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Running the Numbers on a US Pandemic

Posted by Zonk on Thu Oct 25, 2007 02:54 PM
from the plz-stay-theoretical-k-thnx dept.
Lucas123 writes "A U.S. pandemic would exhaust antiviral medications, reduce basic food supplies, put ATMs out of service, shut down call centers, increase gas prices and up health insurance claims by 20%, according a test project developed by financial service firms. The pandemic paper planning scenario is used by 3,000 banks, insurance companies and security firms in preparing for disasters. The financial services groups are now sharing the pandemic flu exercise information, and all the scenarios are available for download."
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  • by BWJones (18351) * on Thursday October 25 2007, @02:55PM (#21118277) Homepage Journal
    Expect this to be shut down fairly quickly as it is a private directory and marked as "Not for public release"

    That said, essentially, what we have is an issue of upkeep. This world does not run itself and requires input to prevent things from running down, so it been said before, but amateurs discuss things such as strategy, but the experts discuss logistics. And it is logistics that need to be organized in times of planning and scenarios run to discover where the logistical chain breaks down. These weak links in the chain are those areas that need attention and typically those are the links that rely upon people to maintain the flow of information/goods/support.

    The interesting thing to me is that they appear to have modeled this pandemic spread as originating in Lagos, Nigeria which would be a relatively slow introduction or pathogenic spread into the rest of the world until it hits an area like Beijing, Calcutta or any other rapidly growing supermetropolis where you have hordes of people living in less than ideal conditions right next to others who travel extensively throughout the developed world. Their exercise appears to miss China and Indonesia entirely which could if modeled in lead to much more rapid spread, involving potentially many more people or even invoke or enhance infective "ringing" where waves of infection or reinfection propegate through various large populations.

    P.S. exercises like this are important to release to the public as most folks simply do not have any guidance or have given any thought to preparing for such a possibility. What are you going to do when the zombies show up at your door? :-)

    • by jollyreaper (513215) on Thursday October 25 2007, @02:58PM (#21118309)

      What are you going to do when the zombies show up at your door? :-)
      Fast zombies or slow zombies?
    • The interesting thing to me is that they appear to have modeled this pandemic spread as originating in Lagos, Nigeria which would be a relatively slow introduction or pathogenic spread into the rest of the world until it hits an area like Beijing, Calcutta or any other rapidly growing supermetropolis where you have hordes of people living in less than ideal conditions right next to others who travel extensively throughout the developed world.

      Lagos is a growing supermetropolis. At current rates, it is expected to be the largest city in the world by mid-century.

      What are you going to do when the zombies show up at your door?

      Try to outwit them as the last sane man in a world gone mad. After all, haven't you read I Am Legend [amazon.com] ?

      • Lagos is a growing supermetropolis. At current rates, it is expected to be the largest city in the world by mid-century.

        I had 1 dollar on Monday, 2 dollars on Tuesday, 4 dollars yesterday, and 8 dollars today. At current rates, I'm expected to be the richest man in the world by mid-December. (Hint: some rates are unsustainable, especially without the infrastructure for sanitation and public health.)

        • Re: (Score:3, Informative)

          The Lagos metropolitan area has 7 million people, and that's not counting the millions of immigrants who squat in shantytowns and tend not to be counted in censuses.
    • After all, all they want to do is eat your brains. They're not unreasonable. I mean, no one's going to eat your eyes!
    • by sm62704 (957197) on Thursday October 25 2007, @03:11PM (#21118473) Journal
      What are you going to do when the zombies show up at your door?

      Indeed. When was the last time we had a pandemic of any kind? IINM, it was some time before the Great Depression. My 76 year old father wasn't even born. And there were no antivirals back then, and few antibiotics. Medicine was downright primitive. Hell, it was primitive when I broke my arms when I was seven in 1959; they used automotive starting fluid [wikipedia.org] as an anesthetic! When I had my eye operated on in 2006, the operating room was so science fictiony that Dr. "He's Dead Jim" McCoy would have been jealous.

      We might as well be worried about asteroids* or terrorists. What? You ARE worried about asteroids and terrorists?

      -mcgrew

      *I had my assteroids [wikipedia.org] removed in 2002
    • by GreggBz (777373) on Thursday October 25 2007, @03:21PM (#21118611) Homepage

      That said, essentially, what we have is an issue of upkeep. This world does not run itself and requires input to prevent things from running down, so it been said before, but amateurs discuss things such as strategy, but the experts discuss logistics. And it is logistics that need to be organized in times of planning and scenarios run to discover where the logistical chain breaks down. These weak links in the chain are those areas that need attention and typically those are the links that rely upon people to maintain the flow of information/goods/support.
      Maybe this is a little OT, but there is an extensively researched book I'm currently reading that deals with things sort of like this:

      http://www.worldwithoutus.com/index2.html [worldwithoutus.com]

      It goes without saying, but so many things we take for granted would collapse, without the humans to run them. Manhattan, for example, would flood in a short 4 days, if not for people to run the drainage pumps. The book is awesome, I just have to plug it.
      • Isn't Manhattan, being an island, above sea level? Remember the hysteria that broke when some would be (incompetent) terrorists were caught plotting to blow up the Lincoln Tunnel in order to flood Manhattan? After about 2 days of panic some one finally got on the news and told everyone it couldn't possibly happen, as water tends to not run uphill.
        • Re: (Score:3, Interesting)

          The subway tunnels and probably the foundations of a lot of the larger buildings are below the water table and would flood. The streets above would eventually collapse as the iron and steel supports corrode away.

          Interestingly we have the opposite problem here in Boston. A lot of our older buildings are built on wooden pilings. The pilings are driven into landfill and sit below the water table. Over the course of the Big Dig, they did a lot of pumping for the tunnels. The water table dropped and the pil
    • What are you going to do when the zombies show up at your door?
      I have a zombie proof bunker stock piled with canned food, can opener, guns and ammo, and enough porn and video games to last me half a lifetime. Naturally i didn't tell my family or GF because the #1 cause of death in a zombie infestation is other people.
    • What are you going to do when the zombies show up at your door? :-)

      I can think of only one thing. [penny-arcade.com]

    • What are you going to do when the zombies show up at your door?

      SKS assault rifle with bayonet, Check.
      1000 rounds of ammo, check.
      M44 Rifle with bayonet, check.
      1000 rounds of ammo, check.
      8mm Mouser sniper rifle, check.
      1000 rounds of ammo, check.
      M1911A1 45cal pistol, check.
      5000 rounds of ammo, check.
      Shotguns with cases of ammo, check.
      Reloading equipment, check.
      Lead, Check.
      5 10lb kegs of powder, check.
      Swords, check.

      I am ready! Bring'em on GTA is boring and I am ready for a challenge. :P
    • Re: (Score:3, Insightful)

      What are you going to do when the zombies show up at your door?
      You need to either chop off their heads or destroy the brain.

      - Shaun of the Dead

    • by WindBourne (631190) on Thursday October 25 2007, @03:49PM (#21119059) Journal
      is that in past epidemics, living in cities was the LAST place to be. They always had the highest death rates due to the intermingling of ppl.

      Now, the places to be will be the cities with high connectivity. It will be possible to minimize our interactions with others. Netgrocers would take off during these times. Likewise, this report says that call center would fail. Yet, I think that the call centers that are using voip and have the ability to allow their employees to work from home will do great. In addition, any work that can be done with little to no interactions with others will continue to thrive. Where the problems will come from are those jobs that require you to interact large number of ppl. What I think will be the big issues will be our schools.

      I find it funny that they believe that an epidemic will originate in Africa. I would expect most to come from extremely populated areas.
    • by markbt73 (1032962) on Thursday October 25 2007, @04:46PM (#21119965)

      What are you going to do when the zombies show up at your door?

      Tell them no thanks; I've read their pamphlets and I wasn't impressed.

    • Re: (Score:3, Interesting)

      The zombie jokes are funny, but did anyone actually RTFA? The estimates are for 1.7 million to die, and some 9 million to be hospitalized. That's less than 11 million people in a population of over 300 million, and the ill are likely to disproportionally older (i.e. retired), or very young. So 3% of the population is incapacitated, and that's going to ruin society? I used to work at a call centre as an analyst; we had some 15 teams, and on any given day, most teams had one person out for some reason or anot
  • by LiquidCoooled (634315) on Thursday October 25 2007, @02:55PM (#21118281) Homepage Journal
    The report is available in paper format.

    Just make sure you print your own copy out, the last guy who wanted to give it you didn't wash his hands.
  • Well... (Score:4, Funny)

    by kevmatic (1133523) on Thursday October 25 2007, @02:56PM (#21118283)
    That would suck.

    Now what?
  • by damn_registrars (1103043) on Thursday October 25 2007, @03:02PM (#21118357) Journal

    A U.S. pandemic would ... up health insurance claims by 20%

    I would expect that a pandemic would place a larger burden on the system than that. Or do they expect that so many of us will just simply die that it will average out to only a 20% increase in claims?

    Of course the hyper-cynical side of me wants to point out that claims for dead people are seldom paid out, so I could see that as an explanation for the increase being at only 20%.
    • I don't know but in times of a pandemic I sure as hell wouldn't go to the doctor/hospital except as an absolute last resort.
      • Good, you shouldn't. Now, get your influenza shot and washing your hand with soap and water after going to the bathroom, every time, is what you should do.
    • Personally, I think all this hype over a massive flu pandemic is nothing more than fear mongering and massive stupidity. Having drills for a flu outbreak? WTF? They hae been touting this crap for the last 2 years... and nothing.

      If the U.S. really wanted to cut back the possibility of the spread of flu, the thing that needs to change is the corporate mentality of this country. That and some basic hygiene [wash your hands people and use a damn tissue].

      Presenteeism is a major problem in the US. People co
  • US pandemic (Score:2, Interesting)

    by Anonymous Coward
    U.S. pandemic. Which idiot came up with that phrase ?

    There is no such thing as a US pandemic, there is only a pandemic.
    • I don't know. Stephen King, in his extremely realistic novel The Stand only showed the United States collapsing. One can assume that everywhere else will continue just rosy.
    • Webster's defines a pandemic as something "occurring over a wide geographic area and affecting an exceptionally high proportion of the population" So defining an area for a pandemic isn't by definition wrong.
  • Inevitable (Score:4, Insightful)

    by MeditationSensation (1121241) on Thursday October 25 2007, @03:08PM (#21118443) Homepage
    Seems like this is inevitable. Already there are med-resistant staph infections in the news which are killing more people than AIDS does. Forget terrorism; the next big die off will be from a microscopic threat.
  • by Pedrito (94783) on Thursday October 25 2007, @03:13PM (#21118511) Homepage
    Really, the fact that it kind of scared the crap out of people has been a good thing. It made everyone realize that we weren't even remotely prepared. The U.S. and other countries are starting to stockpile influenza antivirals like Tamiflu and Relenza. This was something we've been needing to do for a while and the H5N1 scare has really kicked everyone into action.

    Sadly, influenza epidemics are a given. It's not a matter of "if", but "when". There were 3 in the last century and they all happened before good antiviral drugs were available. Stockpiling these drugs could very well save hundreds of thousands, if not millions of lives. The short-term economic cost of a pandemic would be huge, but it would seem trivial compared to the long-term cost of the loss of 5-10%, or more, of the population.

    It's good we're testing these kinds of scenarios, but my biggest concern was the stockpiling and availability of antivirals which, fortunately, seems to be getting much better...
    • by joshv (13017) on Thursday October 25 2007, @03:24PM (#21118669)
      "Sadly, influenza epidemics are a given. It's not a matter of "if", but "when". There were 3 in the last century and they all happened before good antiviral drugs were available. Stockpiling these drugs could very well save hundreds of thousands, if not millions of lives. The short-term economic cost of a pandemic would be huge, but it would seem trivial compared to the long-term cost of the loss of 5-10%, or more, of the population."

      Care to point me to any scientific evidence that Tamiflu, Relenza, or any other such drug in the pipeline will save a single person from a pandemic type flu virus?

      No such evidence exists.

      Even for non-pandemic strains, the evidence that vaccines and antivirals have had any impact of flu death rates is extremely thin.
      • by Pedrito (94783) on Thursday October 25 2007, @04:11PM (#21119411) Homepage
        Care to point me to any scientific evidence that Tamiflu, Relenza, or any other such drug in the pipeline will save a single person from a pandemic type flu virus?

        Sure, because I have nothing better to do with my time than do the research you clearly haven't done yourself.

        First of all, Tamiflu has been shown to not only reduce the duration and severity of flu symptoms, but used as a prophylactic, reduces the chances of catching the flu by 74%. Here are some facts to back that up: Go here [nih.gov] and enter these PMIDs: 17535069, 17253479, 17115954.

        There's tons more out there and anyone willing to get off their butt and do the research can find it. Now granted, there haven't been any large scale trials with H5N1 in people because not that many people have had H5N1. That said, combination therapies in mice with H5N1 have proven quite effective. There's no guarantee it will work in people, but all the evidence suggests that H5N1 is susceptible to neuraminidase inhibitors like Tamiflu will be effective against H5N1. It won't be 100%, but based on the existing data, I suspect it will have a pretty significant impact.

        Now, I've done some of your legwork for you. How about you back up this statement: "Even for non-pandemic strains, the evidence that vaccines and antivirals have had any impact of flu death rates is extremely thin." with some evidence of your own.
      • Re: (Score:3, Informative)

        Care to point me to any scientific evidence that Tamiflu, Relenza, or any other such drug in the pipeline will save a single person from a pandemic type flu virus?

        Sure. Search Google Scholar with "TamiFlu H5N1". The first link on the results page takes you to an article by Roche scientists, http://jac.oxfordjournals.org/cgi/reprint/55/suppl_1/i5.pdf [oxfordjournals.org]. They have a financial interest in TamiFlu, so don't just take their word for it - feel free to read the all 95 of the references. Flu antivirals are well characterized, and mutations that cause resistance are well understood. There have been plenty of animal studies, and multiple case studies in humans. For furt

        • by Pedrito (94783) on Thursday October 25 2007, @04:34PM (#21119775) Homepage
          What is already available, will likely not be effective against a pandemic because the reason the flu is pandemic, is because it is able to bypass all available methods of treatment/prevention.

          That's just wrong. Flu pandemics don't happen because of vaccines working or not working. Flu pandemics started before vaccines existed and didn't become any less frequent after their creation. In fact, they've only appear to be getting more common because of easier access to the world (flight) and increasing overcrowding in urban areas.

          Flu pandemics happen because a particularly virulent strain of the flu evolves. Sometimes it's the evolution of an existing human-infectious strain (like the H1N1 subtype that caused the Spanish Flu pandemic from 1918-1920) or from crossing over from animals (like the avian H2N2 subtype caused the Asian Flu pandemic in '57). The former happened before flu vaccines existed. The latter, after flu vaccines.

          Granted, coming up with a vaccine for a pandemic strain would be helpful, but it's unlikely to happen in time because they tend to spread faster than normal flu strains (because of their increased virulence). I don't want to get into the whole thing about how flu strains are chosen for a vaccine and how vaccines works, but suffice it to say, vaccines are usually for several strains that already exist and are predicted to be the most likely to be widely spread, but because it takes so long to incubate the vaccine, the flu must be relatively slow-spreading.

          Pandemic influenza strains, on the other hand, spread very quickly. Far too quickly for a vaccine to be created in time. We worried about the H5N1 avian variant because it was very deadly. We can't start creating a vaccine for it until it has evolved into a variant that is easily spread from human to human. Well, that's not entirely true. We could, but it probably wouldn't be effective against the easily spread variant. The vast majority of cases in people (if not all) of H5N1 were from direct contact with infected animals, but it was not easily spread. Had it evolved into an easily spread form (and it still could), then it would very likely become a pandemic influenza variant.
  • But what about WoW (Score:3, Insightful)

    by jconley (28741) on Thursday October 25 2007, @03:14PM (#21118527) Homepage
    The whole study comes into question for not using World of Warcraft as a modeling tool for pandemic.

    Bah.
  • What a bunch of BS (Score:5, Informative)

    by SiliconEntity (448450) on Thursday October 25 2007, @03:18PM (#21118575)
    The last flu pandemic was the Hong Kong flu 1969. It didn't exactly bring the end of the world. There were no effects like what are described here.

    Everyone hears "flu pandemic" and they think 1918, which was the worst in history. But there have been pandemics since then and they haven't been that bad. Just cause it's a pandemic doesn't mean it's the worst pandemic in history. That's like thinking that every recession is going to be the Great Depression.
    • Re: (Score:3, Interesting)

      Everyone hears "flu pandemic" and they think 1918, which was the worst in history


      Well only if you don't count the black death, which killed 30-60% of the population of Europe, or the Small Pox pandemic which possibly killed upwards of 70% of Native Americans and advanced faster and was more ruthless than the conquering European armies.
  • We have to protect our banking system! We should definitely start some kind of a group that would be willing to donate food, medicines, educational supplies or potable water to the banking system. We can't let anything bad happen to them.
    • by ScentCone (795499) on Thursday October 25 2007, @04:02PM (#21119247)
      We have to protect our banking system! We should definitely start some kind of a group that would be willing to donate food, medicines, educational supplies or potable water to the banking system. We can't let anything bad happen to them.

      You know, sarcasm can be a really elegant tool, when it isn't used in the service of ignorance.

      You think the economy would suck if a whole lot of people couldn't physically go to work or handle food? How much MORE do you think it would suck if everyone who was still participating in a wounded economy had to also drive around wheelbarrows of barter goods in order to get anything done? A well-oiled electronic banking system could well be one of the most important assets in preventing social collapse in the event of a particularly ugly pandemic. So, what will YOU be bartering? Copies of Ubuntu on cool purple DVDs? Your three extra pairs of clean socks? Your ability to dig out latrines? Hmmm. Many a modern economy is more convenient than a medieval one, and worth protecting. No banking system, no modern economy.
  • Now that is a surprise to me. My guess would have been that the U.S. government had classified the report. Embolding the terrorists or such some.
  • On the upside... (Score:5, Interesting)

    by lobiusmoop (305328) on Thursday October 25 2007, @03:56PM (#21119157) Homepage
    A massive reduction of human population would reduce the stress on:
    - fresh water reserves
    - dwindling oil supplies
    - food crops already threatened by global warming
    - natural resources such as forests

    so it's not all bad.
    • The problems would likely be compounded:
      • reserves of potable water would likely falter (and in places like, oh, Phoenix - fail entirely) due to now un-manned and un-maintained water treatment plants, which means you're stuck with either boiling what you can find, catch as much rain as is possible (outside of the US Pacific Northwest? Good Luck with that one), or hoping for the best when you draw it out of the well/stream/whatever.
      • no problem - because there would be few to no oil refinery capabilities, whi
  • yfluk (Score:3, Funny)

    by CompMD (522020) on Thursday October 25 2007, @04:07PM (#21119335)
    It took me about 9 seconds to get the "yfluk" tag, but when I did, I almost fell out of my chair.
    • by spun (1352) <loverevolutionary&yahoo,com> on Thursday October 25 2007, @03:15PM (#21118545) Journal
      I bet you don't have health insurance either, I mean, you aren't sick right now so why bother?

      You know, sometimes when people warn you about potential dangers, they aren't just trying to alarm you, scam you or hijack the world back into some kind of pre-industrial state. Sometimes they are trying to do you a damn favor, idiot.
    • Not if you keep that tin foil hat on fellow.
      Not even WWII stopped presidential elections in the US. Just not going to happen and no evidence that it could.
    • by Thrustworthy (1177055) on Thursday October 25 2007, @05:36PM (#21120673)
      The Pentagon is looking at the possibility of using federal troops to enforce a quarantine in the event of an outbreak of pandemic bird flu in the United States, a senior official said on Wednesday.

      President George W. Bush said last week he would consider using the military to "effect a quarantine" in response to any outbreak of avian influenza, but provided few details.

      Bush at the time also suggested he might place National Guard troops, normally commanded by state governors, under federal control as part of the government's response to the "catastrophe" of such a flu pandemic.

      Paul McHale, assistant defense secretary for homeland defense, said quarantine law historically has been under the primary jurisdiction of states, not the federal government.

      "And my expectation is that any quarantine measures that would be put in place would likely involve a substantial employment of the National Guard, probably under command and control of the governor of an affected state," McHale told a group of reporters.

      "However, we are looking at a wide range of contingencies, potentially involving Title 10 forces (federal troops) if a pandemic outbreak of a biological threat were to occur," McHale added.

      The H5N1 avian influenza virus has killed or forced the destruction of tens of millions of birds and infected more than 100 people, killing at least 60 in four Asian nations since late 2003.

      Experts fear that the virus, known to pass to humans from birds, could mutate and start to spread easily from person to person, potentially killing millions worldwide. Experts have questioned America's preparedness.

      McHale said he believed there would be a clearer understanding within a few weeks of the military role in response to pandemic bird flu as part of a broader federal response. Pentagon officials were meeting on Wednesday to discuss the department's role in a flu pandemic.

      One issue that could face the U.S. government in the event of an outbreak is whether or how to cordon off parts of the country to prevent the disease from spreading.

      The Posse Comitatus Act of 1878, enacted during the post-Civil War reconstruction period, prohibits federal military personnel from taking part in law-enforcement within the United States. But a president can waive the law in an emergency.