7 ms·

America's first bird flu death reported in Louisiana

51 points by bikenaga 2y ago

biofox 2y ago
This is concerning, but not worth panicking about yet. The person had direct contact with infected birds, so there is no evidence of human-to-human transmission. For those wanting to learn more about bird flu, and flu in general, I highly recommend the recent Scott Alexander post: https://www.astralcodexten.com/p/h5n1-much-more-than-you-wanted-to https://www.astralcodexten.com/p/h5n1-much-more-than-you-wan... [Edited for clarity]
- krunck 2y ago
  Thanks. Excellent article. This made me laugh: "If reassortment is sort of like viral sex, pigs are sort of like Tinder."
- xmddmx 2y ago
  The person who got infected in Canada came very close to dying. They were on ECMO for a while. https://www.nejm.org/doi/full/10.1056/NEJMc2415890 https://www.nejm.org/doi/full/10.1056/NEJMc2415890
  - timr 2y ago
    > 13-year-old girl with a history of mild asthma and an elevated body-mass index of greater than 35 Essential context. That's the equivalent of a 5'4" (163cm) woman at >=205 lbs (93kg).
- locopati 2y ago
  [dead]
  - wmf 2y ago
    There's already a (regular) flu outbreak in Louisiana and people are probably dying from it but it's not considered newsworthy because people die from flu every year.
    - timr 2y ago
      Please don't speculate. We know what serotypes are circulating in humans, and they're not this type.
  - deleted 2y ago
    [deleted]
- NewJazz 2y ago
  This is something to worry about if you have a backyard flock.
  - bee_rider 2y ago
    Is there a large non-worried population posting from somewhere without access to, uh, the sky?
- onlyrealcuzzo 2y ago
  This article is great - enlightening and quit funny: > Pigs can be infected by both human and bird viruses, so they are a common place for this reassortment to take place. If reassortment is sort of like viral sex, pigs are sort of like Tinder.
timr 2y ago
> But even if the actual case fatality rate were 10 times lower – about 5% – it would still be a serious virus to contend with. The case fatality rate for the ancestral strain of Covid-19 was estimated to be around 2.6%, for example. Ugh. The news media never learns [1]: 1) The IFR for Covid-19 was not 2.6%. Less than a tenth of that, actually (yes, even for the ancestral strains). 2) "CFR" is a made up number, because it depends on what cases you count. If you count only a sample of people in the ICU, you can make the CFR look horrible for pretty much any illness. We made this mistake during covid! 3) You can see the same mistake in progress here, because you can't just take this sample of deaths you looked for, divide it by the cases you know about, scale it down by a random factor (that you pulled out of your butt), and then panic about the result [2]. [1] or more likely: never wants to learn, because fear drives clicks. [2] for those who wonder: the right way to do this is random sampling -- you at least have to sample the population randomly to estimate seroprevalence correctly.
- perihelions 2y ago
  - "for those who wonder: the right way to do this is random sampling -- you at least have to sample the population randomly to estimate seroprevalence correctly" There was a recent experiment that found 7% antibody prevalence in US diary workers, https://www.cdc.gov/mmwr/volumes/73/wr/mm7344a3.htm https://www.cdc.gov/mmwr/volumes/73/wr/mm7344a3.htm
- sampo 2y ago
  > The IFR for Covid-19 was not 2.6%. Less than a tenth of that, actually If we take the number of Covid deaths for, for example New Jersey (the whole state) or New York City from Wikipedia as: 26,795 [1] and 40,000 [2] and divide by the total population (9.5M and 8.8M), we get IFR estimates of 0.28% and 0.51% for NJ and NYC. [1] "As of January 11, 2022, 1.63 million cases were confirmed in the state, incurring 26,795 deaths." [2] "As of August 19, 2023 the city's confirmed COVID-19 deaths exceeded 45,000 and probable deaths exceeded 5,500."
  - timr 2y ago
    I can't tell if you're agreeing or disagreeing, but: yeah, don't do what you're doing. There are lots of good publications on this question now. You don't have to make stuff up. https://pmc.ncbi.nlm.nih.gov/articles/PMC9613797/ https://pmc.ncbi.nlm.nih.gov/articles/PMC9613797/ > we identified 40 eligible national seroprevalence studies covering 38 countries with pre-vaccination seroprevalence data. For 29 countries (24 high-income, 5 others), publicly available age-stratified COVID-19 death data and age-stratified seroprevalence information were available and were included in the primary analysis. The IFRs had a median of 0.034% (interquartile range (IQR) 0.013–0.056%) for the 0–59 years old population, and 0.095% (IQR 0.036–0.119%) for the 0–69 years old. The median IFR was 0.0003% at 0–19 years, 0.002% at 20–29 years, 0.011% at 30–39 years, 0.035% at 40–49 years, 0.123% at 50–59 years, and 0.506% at 60–69 years. IFR increases approximately 4 times every 10 years. Including data from another 9 countries with imputed age distribution of COVID-19 deaths yielded median IFR of 0.025–0.032% for 0–59 years and 0.063–0.082% for 0–69 years. Meta-regression analyses also suggested global IFR of 0.03% and 0.07%, respectively in these age groups.
leotravis10 2y ago
Another pandemic is surely coming as the US has already lost control. It'll get ugly real fast with no safeguards whatsoever. https://kffhealthnews.org/news/article/bird-flu-spread-cattle-poultry-pandemic-cdc/ https://kffhealthnews.org/news/article/bird-flu-spread-cattl...
- hall0ween 2y ago
  Geez
pottertheotter 2y ago
I don't know if this will help anyone, but my sister is an expert in this area. She is an infectious disease epidemiologist with a couple decades of experience. She was the head of vaccine-preventable epidemiology for one of the states in the U.S., and is now the head of epidemiology data and informatics for that state. Over the holidays, I was asking her about bird flu because some of the things I was reading were frightening, but I wasn't sure what to make of them. When I showed her this paper that is linked to in another comment here https://www.nejm.org/doi/full/10.1056/NEJMc2415890 https://www.nejm.org/doi/full/10.1056/NEJMc2415890, she responded with this: Everyone will react differently to the flu. There are kids in her exact situation that have that kind of reaction to the normal flu. However, it is still concerning. If the virus does cause more severe illness overall and it does mutate to become person-to-person, we are in trouble. That is the hardest thing about public health—you just don't know which way things will swing. So you are always on the edge of either overreacting or underreacting.
- dbish 2y ago
  What did your sister say before the last pandemic?
  - rscho 2y ago
    The sister's answer is the answer pretty much any doc knowing the bare minimum about flu would give. This was already the case before the last pandemic. The flu virus is closely monitored for this exact reason: medical authorities and the WHO have been expecting a problematic flu pandemic for at least two decades. No one can know when the 'big one' will appear, but this one's a good candidate.
ruthmarx 2y ago
Time to invest in bleach shares.
asdasdsddd 2y ago
Im not worried since this one wasnt created in a lab. Only half joking.
- mikeyouse 2y ago
  Neither was Covid - it was always a silly idea with zero actual evidence for it. The steel man case for a lab leak was a leak of a natural virus, but even that has no evidence.
  - asdasdsddd 2y ago
    How is the steelman not, a leak involving viruses with gain of function.
    - mikeyouse 2y ago
      In the leak of existing virus scenario, you’d just need an existing virus kept secret from the entire worlds scientific and intelligence apparatus that accidentally escaped. In the gain of function one, you’d need that same virus as the backbone but also you’d need a lab to have discovered and used a new, unpublished and less effective insert (PRRAR) that accidentally created the worlds first artificial pandemic virus… again, all completely under the scientific and intelligence radar. The number of people who would need to be involved and kept quiet in the latter quickly reaches implausible numbers. I don’t consider it much of a steel man to create a huge conspiracy when a simple mistake would suffice.
      - asdasdsddd 2y ago
        Are you telling me its crazy that a scientist accidentally caught an undocumented strain of the virus and spread it? Why would there need to be a cover up if they can't even find patient zero. And even if there was a cover up, both the US and China have massive incentives to cover it up.
        defrost 2y ago
mtoner23 2y ago
Can we just preemptively start vaccinating against this strain? we have the vaccine and seems like a low risk thing to get started on. even if no evidence of human to human transmission.
- VirusNewbie 2y ago
  But the current strain isn’t the one that would allow for human to human transmission, so efficacy is completely unknown.
  - XorNot 2y ago
    There is however some promising work on designing antibodies which might be broadly effective against all flus including H5N1: https://pubmed.ncbi.nlm.nih.gov/21320540/ https://pubmed.ncbi.nlm.nih.gov/21320540/ But that's a decade away from deployment - though fortunately likely highly motivated if it works because the other promise is long-term immunity, rather then yearly boosters.
- attila-lendvai 2y ago
  peak dark age: i can't decide whether this is sarcasm or not...
observer987 2y ago
I am not going to panic about it at this point. But, if it does develop into a pandemic, I am quite certain that the initial response will be more along the lines of "let's just see what happens. Gotta keep the economy going, right?"
attila-lendvai 2y ago
looks like we still haven't learned the lesson...

51 points by bikenaga 2y ago

This is concerning, but not worth panicking about yet. The person had direct contact with infected birds, so there is no evidence of human-to-human transmission. For those wanting to learn more about bird flu, and flu in general, I highly recommend the recent Scott Alexander post: https://www.astralcodexten.com/p/h5n1-much-more-than-you-wanted-to https://www.astralcodexten.com/p/h5n1-much-more-than-you-wan... [Edited for clarity]

krunck 2y ago
Thanks. Excellent article. This made me laugh: "If reassortment is sort of like viral sex, pigs are sort of like Tinder."
xmddmx 2y ago
The person who got infected in Canada came very close to dying. They were on ECMO for a while. https://www.nejm.org/doi/full/10.1056/NEJMc2415890 https://www.nejm.org/doi/full/10.1056/NEJMc2415890
- timr 2y ago
  > 13-year-old girl with a history of mild asthma and an elevated body-mass index of greater than 35 Essential context. That's the equivalent of a 5'4" (163cm) woman at >=205 lbs (93kg).
locopati 2y ago
[dead]
- wmf 2y ago
  There's already a (regular) flu outbreak in Louisiana and people are probably dying from it but it's not considered newsworthy because people die from flu every year.
  - timr 2y ago
    Please don't speculate. We know what serotypes are circulating in humans, and they're not this type.
- deleted 2y ago
  [deleted]
NewJazz 2y ago
This is something to worry about if you have a backyard flock.
- bee_rider 2y ago
  Is there a large non-worried population posting from somewhere without access to, uh, the sky?
onlyrealcuzzo 2y ago
This article is great - enlightening and quit funny: > Pigs can be infected by both human and bird viruses, so they are a common place for this reassortment to take place. If reassortment is sort of like viral sex, pigs are sort of like Tinder.

timr 2y ago

> But even if the actual case fatality rate were 10 times lower – about 5% – it would still be a serious virus to contend with. The case fatality rate for the ancestral strain of Covid-19 was estimated to be around 2.6%, for example. Ugh. The news media never learns [1]: 1) The IFR for Covid-19 was not 2.6%. Less than a tenth of that, actually (yes, even for the ancestral strains). 2) "CFR" is a made up number, because it depends on what cases you count. If you count only a sample of people in the ICU, you can make the CFR look horrible for pretty much any illness. We made this mistake during covid! 3) You can see the same mistake in progress here, because you can't just take this sample of deaths you looked for, divide it by the cases you know about, scale it down by a random factor (that you pulled out of your butt), and then panic about the result [2]. [1] or more likely: never wants to learn, because fear drives clicks. [2] for those who wonder: the right way to do this is random sampling -- you at least have to sample the population randomly to estimate seroprevalence correctly.

perihelions 2y ago
- "for those who wonder: the right way to do this is random sampling -- you at least have to sample the population randomly to estimate seroprevalence correctly" There was a recent experiment that found 7% antibody prevalence in US diary workers, https://www.cdc.gov/mmwr/volumes/73/wr/mm7344a3.htm https://www.cdc.gov/mmwr/volumes/73/wr/mm7344a3.htm
sampo 2y ago
> The IFR for Covid-19 was not 2.6%. Less than a tenth of that, actually If we take the number of Covid deaths for, for example New Jersey (the whole state) or New York City from Wikipedia as: 26,795 [1] and 40,000 [2] and divide by the total population (9.5M and 8.8M), we get IFR estimates of 0.28% and 0.51% for NJ and NYC. [1] "As of January 11, 2022, 1.63 million cases were confirmed in the state, incurring 26,795 deaths." [2] "As of August 19, 2023 the city's confirmed COVID-19 deaths exceeded 45,000 and probable deaths exceeded 5,500."
- timr 2y ago
  I can't tell if you're agreeing or disagreeing, but: yeah, don't do what you're doing. There are lots of good publications on this question now. You don't have to make stuff up. https://pmc.ncbi.nlm.nih.gov/articles/PMC9613797/ https://pmc.ncbi.nlm.nih.gov/articles/PMC9613797/ > we identified 40 eligible national seroprevalence studies covering 38 countries with pre-vaccination seroprevalence data. For 29 countries (24 high-income, 5 others), publicly available age-stratified COVID-19 death data and age-stratified seroprevalence information were available and were included in the primary analysis. The IFRs had a median of 0.034% (interquartile range (IQR) 0.013–0.056%) for the 0–59 years old population, and 0.095% (IQR 0.036–0.119%) for the 0–69 years old. The median IFR was 0.0003% at 0–19 years, 0.002% at 20–29 years, 0.011% at 30–39 years, 0.035% at 40–49 years, 0.123% at 50–59 years, and 0.506% at 60–69 years. IFR increases approximately 4 times every 10 years. Including data from another 9 countries with imputed age distribution of COVID-19 deaths yielded median IFR of 0.025–0.032% for 0–59 years and 0.063–0.082% for 0–69 years. Meta-regression analyses also suggested global IFR of 0.03% and 0.07%, respectively in these age groups.

leotravis10 2y ago

Another pandemic is surely coming as the US has already lost control. It'll get ugly real fast with no safeguards whatsoever. https://kffhealthnews.org/news/article/bird-flu-spread-cattle-poultry-pandemic-cdc/ https://kffhealthnews.org/news/article/bird-flu-spread-cattl...

hall0ween 2y ago
Geez

pottertheotter 2y ago

I don't know if this will help anyone, but my sister is an expert in this area. She is an infectious disease epidemiologist with a couple decades of experience. She was the head of vaccine-preventable epidemiology for one of the states in the U.S., and is now the head of epidemiology data and informatics for that state. Over the holidays, I was asking her about bird flu because some of the things I was reading were frightening, but I wasn't sure what to make of them. When I showed her this paper that is linked to in another comment here https://www.nejm.org/doi/full/10.1056/NEJMc2415890 https://www.nejm.org/doi/full/10.1056/NEJMc2415890, she responded with this: Everyone will react differently to the flu. There are kids in her exact situation that have that kind of reaction to the normal flu. However, it is still concerning. If the virus does cause more severe illness overall and it does mutate to become person-to-person, we are in trouble. That is the hardest thing about public health—you just don't know which way things will swing. So you are always on the edge of either overreacting or underreacting.

dbish 2y ago
What did your sister say before the last pandemic?
- rscho 2y ago
  The sister's answer is the answer pretty much any doc knowing the bare minimum about flu would give. This was already the case before the last pandemic. The flu virus is closely monitored for this exact reason: medical authorities and the WHO have been expecting a problematic flu pandemic for at least two decades. No one can know when the 'big one' will appear, but this one's a good candidate.

ruthmarx 2y ago

Time to invest in bleach shares.

asdasdsddd 2y ago

Im not worried since this one wasnt created in a lab. Only half joking.

mikeyouse 2y ago
Neither was Covid - it was always a silly idea with zero actual evidence for it. The steel man case for a lab leak was a leak of a natural virus, but even that has no evidence.
- asdasdsddd 2y ago
  How is the steelman not, a leak involving viruses with gain of function.
  - mikeyouse 2y ago
    In the leak of existing virus scenario, you’d just need an existing virus kept secret from the entire worlds scientific and intelligence apparatus that accidentally escaped. In the gain of function one, you’d need that same virus as the backbone but also you’d need a lab to have discovered and used a new, unpublished and less effective insert (PRRAR) that accidentally created the worlds first artificial pandemic virus… again, all completely under the scientific and intelligence radar. The number of people who would need to be involved and kept quiet in the latter quickly reaches implausible numbers. I don’t consider it much of a steel man to create a huge conspiracy when a simple mistake would suffice.
    - asdasdsddd 2y ago
      Are you telling me its crazy that a scientist accidentally caught an undocumented strain of the virus and spread it? Why would there need to be a cover up if they can't even find patient zero. And even if there was a cover up, both the US and China have massive incentives to cover it up.
      - defrost 2y ago

mtoner23 2y ago

Can we just preemptively start vaccinating against this strain? we have the vaccine and seems like a low risk thing to get started on. even if no evidence of human to human transmission.

VirusNewbie 2y ago
But the current strain isn’t the one that would allow for human to human transmission, so efficacy is completely unknown.
- XorNot 2y ago
  There is however some promising work on designing antibodies which might be broadly effective against all flus including H5N1: https://pubmed.ncbi.nlm.nih.gov/21320540/ https://pubmed.ncbi.nlm.nih.gov/21320540/ But that's a decade away from deployment - though fortunately likely highly motivated if it works because the other promise is long-term immunity, rather then yearly boosters.
attila-lendvai 2y ago
peak dark age: i can't decide whether this is sarcasm or not...

observer987 2y ago

I am not going to panic about it at this point. But, if it does develop into a pandemic, I am quite certain that the initial response will be more along the lines of "let's just see what happens. Gotta keep the economy going, right?"

attila-lendvai 2y ago

looks like we still haven't learned the lesson...