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PaperclipPerfector  3d ago (text post)   1429 thread views

Small-Scale Question Sunday for December 1, 2024

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

This is your opportunity to ask questions. No question too simple or too silly.

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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.

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.

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.

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.

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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