8 ms·

In good news, the CDC reports a 91% drop in flu infections this year[1]. Since people are sheltering in place and not going to school, there will probably be a

In good news, the CDC reports a 91% drop in flu infections this year[1]. Since people are sheltering in place and not going to school, there will probably be a lot less measles transmission too. One way to not get measles besides getting the vaccine is for kids to not leave the house and not have friends over, which is the norm in 2020. The 200,000 number of measles deaths referenced in the article was from 2019, before the pandemic. [1] https://www.cdc.gov/mmwr/volumes/69/wr/mm6937a6.htm https://www.cdc.gov/mmwr/volumes/69/wr/mm6937a6.htm

Florin_Andrei 6y ago
That's not the issue here. The issue is - COVID, too, shall pass, people will come out in the open again, and meanwhile the measles vaccination rates have dropped a lot, thanks to irrational beliefs made popular by "influencers".
saiya-jin 6y ago
Maybe its the norm in US, but in Europe kids are very much going to school even if overall the society in given state is close to standstill. Not claiming every single state is like that here over the pond (situation evolves), but most are. Even in most infectious region per 100k citizen in last 14 days - canton Geneva in Switzerland, schools are running open, so are kindergartens. Doesn't make much sense, I know. But on the other side at least for us we are not skipping nay vaccinations, nor for us (mainly flu) nor for out 11 month old kiddo.
- InitialLastName 6y ago
  Some amount of in-person-schooling-as-necessary-function makes a lot of sense. We know that kids under 10 are very unlikely to transmit Covid, and younger kids are also the least able to thrive in a remote learning environment. My SO is currently teaching second grade (7-8 year olds) remote, and I get nightmares just imagining trying to keep 7-year-old me staring at a teacher on a computer screen (that was a difficult enough task in person). If you can orchestrate your staff in such a way that they're in limited contact with one another (maybe specials suffer) you can probably teach younger kids safely.
  - MereInterest 6y ago
    > We know that kids under 10 are very unlikely to transmit Covid Source? My impression was that very few cases of transmission from young kids were observed, precisely because they were isolated. The adults might bring Covid into the house and spread it to the entire household, but the kids staying home means they can only get it from the adults. Nothing about being intrinsically less contagious, and everything about having an environment that minimizes contact.
    - zaroth 6y ago
      In MA, where most schools are in a hybrid (part time) model, there has been “maybe 1” case of confirmed transmission of COVID in schools.
snarf21 6y ago
Yeah and the article says it has been rising since 2017. This isn't really about covid, we have a global outbreak of measles and it is mega contagious.
- Broken_Hippo 6y ago
  You can have numbers rising since 2017 while still seeing that Covid has further increased numbers by disrupting normal vaccinations. I'm pretty sure we do have a fair way to know how about how many measles vaccines were manufactured and likely used from year to year.
Semaphor 6y ago
and I love it. this is my first year I've not had a bad cold. I'm starting to wish everyone would wear masks all the time and keep their distance
- viraptor 6y ago
  I'm considering keeping the mask for shop trips and school pickups in the future, after covid dies down. There's just no downside to that really.
  - Semaphor 6y ago
    I wish there wasn't, but I have minor claustrophobia and masks make it worse. But my understanding is that the vast majority of protection comes from other people wearing masks, is that wrong?
    - Larrikin 6y ago
      The thinking before the pandemic was that there was almost no protection in wearing the mask for yourself which has been shown to be incorrect. The best thing to stop infection is still for everyone to wear a mask.
      - aquadrop 6y ago
        Can you point to where it was shown to be incorrect?
        Larrikin 6y ago
        https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.html https://www.cdc.gov/coronavirus/2019-ncov/more/masking-scien... The US has been extremely behind other countries but even the CDC has finally acknowledged the benefits
    - mensetmanusman 6y ago
      If you wear a properly fitting N95, you are protecting yourself, full stop.
loosescrews 6y ago
One thing to note is that measles is a lot more contagious [1] than sars-cov-2 or any of the flu strains [2]. Measels is also an airborne disease [3], which is distinct from respiratory droplet transmitted diseases [4], like the sars-cov-2 virus [5]. As a result, many of the precautions that people are taking for the sars-cov-2 virus, while also effective against the flu, are not effective against measles. The measles boom in 2019 was driven by an anti-vaccine movement. The current reduction in vaccination is much larger and more widespread. I therefore don't think that we can conclude that measles cases will decrease in 2020 without data. I also wouldn't be surprised if we see an even larger measles boom when current precautions are phased out. [1] https://www.cdc.gov/measles/transmission.html https://www.cdc.gov/measles/transmission.html [2] https://www.popsci.com/story/health/how-diseases-spread/ https://www.popsci.com/story/health/how-diseases-spread/ [3] https://en.wikipedia.org/wiki/Measles https://en.wikipedia.org/wiki/Measles [4] https://en.wikipedia.org/wiki/Airborne_transmission https://en.wikipedia.org/wiki/Airborne_transmission [5] https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-sars-cov-2.html https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-br...
- snazz 6y ago
  Hasn't there been a fair bit of evidence that covid spreads in an airborne manner some of the time?
  - Retric 6y ago
    Covid is also airborne, but Measles is almost absurdly infections. We quantify this stuff with the basic reproduction number. Measles Aerosol R0 12–18 vs COVID-19 Respiratory droplets and aerosol R0 2–6. https://en.wikipedia.org/wiki/Basic_reproduction_number https://en.wikipedia.org/wiki/Basic_reproduction_number
- gingerlime 6y ago
  We realised it during the height of the lock down in spring. Our son did not interact with any other child for a few weeks, and only went out occasionally with a mask on. Then he suddenly got chicken pox...
gojomo 6y ago
To some extent, the circulation of natural flu cases, of routine non-severe varieties, serves as a natural 'booster' refreshing immunity against related strains. For example, every once in a while, a new flu strain hits a certain younger or middle-aged cohort much harder than usual, because some other strain decades ago left lingering immunity in yet-older people. Examples: 2014 flu season: https://www.fredhutch.org/en/news/center-news/2014/10/flu-hit-hardest-last-year.html https://www.fredhutch.org/en/news/center-news/2014/10/flu-hi... 1977-78 Russian flu: https://en.wikipedia.org/wiki/Influenza_A_virus_subtype_H1N1#1977%E2%80%931978_Russian_flu https://en.wikipedia.org/wiki/Influenza_A_virus_subtype_H1N1... As a result, this season of abnormally-low flu infections may not be unvarnished good news. When normal interaction levels recur, we may see a rebound of flu cases – in numbers & severity – from all the people who didn't get a typical mild seasonal re-exposure. Decades from now, people may suffer for having missed a survivable-exposure-while-young. Time will tell.
- trhway 6y ago
  one can wonder what other antigens we decreased the exposure to with the resulting immune system changes like decreased diversity and levels of antibodies present - i mean it may be kind of similar to the effect of living in highly antimicrobal environment which results in weaker immune system with all the allergies and autoimmunes as a result down the road. Even super-healthy people like astronauts have immune system weakening and hypersensitivites developed as result of decreased exposure to diverse antigens: https://www.sciencedaily.com/releases/2019/01/190123174405.htm https://www.sciencedaily.com/releases/2019/01/190123174405.h... "Scientists compared blood samples of eight crewmembers who completed missions to the International Space Station with healthy individuals who remained on Earth. Blood samples were taken before launch, at several points during the mission and after the astronauts' return to Earth. The results showed that NK-cell function is impaired in astronauts as compared with pre-flight levels and ground-based controls. At flight day 90, NK-cell cytotoxic activity against leukemia cells in vitro was reduced by approximately 50 percent in International Space Station crew members."
  - TheSpiceIsLife 6y ago
    > as result of decreased exposure to diverse antigens: The link you posted doesn't make that claim. The word antigen doesn't even appear in the article you linked. Rather, it claims: "In order to do that, you have to first figure out what's causing the decline: Is it stress? Is it microgravity? Is it radiation? Is it a plethora of things? When we figure that out, we can try to find ways to directly target those factors and mitigate them." Having said that, we know for a fact humans can't survive long term in a completely sterile environment as babies wouldn't have their integumentary system and digestive systems populated with commensal organisms shortly after birth in a completely sterile environment. So it's seems at least plausible to me that living in a increasingly sterile environments is likely to be a net negative on overall health etc etc.
jeffbee 6y ago
I imagine head lice are having a hard time also.
sandworm101 6y ago
Measles is a special case in terms of infection. There is a line of thought that exposure simply cannot be stopped, that immunization or inevitable infection are the only options. It is a truly airborne disease. If someone with measles coughs in a room and walks away, people walking through that room an hour later will be infected. The standard for social-distancing for measles wouldn't be 6 feet. It would be something like 600 feet, preferably upwind. I read once about the cleaning standard for clothes or objects exposed to measles. Not bleach. Fire. Lots of fire. Measles in the past was endemic. Everyone got it at some point. Most survived and so the population was somewhat resistant. But today? Without that resistance it would spread through any unvaccinated population like something from a hollywood movie.
- JumpCrisscross 6y ago
  > Measles is a special case in terms of infection Measles is the most virulent common infectious disease, clocking in at R0 ~ 12 to 18. For comparison, Covid's is 2 to 6 and chickenpox 10 to 12. Only about 1 or 2 out of a 1,000 measles infections results in death [2]. But something like 1 in 4 results in hospitalization. We don't have that hospital capacity. [1] https://en.wikipedia.org/wiki/Basic_reproduction_number https://en.wikipedia.org/wiki/Basic_reproduction_number [2] https://www.cdc.gov/measles/symptoms/complications.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmeasles%2Fabout%2Fcomplications.html https://www.cdc.gov/measles/symptoms/complications.html?CDC_...
  - contravariant 6y ago
    Damn. Good thing measles came into existence before worldwide travel became a thing instead of the other way around.
    - s3cur3 6y ago
      Not sure why you're getting downvoted. It is absolutely the case that COVID should make us think very hard about how lucky we got this time. There's no reason to think this couldn't have happened with a virus 10 or 100x as deadly. Given many countries' poor performance containing it, I shudder to think what the next pandemic might look like.
easytiger 6y ago
> In good news, the CDC reports a 91% drop in flu infections this year[1] Why's that a good thing? Children get between 4-8 viral infections a year and thus build up natural immunity with no issue. There's a reason you have an immune system.
- nostrademons 6y ago
  Flu immunity doesn't mean all that much because flu viruses mutate so quickly. That's why the flu shot has to be given every year: it protects against different strains, whatever is predicted to be predominant that year. Natural immunity is much more effective for viruses that don't change much: measles, polio, chickenpox, coxsackievirus (hand-foot-mouth), even common-cold coronaviruses.
  - easytiger 6y ago
    Infant immune systems are significantly dependant on exposure to infections to workand transition from their in vitro system. Lack of natural exposure is already thought to be responsible for a whole host of medical issues.
worker767424 6y ago
I didn't get the big push for flu shots this year. Between social distancing and masks, it's obviously going to spread a lot less, there some risk to going to a clinic to get the shot, and we normally use data from the southern hemisphere to predict which strains will be dominant this season, but with significantly reduced travel and social restrictions in the southern hemisphere, the data's going to be bad, so this year's flu shot won't be as effective.
- rconti 6y ago
  1. I do NOT want to get sick and wonder if I have COVID-19. 2. The medical establishment does NOT want a bunch of flu cases flooding into already-overwhelmed hospitals. 3. Is there a possibility of interaction between COVID-19 and the flu? I have no idea, I just made this up. so yeah, I think the risk of the flu is a lot lower, and the vaccine might be less effective, and there are risks to getting vaccinated, but presumably the various risks of the flu during a pandemic are worse than the risks of the flu during normal times.
- mikestew 6y ago
  Earlier in the year I decided I was going to get a flu shot this year, for the first time ever. I was in the hospital for a non-Covid-related thing, and a nurse convinced me to do it for everyone else. Okay, sold. And then around April it became evident to me that maybe it is fine to wait until next year.
  - ValentineC 6y ago
    Heh, I was sneezing a lot late last year, and put an entry into my calendar to get a flu jab in October 2020. (I've never gotten one before, but figured that maybe I've hit the age where my body doesn't bounce back as quickly anymore.) Never got around to getting it.
- hcknwscommenter 6y ago
  > with significantly reduced travel and social restrictions in the southern hemisphere, the data's going to be bad, so this year's flu shot won't be as effective This does not seem correct. The data on this does not require travel or social interaction. The CDC (and other gov't agencies throughout the world) literally has cooperation with sites around the world to monitor the rise of new flu strains. These sites use technology like: the telephone, the internet, and the fax machine, to transmit the information the world uses to develop the current generation flu vaccine.

Florin_Andrei 6y ago

That's not the issue here. The issue is - COVID, too, shall pass, people will come out in the open again, and meanwhile the measles vaccination rates have dropped a lot, thanks to irrational beliefs made popular by "influencers".

saiya-jin 6y ago

Maybe its the norm in US, but in Europe kids are very much going to school even if overall the society in given state is close to standstill. Not claiming every single state is like that here over the pond (situation evolves), but most are. Even in most infectious region per 100k citizen in last 14 days - canton Geneva in Switzerland, schools are running open, so are kindergartens. Doesn't make much sense, I know. But on the other side at least for us we are not skipping nay vaccinations, nor for us (mainly flu) nor for out 11 month old kiddo.

InitialLastName 6y ago
Some amount of in-person-schooling-as-necessary-function makes a lot of sense. We know that kids under 10 are very unlikely to transmit Covid, and younger kids are also the least able to thrive in a remote learning environment. My SO is currently teaching second grade (7-8 year olds) remote, and I get nightmares just imagining trying to keep 7-year-old me staring at a teacher on a computer screen (that was a difficult enough task in person). If you can orchestrate your staff in such a way that they're in limited contact with one another (maybe specials suffer) you can probably teach younger kids safely.
- MereInterest 6y ago
  > We know that kids under 10 are very unlikely to transmit Covid Source? My impression was that very few cases of transmission from young kids were observed, precisely because they were isolated. The adults might bring Covid into the house and spread it to the entire household, but the kids staying home means they can only get it from the adults. Nothing about being intrinsically less contagious, and everything about having an environment that minimizes contact.
  - zaroth 6y ago
    In MA, where most schools are in a hybrid (part time) model, there has been “maybe 1” case of confirmed transmission of COVID in schools.

snarf21 6y ago

Yeah and the article says it has been rising since 2017. This isn't really about covid, we have a global outbreak of measles and it is mega contagious.

Broken_Hippo 6y ago
You can have numbers rising since 2017 while still seeing that Covid has further increased numbers by disrupting normal vaccinations. I'm pretty sure we do have a fair way to know how about how many measles vaccines were manufactured and likely used from year to year.

Semaphor 6y ago

and I love it. this is my first year I've not had a bad cold. I'm starting to wish everyone would wear masks all the time and keep their distance

viraptor 6y ago
I'm considering keeping the mask for shop trips and school pickups in the future, after covid dies down. There's just no downside to that really.
- Semaphor 6y ago
  I wish there wasn't, but I have minor claustrophobia and masks make it worse. But my understanding is that the vast majority of protection comes from other people wearing masks, is that wrong?
  - Larrikin 6y ago
    The thinking before the pandemic was that there was almost no protection in wearing the mask for yourself which has been shown to be incorrect. The best thing to stop infection is still for everyone to wear a mask.
    - aquadrop 6y ago
      Can you point to where it was shown to be incorrect?
      - Larrikin 6y ago
        https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.html https://www.cdc.gov/coronavirus/2019-ncov/more/masking-scien... The US has been extremely behind other countries but even the CDC has finally acknowledged the benefits
  - mensetmanusman 6y ago
    If you wear a properly fitting N95, you are protecting yourself, full stop.

loosescrews 6y ago

One thing to note is that measles is a lot more contagious [1] than sars-cov-2 or any of the flu strains [2]. Measels is also an airborne disease [3], which is distinct from respiratory droplet transmitted diseases [4], like the sars-cov-2 virus [5]. As a result, many of the precautions that people are taking for the sars-cov-2 virus, while also effective against the flu, are not effective against measles. The measles boom in 2019 was driven by an anti-vaccine movement. The current reduction in vaccination is much larger and more widespread. I therefore don't think that we can conclude that measles cases will decrease in 2020 without data. I also wouldn't be surprised if we see an even larger measles boom when current precautions are phased out. [1] https://www.cdc.gov/measles/transmission.html https://www.cdc.gov/measles/transmission.html [2] https://www.popsci.com/story/health/how-diseases-spread/ https://www.popsci.com/story/health/how-diseases-spread/ [3] https://en.wikipedia.org/wiki/Measles https://en.wikipedia.org/wiki/Measles [4] https://en.wikipedia.org/wiki/Airborne_transmission https://en.wikipedia.org/wiki/Airborne_transmission [5] https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-sars-cov-2.html https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-br...

snazz 6y ago
Hasn't there been a fair bit of evidence that covid spreads in an airborne manner some of the time?
- Retric 6y ago
  Covid is also airborne, but Measles is almost absurdly infections. We quantify this stuff with the basic reproduction number. Measles Aerosol R0 12–18 vs COVID-19 Respiratory droplets and aerosol R0 2–6. https://en.wikipedia.org/wiki/Basic_reproduction_number https://en.wikipedia.org/wiki/Basic_reproduction_number
gingerlime 6y ago
We realised it during the height of the lock down in spring. Our son did not interact with any other child for a few weeks, and only went out occasionally with a mask on. Then he suddenly got chicken pox...

gojomo 6y ago

To some extent, the circulation of natural flu cases, of routine non-severe varieties, serves as a natural 'booster' refreshing immunity against related strains. For example, every once in a while, a new flu strain hits a certain younger or middle-aged cohort much harder than usual, because some other strain decades ago left lingering immunity in yet-older people. Examples: 2014 flu season: https://www.fredhutch.org/en/news/center-news/2014/10/flu-hit-hardest-last-year.html https://www.fredhutch.org/en/news/center-news/2014/10/flu-hi... 1977-78 Russian flu: https://en.wikipedia.org/wiki/Influenza_A_virus_subtype_H1N1#1977%E2%80%931978_Russian_flu https://en.wikipedia.org/wiki/Influenza_A_virus_subtype_H1N1... As a result, this season of abnormally-low flu infections may not be unvarnished good news. When normal interaction levels recur, we may see a rebound of flu cases – in numbers & severity – from all the people who didn't get a typical mild seasonal re-exposure. Decades from now, people may suffer for having missed a survivable-exposure-while-young. Time will tell.

trhway 6y ago
one can wonder what other antigens we decreased the exposure to with the resulting immune system changes like decreased diversity and levels of antibodies present - i mean it may be kind of similar to the effect of living in highly antimicrobal environment which results in weaker immune system with all the allergies and autoimmunes as a result down the road. Even super-healthy people like astronauts have immune system weakening and hypersensitivites developed as result of decreased exposure to diverse antigens: https://www.sciencedaily.com/releases/2019/01/190123174405.htm https://www.sciencedaily.com/releases/2019/01/190123174405.h... "Scientists compared blood samples of eight crewmembers who completed missions to the International Space Station with healthy individuals who remained on Earth. Blood samples were taken before launch, at several points during the mission and after the astronauts' return to Earth. The results showed that NK-cell function is impaired in astronauts as compared with pre-flight levels and ground-based controls. At flight day 90, NK-cell cytotoxic activity against leukemia cells in vitro was reduced by approximately 50 percent in International Space Station crew members."
- TheSpiceIsLife 6y ago
  > as result of decreased exposure to diverse antigens: The link you posted doesn't make that claim. The word antigen doesn't even appear in the article you linked. Rather, it claims: "In order to do that, you have to first figure out what's causing the decline: Is it stress? Is it microgravity? Is it radiation? Is it a plethora of things? When we figure that out, we can try to find ways to directly target those factors and mitigate them." Having said that, we know for a fact humans can't survive long term in a completely sterile environment as babies wouldn't have their integumentary system and digestive systems populated with commensal organisms shortly after birth in a completely sterile environment. So it's seems at least plausible to me that living in a increasingly sterile environments is likely to be a net negative on overall health etc etc.

jeffbee 6y ago

I imagine head lice are having a hard time also.

sandworm101 6y ago

Measles is a special case in terms of infection. There is a line of thought that exposure simply cannot be stopped, that immunization or inevitable infection are the only options. It is a truly airborne disease. If someone with measles coughs in a room and walks away, people walking through that room an hour later will be infected. The standard for social-distancing for measles wouldn't be 6 feet. It would be something like 600 feet, preferably upwind. I read once about the cleaning standard for clothes or objects exposed to measles. Not bleach. Fire. Lots of fire. Measles in the past was endemic. Everyone got it at some point. Most survived and so the population was somewhat resistant. But today? Without that resistance it would spread through any unvaccinated population like something from a hollywood movie.

JumpCrisscross 6y ago
> Measles is a special case in terms of infection Measles is the most virulent common infectious disease, clocking in at R0 ~ 12 to 18. For comparison, Covid's is 2 to 6 and chickenpox 10 to 12. Only about 1 or 2 out of a 1,000 measles infections results in death [2]. But something like 1 in 4 results in hospitalization. We don't have that hospital capacity. [1] https://en.wikipedia.org/wiki/Basic_reproduction_number https://en.wikipedia.org/wiki/Basic_reproduction_number [2] https://www.cdc.gov/measles/symptoms/complications.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmeasles%2Fabout%2Fcomplications.html https://www.cdc.gov/measles/symptoms/complications.html?CDC_...
- contravariant 6y ago
  Damn. Good thing measles came into existence before worldwide travel became a thing instead of the other way around.
  - s3cur3 6y ago
    Not sure why you're getting downvoted. It is absolutely the case that COVID should make us think very hard about how lucky we got this time. There's no reason to think this couldn't have happened with a virus 10 or 100x as deadly. Given many countries' poor performance containing it, I shudder to think what the next pandemic might look like.

easytiger 6y ago

> In good news, the CDC reports a 91% drop in flu infections this year[1] Why's that a good thing? Children get between 4-8 viral infections a year and thus build up natural immunity with no issue. There's a reason you have an immune system.

nostrademons 6y ago
Flu immunity doesn't mean all that much because flu viruses mutate so quickly. That's why the flu shot has to be given every year: it protects against different strains, whatever is predicted to be predominant that year. Natural immunity is much more effective for viruses that don't change much: measles, polio, chickenpox, coxsackievirus (hand-foot-mouth), even common-cold coronaviruses.
- easytiger 6y ago
  Infant immune systems are significantly dependant on exposure to infections to workand transition from their in vitro system. Lack of natural exposure is already thought to be responsible for a whole host of medical issues.

worker767424 6y ago

I didn't get the big push for flu shots this year. Between social distancing and masks, it's obviously going to spread a lot less, there some risk to going to a clinic to get the shot, and we normally use data from the southern hemisphere to predict which strains will be dominant this season, but with significantly reduced travel and social restrictions in the southern hemisphere, the data's going to be bad, so this year's flu shot won't be as effective.

rconti 6y ago
1. I do NOT want to get sick and wonder if I have COVID-19. 2. The medical establishment does NOT want a bunch of flu cases flooding into already-overwhelmed hospitals. 3. Is there a possibility of interaction between COVID-19 and the flu? I have no idea, I just made this up. so yeah, I think the risk of the flu is a lot lower, and the vaccine might be less effective, and there are risks to getting vaccinated, but presumably the various risks of the flu during a pandemic are worse than the risks of the flu during normal times.
mikestew 6y ago
Earlier in the year I decided I was going to get a flu shot this year, for the first time ever. I was in the hospital for a non-Covid-related thing, and a nurse convinced me to do it for everyone else. Okay, sold. And then around April it became evident to me that maybe it is fine to wait until next year.
- ValentineC 6y ago
  Heh, I was sneezing a lot late last year, and put an entry into my calendar to get a flu jab in October 2020. (I've never gotten one before, but figured that maybe I've hit the age where my body doesn't bounce back as quickly anymore.) Never got around to getting it.
hcknwscommenter 6y ago
> with significantly reduced travel and social restrictions in the southern hemisphere, the data's going to be bad, so this year's flu shot won't be as effective This does not seem correct. The data on this does not require travel or social interaction. The CDC (and other gov't agencies throughout the world) literally has cooperation with sites around the world to monitor the rise of new flu strains. These sites use technology like: the telephone, the internet, and the fax machine, to transmit the information the world uses to develop the current generation flu vaccine.