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Notes -
Has anyone been tracking H5N1 bird flu? I see occasional doomposting updates from accounts like https://x.com/outbreakupdates/ and I'm trying to figure out if we're all sleeping on something about to go very bad, or if it's "under control" and/or likely to burn out. Haven't seen any recent posts about it on LessWrong, and I'd expect to if it were something (since they were right and early on SARS-CoV-2).
Yep, you'll see posts on Meddit every once and awhile.
The bad news: It's really really bad (as much as 50% CFR) and it's likely going to happen sooner rather than later. This is a real threat that will probably happen, BUT-
The good news: We actually have a vaccine stock already (only 5 mill doses IIRC), everyone is mad about the new vaccine type but we can roll that out fast if need be, and we really understand flu rather well. Flu mutates more frequently because of its structure but we know a lot about that, and what to look for in terms of human to human transmission and all kinds of other junk.
This is much less of an unknown and the U.S. would likely be able to do a safe and actually temporary lockdown (that...obviously a lot of people wouldn't listen to) that would solve the problem.
Other countries may be fucked.
If we know how to make a vaccine for it, why was it not included in the annual flu vaccine this year? I was assuming the reason is that we don't know how to make a vaccine for a potential future H5N1 that can sustain human-to-human transmission because it doesn't exist and may be sufficiently different from the currently known strains that a different vaccine may be necessary (or, worse, that immune imprinting may mean a future vaccine against the pandemic strain wouldn't work as well).
Uhhhhhh I don't want to do a lit review so please forgive me if I get some of the details wrong but basically they try and predict well in advance which mutations are going to be prevalent the next year (like almost a year in advance) and make all the vaccines accordingly. The mutations are typically pretty well understood, that's what the H and Ns are about.
This is also why the flu vaccine doesn't always stop the flu, you can end up with one of the other variations, which annoys people to no end and makes them feel like it's pointless, it's not.
I believe the specific issue with H5N1 is that it stays trapped in the lower lungs which makes it even more dangerous (because you get more ARDS) but less contagious since you have less of the virus carried in cough and so on. The specific elements responsible for this are not necessarily in the same place in other animals, which can be why something is virulent in pigs or whatever but not humans.
My favorite example of this is the fact that allergic reactions for dogs are more diarrheal as opposed to throat closing, because that's where the histamine receptors are mostly located in dogs.
So it's more that a year ago or whenever they were actually selecting the strains for this year, H5N1 wasn't looking as scary, but maybe it could be included in next years' (assuming we don't get a pandemic and manage to rush a separate vaccine before then)?
Yeah my understanding is that we are sitting on a stockpile of at least 5 mill doses, and our routine process could be reasonably effective at dealing with this without resorting to "novel" technologies, but it's very severe and potentially a fast moving problem.
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Where are you getting that bird flu might be 50% CFR? I thought it hadn't spread to humans yet
+1. 50% CFR is a rather extraordinary claim. Data varies, but I am seeing 60% CFR for ebola.
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Random flu combinations is a yearly occurrence and something that is tracked by global public heath authorities. Also reminder that the flu is really fucking bad but we mostly forget about that because at risk persons are strongly incentivized to get flu shots.
Here's a link-
https://cdn.who.int/media/docs/default-source/wpro---documents/emergency/surveillance/avian-influenza/ai_20241025.pdf
It is worth noting that the type of flu most likely to result in human to human transmission does have a strong possibility of resulting in lower lethality.
However we've had presumed mammal to human transmission in the U.S. already, IIRC.
The problem is when it goes human to human (which it may not).
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I'm tracking it from time to time.
My suspicion is there is a solid chance we're going to get a pandemic sooner or later.
The spread in animals is not under control at all. The avian flus get more and more chances to mutate into something that transmits from human to human. So far we've been lucky, but how long can that last?
According to some experts who spoke at a WHO webinar I watched, we're in a "low risk situation that can suddenly become very high risk"...
Vaccines are being developed, but it remains to be seen if we get them quickly enough, or if not, if enough doses can be manufactured in time to at least reduce the damage done.
And if people will actually take the damn thing after the fights across the country about COVID that are just now cooling down.
If the death rate is much higher than COVID, which appears increasingly likely, people will forget about those objections pretty fast.
Uh, hate to break it to you, but no we won't. Maybe the bodies will teach us to trust public health again, but it'll be too late.
We’ll see, I expect that if Trump comes out in full support (like last time) you will.
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How much higher do you figure it has to be? I think trust in reporting and statistics has gotten so low as a result of COVID that nothing will resurrect it. Unless and until it reaches the point where people actually know the dead. When it's probably too late.
Yep, one of the big reasons I'm so angry about our COVID response is it absolutely slaughtered trust in public health for nothing. They cried wolf, and now if a wolf comes, we will be utterly unable to strike at it.
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Grim, but about where I'm at too. Thanks for the cross-check.
No problem!
Will you do any prepping?
So far I've just bought a bunch of ffp3 masks and I'm slowly building up a store of a few foods that don't perish easily.
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