3 ms·

While I'm in agreement that one can't dismiss them out of hand, I wonder how likely a 1918 Style pandemic really is. I don't believe we have had a pandemic on t

by JunkDNA 13y ago

While I'm in agreement that one can't dismiss them out of hand, I wonder how likely a 1918 Style pandemic really is. I don't believe we have had a pandemic on the scale of the 1918 flu in modern times. 1918 was a long time ago. The outbreak of HIV comes closest. It's easy to forget how much modern practices cut down on disease: wash hands, don't drink water people (or animals) poop in, sterilize (or dispose of) medical devices, store your food properly, don't live in a house also occupied by rodents, etc... That is all a great start, and we haven't even talked about antibiotics and other modern medical tech. Granted, access to all of this is far from uniform around the world. However, the situation has been steadily improving. Epidemiology and monitoring are also vastly better than years ago. I was working in pharma during the SARS outbreak and saw firsthand how fast research can move when people perceive something as an existential threat. Government and corporate red tape that normally gums things up immediately falls by the wayside (as does the usual academic quarreling over turf and recognition). Not wanting to see mass death has a way of focusing the minds of even the most recalcitrant beaurocrats in any organization.

graeme 13y ago
As Nassim Taleb points out, you can't assess the likelihood of a high impact event merely from the fact that one hasn't happened for a while. We can identify reasons that disease transmission rates may be lower. We can also identify reasons a pandemic would travel more easily, such as air travel and more open borders in Europe. There are surely many factors that would only be identified as impactful after the fact. Likewise, we can't predict the virulence or transmissibility of any future virus. Pandemics belong in that class of rare events where it's impossible to predict the likelihood, the impact, or the timeframe. All this to say, you're correct that a 1918 pandemic is unlikely. But I don't think that's meaningful.
brazzy 13y ago
> It's easy to forget how much modern practices cut down on disease: wash hands, don't drink water people (or animals) poop in, sterilize (or dispose of) medical devices, store your food properly, don't live in a house also occupied by rodents, etc... That is all a great start, and we haven't even talked about antibiotics and other modern medical tech. With the exception of washing hands (which we don't do nearly enough) and the vague "modern medical tech", none of this would help against a flu pandemic at all...
- JunkDNA 13y ago
  I disagree. If your immune system is already run down by low grade infection and you've got a persistent case of diaorreah from poorly sourced drinking water, it's pretty easy for a flu virus to knock you out. No anibiotics means there's no way to keep you from getting pneumonia or other secondary lung infections. The healthier you are to start, the more likely you are to make it. The one exception to this is the paradoxical case where people's immune response goes crazy from battling all the virus particles. This can happen in really healthy young people. My reference to medical tech is the whole system of diagnostic testing and patient monitoring. It allows for early identification, quarantine, etc... We also know a heck of a lot about proper bio safety procedures in medical centers to lessen the spread of disease through health care workers. Again, not arguing that a pandemic like 1918 can't happen at all. I'm just saying that we're not showing up completely clueless and unarmed to a gun fight. We're bringing a knife this time :)

by JunkDNA 13y ago

graeme 13y ago

As Nassim Taleb points out, you can't assess the likelihood of a high impact event merely from the fact that one hasn't happened for a while. We can identify reasons that disease transmission rates may be lower. We can also identify reasons a pandemic would travel more easily, such as air travel and more open borders in Europe. There are surely many factors that would only be identified as impactful after the fact. Likewise, we can't predict the virulence or transmissibility of any future virus. Pandemics belong in that class of rare events where it's impossible to predict the likelihood, the impact, or the timeframe. All this to say, you're correct that a 1918 pandemic is unlikely. But I don't think that's meaningful.

brazzy 13y ago

> It's easy to forget how much modern practices cut down on disease: wash hands, don't drink water people (or animals) poop in, sterilize (or dispose of) medical devices, store your food properly, don't live in a house also occupied by rodents, etc... That is all a great start, and we haven't even talked about antibiotics and other modern medical tech. With the exception of washing hands (which we don't do nearly enough) and the vague "modern medical tech", none of this would help against a flu pandemic at all...

JunkDNA 13y ago
I disagree. If your immune system is already run down by low grade infection and you've got a persistent case of diaorreah from poorly sourced drinking water, it's pretty easy for a flu virus to knock you out. No anibiotics means there's no way to keep you from getting pneumonia or other secondary lung infections. The healthier you are to start, the more likely you are to make it. The one exception to this is the paradoxical case where people's immune response goes crazy from battling all the virus particles. This can happen in really healthy young people. My reference to medical tech is the whole system of diagnostic testing and patient monitoring. It allows for early identification, quarantine, etc... We also know a heck of a lot about proper bio safety procedures in medical centers to lessen the spread of disease through health care workers. Again, not arguing that a pandemic like 1918 can't happen at all. I'm just saying that we're not showing up completely clueless and unarmed to a gun fight. We're bringing a knife this time :)