hospitalized with COVID-19 was close to 30%. The mortality rate of hospital-acquired Covid has decreased with multiple vaccinations, but is still 10% or higher. This is still higher than community-acquired infection. So it makes sense that hospitals should do what they can to prevent transmission within the hospital so prevent these needless and avoidable deaths.

As I noted previously, "More than 900 experts in infectious disease, public health, industrial hygiene, aerosol science and ventilation engineering signed a letter to Mandy Cohen, M.D., the new CDC director, explaining how the new draft guidelines weaken protections for healthcare workers. They state, "Surgical masks cannot be recommended to protect health care personnel against inhalation of infectious aerosols."

So in terms of creating/maintaining a stockpile, here's something that would absolutely undermine that mentality. Why stockpile what you don't need?

That said, I'm not sure what the current state is of federal stockpiles, or even my own state. I've been a bit...out of it lately and it's not something I've kept up on. Back to you:

I'm doing what I can to try to get our firm thinking of pandemic operation protocol again. The area in which I work is bound to get hit eventually if it continues to spread, as we have a contingent here that believes in raw milk.

In a different lifetime I was the head of a committee that was in charge of pandemic operations; at the time it was largely a thought exercise. I cannot imagine what that would entail now having (1) lived through a pandemic and (2) having collectively decided it wasn't that bad and we should just press on.

[Zarathud]

That may be true, but Presidents tend to get the blame for bad things that happen. And Democrats are regularly cleaning up Republican messes then turning over the resulting prosperity to a Republican administration.

If we’re going to have a bad time due to world events, it’s only just for the Republicans to get the blame when the government fails. Especially when Trump’s politicization of public health limits any response. That way Democrats can run on a good government and reform agenda and get a mandate to do good, rather than just hold the line.

[LawBeefaroni]

And while I hope Smoove will correct me, I'm guessing we once again don't remotely have enough PPE stockpiled.

It's likely even worse than you realize.

Heck, we're still in the middle of an IV fluid shortage caused by Hurricane Helene.

[Isgrimnur]

H5N1 found in raw milk – the same drink promoted by America’s next health chief

Live traces of H5N1 bird flu have been found in batches of raw milk sold at retail stores across California, state regulators said on Sunday.

The virus was detected in a batch of raw or unpastured milk from Fresno-based brand Raw Farm, the largest producer of raw milk in California, via a sampling programme run by state health authorities.

Retailers were told to pull the product from their shelves, and consumers have been urged to discard the milk. No human infections have yet been linked to the product.

[Smoove_B]

There are posts on social media today absolutely filled with people sharing pictures of shopping carts and trunks loaded with raw milk and raw-milk products in anticipation of anything being pulled.

I'm not a financial planner, but if I was I'd suggest diverting a bit of your portfolio to include child-sized coffin manufacturing.

Gallows humor is all I have left.

[Max Peck]

purchase/acquire the best masks you can get your hands on

Speaking of which, the company that I use for N95 masks is having a Black Friday sale right now, and they service both Canada and the USA.

https://www.vitacore.com/

My mask of choice is their CAN99 (headband) and CAN99E (earloop) respirators. I use the headband version if the mask is staying on for an extended period, but the earband version is more convenient for short periods since it's less hassle to put it on and take it off.

[LordMortis]

I've never had problems getting them at reasonable pricing from Home Depot and fortunately for me, they've always been in stock in store when I needed them.

https://www.homedepot.com/s/n95%20mask?NCNI-5

I rarely wear them any more. I pretty much only wear them in medical environments, because that's where I always seem to get my illnesses from. (See the old age thread for me fear of secondary infections and people I know who have had them or my life catching things like TB or whooping cough, where essentially that's where they had to come from) I saw too many medical exhausted medical staff crying for freedom and how quickly the option to not use sanitation was completely dropped in environments that need it most.

[Max Peck]

Yeah, but the context here is preparedness for an H5N1 pandemic. I'm not assuming that once it erupts I will be able to walk into a store and buy a supply of N95s when the rest of the population (or at least the part of it that is paying attention) is trying to do the same. I haven't forgotten how much fun it was trying to come up with good masking options back in 2020.

[LordMortis]

I have a reasonable supply for the moment, and I'm too good at isolating, so I guess I'm not too concerned. If the bird signal goes up, I'm also likely to jump before most and I don't think what we're seeing counts as a bird signal. We're not even close to what triggered COVID shortages and 48% of likely voters in the US (and much more in my area) won't likely be feel the need to mask if/when the evidence starts kicking in.

I do wonder how many people have kept a reasonable supply in our "post" COVID world. I bet it's small and the people I see that do mask much more responsibly than I do nowadays all wear surgical masks. I'd likely do the same if I was wearing them everywhere. Expense is too high and I'd buy ear stress easing devices to make them much more comfortable than N95s as well.

[Max Peck]

It really depends on which variant of H5N1 we end up getting. The flavor that people get from licking chickens in Asia has a terrifying CFR, something like 50% iirc, while the flavor that Americans get from licking cows seems pretty mild. Who knows which end of the scale we'll see when we arrive at a flavor that people get from licking people.