CWmike writes "The US Centers for Disease Control and Prevention launched an effort this week to better and more easily track for H1N1 and other seasonal influenza activity throughout the US. The CDC said it is now tracking data on 14 million patients from physician practices and hospitals stored on a database hosted by GE Healthcare. The data is submitted daily from physicians' offices and hospitals that use GE's electronic medical record system. The data is then uploaded to GE Healthcare's Medical Quality Improvement Consortium, a database repository designed with HIPAA-compliance parameters of patient anonymity and best practices, where it can be the subject of medical data queries. The CDC can perform queries to look for flu-like symptoms being reported by physicians, and then disseminate the data for health care providers and local government officials throughout the country, who can alert businesses and others about flu outbreak hot spots. The CDC also hopes its analysis of the data helps it better understand the characteristics of H1N1 outbreaks and to determine who is most at risk for developing complications from the virus. Prior to implementing the new system, the CDC relied heavily on tracking insurance claims data, which could take days or weeks to make its way to the agency's medical staff for analysis. The medical data is normalized so that, for example, reports of hypertension, HTN, and high blood pressure all mean the same thing when a researcher enters a query against the data."
You can find the latest map on the CDC site [cdc.gov] and look at how helpful it is! Apparently everyone's boned except for DC, Georgia, Guam, Hawaii, Puerto Rico and the US Virgin Islands. Since there's no report of flu in the Virgin Islands, I propose the government provides free plane tickets for anyone who isn't infected so that they might escape the wave of vomit brewing in our fair country.
But in all seriousness their report does have some decent data on it [cdc.gov].
Uh. Dood. According to the CDC, there was no report of any kind received from the Virgin Islands. That's right, silence! Now what do you suppose *that* means, eh? That's right, EVERYONE in the Virgin Islands has already died from the flu and probably turned into hideous flesh-eating monstrosities!
Do NOT go there.
It would be bad.
Are they correlating this data with the fear of people [slashdot.org] of getting H1N1 in an airplane?
I recently sent an e-mail to a local radio station after they read a news item stating that, so far this year, 12 people have died from the swine flu in my state. I sent them a letter because that's all that the news item said. It did not mention that about 1600 die of the regular old influenza every year. With all the hysteria about this issue I think some perspective is very badly needed. It's just piss-poor journalism to report a raw figure with no context like this.
Your comment about the fear of H1N1 made me think about the various ways that it's being encouraged. To me that's just media sensationalism, which is not really unusual because it sells. Is H1N1 a threat to some people? Probably so; I am not a doctor so I should not say too much on that. Do I personally feel threatened by it? Not in the slightest. It'd be a nuisance to me, but not a threat. There's no way I am going to cower in fear and alter my life over it. It is their own damned laziness but the fact is most people aren't going to do their own research on this one. If there were more perspective and context in media reports about H1N1, it would be much easier for others to make up their own minds as I have done.
Even if this is or were a true threat to life and limb, acting like a bunch of panicked animals is the wrong way to reduce a threat.
It'd be a tragedy, and I might loose a couple good friends, but the golden lining of the pandemic killing a couple million people in Western countries would be that it's more likely the dead would be the ones prone to believing in conspiracy theories and the like. The rest of us having gone and gotten immunized.
Finally -- Darwin Awards on a massive systematic scale.
I had an epiphany while trying to describe attitudes like yours to someone else yesterday. I was trying to put into words why it aggravates me so much when it suddenly hit me. I was watching 3 or 4 live streams last year when the outbreak was first detected, and we were being bombarded with press conferences as one state after another started announcing how many cases they were treating. As it happens, I was in the middle of making my first serious attempt at writing a novel about a pandemic and all the hysteria it may cause. Of course, now that we're in the middle of one, there's really no point to finishing the book. Having said that, I had researched dozens of reports, information sites from both government and non-government entities, and other things like various states' emergency response plans. It was actually pretty cool having the various states' plans open while "following along" through live streaming on the net. Then someone wrote a post somewhere that aggravated me to my core. He wrote, "call me when there are 36,000 dead because that's how many die every year."
What his, and apparently your, thoughts about this don't take into account is that we may pass the typical number of fatalities on a single day as the body count rises from say, 28,000 to 42,000. In that hypothetical situation, you and that guy are ready to start caring. What are you going to do the next day when the count climbs from 42,000 to 60,000? At what point do you shit yourself? I watched a symposium on pandemic flu given by the NIH as part of my research, and I learned an interesting fact. During the 1918 Spanish flu outbreak, approximately 4,500 people died in the City of Philadelphia during the course of *one week*.
Yet you two don't want to do anything until the death toll passes the normal annual figure. Please don't take my word for it. Do your own research. Spend just a little bit of time reading up on the topic. Think about the logistics, and hopefully you will form an opinion that you feel is well-informed and is something you can defend. But just turning your back and calling it scaremongering is irresponsible and dangerous. A lot of people are going to die during the second wave. If we wait until you suggest before taking action, it will be way too late.
It was way before my time, but if I had lived during the 1950s-1960s I would have voluntarily accepted a polio vaccine. Why? Because polio is a horrible crippling illness that can maim someone for life. That's a real threat.
For what I am about to say now, it must be understood that I am speaking only for myself. I am not a doctor. Therefore, I would not dream of telling someone else what they should do about a medical issue. You as an individual must handle this as you see fit, which is exactly wha
What his, and apparently your, thoughts about this don't take into account is that we may pass the typical number of fatalities on a single day as the body count rises from say, 28,000 to 42,000. In that hypothetical situation, you and that guy are ready to start caring. What are you going to do the next day when the count climbs from 42,000 to 60,000? At what point do you shit yourself? I watched a symposium on pandemic flu given by the NIH as part of my research, and I learned an interesting fact. During
At first I thought the map updated dynamically via an xml, but it seems we have a flash movie that dynamically loads a big JPEG image and shows it - nothing more.
Improper use of a technology, nothing new.
Should I also count how many times I've seen a big js framework like jQuery being used for a trivial thing? I mean, load an entire 100Kb library to do something that could be done with 2-5 lines of javascript anyway...
Well, if that's done by the people, who are advising us on what they believe to be a life-and-death decisions, their improper use of technology is noteworthy, even if not, indeed, "new".
is GE can then take the database info and use it to go after their credit card customers who might be sickest, that way ensuring they'll get their dough before the patients croak.
Oh, so the evil the mega-corporation did was to loan someone who wanted money some money. What bastards.
(I use a credit card, but I don't carry a balance, I think people who do are crazy, the idea that someone would max out 9 credit cards out of 'necessity' isn't very credible, clearly they need to find a way to spend less money, or to earn more money)
They are a very big division of GE, that makes equipment, like X-Ray machines, and software, such as electronic medical record software...
Interestingly enough, someone there has recently said that as profitable as GE Healthcare is, it doesn't bring in as much money as GE as a whole pays for healthcare for its employees.
And Immelt is one of the big time White House visitors [nytimes.com]. With the health care division, and the "green" products, they stand to make a killing from this influence peddling. Not to mention their extension of the communications office, NBC News/MSNBC.
So google's flu results [google.org] will be validated a few days faster. People start feeling crappy, do some self diagnosis via google, then see a doctor who then files a report when then is summarized and reported by the CDC.
I hope someone does some regression analysis on this and writes a paper. I would be very interested in how well the google trends data fits with the new rapid CDC data assuming that one of them is a lagged indicator of the other. How well would the data fit? What are the likely sources of error? Omitted variables? Fascinating questions.
One interesting thing I have noted in the trends is how 'off the chart' the flu trends are this year - I suspect google may not be able to apply an appropriate media hype attenuator to the results this year. But this is a good thing, as google will probably aggregate the search data with media reporting data and adjust their hype-limiter so that when the next overhyped pandemic / outbreak occurs the results will be more accurate and timely than the current official sources.
Actually just thinking about answering my own question; having real lagged data to the trend data could be useful in correcting for the hype no? Hype is essentially another variable in the regression analysis. I'm not sure where the data would come from for it but if you could estimate the hype factor for recent past data and had some measure of present hype you may be able to correct for some of it right?
I'm sure that there are lots of studies from manufacturers of hand cleaners and other potions that there products kill xx% of flue viruses. I know I'm being bombarded by directions all the way from my HR department to the CDC on how to prevent getting swine flu. While I'm sure that some of those narrow studies are correct that lots of alcohol will kill the virus, does any of this really make any difference with preventing transmission of the flu. There are lots of assumptions built into suggestions that
In the UK you're banned from entering your doctor's surgery with flu-like symptoms. You get redirected to the NHS's Pandemic self-diagnosis expert system, which asks you about 10 questions (of which the important one is "do you have more than 2 of the following symptoms: fever, headache, nausea" etc). At the end it spits out a unique reference number for your flu-buddy to go and pickup your prescription of Tamiflu from a chemists. That's it. I did it last week for my partner - she's fine now.
The thing is, this will lead to overprescribing, and also is probably likely to encourage people to self certify themselves ill when they aren't - so they can have a week off work (no sicknote required for Swine Flu, as you can't get in to see your doctor) and get their supply of Tamiflu in before stocks run out...
That's the problem I've had with the explosion of reported cases of swine flu. From what I'm told the phone lines aren't even manned by anyone who works in the health care industry, and there's roughly a 100% chance that if you call in with anything remotely flu like you'll be a reported case of swine flu before you get off the phone.
Right now, if you have flu, you have swine flu. Only something like 1/1,000 flu cases is "some other" flu. 99% of all cases tested, test positive for swine flu.
The thing is, this will lead to overprescribing, and also is probably likely to encourage people to self certify themselves ill when they aren't - so they can have a week off work (no sicknote required for Swine Flu, as you can't get in to see your doctor) and get their supply of Tamiflu in before stocks run out...
I know more than a few doctors and after the initial panic (in the USA), they mostly just stopped testing for H1N1.
Taking Tamiflu sucks almost as bad as the H1N1 flu (which I learned from one of my Doctor friends) and both will put you out of rotation for ~10 days.
I know more than a few doctors and after the initial panic (in the USA), they mostly just stopped testing for H1N1.
You're right. CDC guidelines don't suggest testing everyone. Really just the sickest patients. The problem being that 1) it's expensive 2) the rapid tests are really pretty bad with significant false negative rates and the better tests take too long to be useful.
So you are seeing H1H1 + some percentage of seasonal viral illnesses of various types. The interesting thing to me as an ER doc
Even if the doctors are telling the CDC it's verified who is checking that they actually did the tests?
Yeah, the thing that caught my eye was the claim in the summary: "The medical data is normalized so that fir example reports of hypertension, HTN, and high blood pressure all mean the same thing when a researcher enters a query against the data."
"Mean the same thing", eh? To whom? Meaning is a verb: it is what knowing subjects do with data, information, raw stuff.
Back in July, the CDC told the states to not to bother to test people for H1N1; they should just count people that appear to have H1N1 symptoms as a positive test result since it is a "OMG! We're all fucked! Pig are flying and they have teh flu!" situation.
Of course, the fact that this overestimates the reported occurence of H1N1 by a factor of 5 to 50 times [cbsnews.com] is of no concern to us peasants.
This is purely antidotal but a colleague got sick and when to the doctor. The doctor, without testing, said he had H1N1.
This is actually a reasonably diagnosis.
From statistical sampling of the population (with strain typing) that's been done so far, the normal seasonal flu strains are not really circulating yet, while H1N1 has been observed to be spiking in frequency. I think there's some diagnosis guideline out there that your family doctor should assume any flu case is H1N1, at this time of the year.
Right now, something like 1% of all flu in the US that is attempted to be subtyped is NOT H1N1. See http://www.cdc.gov/flu/weekly/ So basically, if the person has the flu, it is almost definitely H1N1.
What I've heard from doctors and nurses around the DC area is that if you have flu-like symptoms outside of the flu season (which starts week 40), then they can be reasonably certain (99%) that it is H1N1.
What I've heard from doctors and nurses around the DC area is that if you have flu-like symptoms outside of the flu season (which starts week 40), then they can be reasonably certain (99%) that it is H1N1.
Gimme a break. EVERY cold I've ever had in my life matched the symptoms of H1N1. The symptoms we are told to look for are so vague and all-inclusive that they would fit nicely into the newspaper astrology section. --And guess what? I've had plenty of colds which hit me before "week 40".
No, genetic testing of the virus is EXPENSIVE and generally not needed at this point as we are so early in the normal flu season that it is obvious on the face that the majority of cases are related to H1N1.
No, genetic testing of the virus is EXPENSIVE and generally not needed at this point as we are so early in the normal flu season that it is obvious on the face that the majority of cases are related to H1N1.
I've decided that anybody who prefaces some idiotic statement with the word, "Obviously" is more than likely an ignoramus trying to sound more informed and intelligent than they really are.
Please do some research before you open your mouth and advance the agenda of planned hysteria.
Please mod the AC up. I was exposed to someone with a confirmed case of H1N1 and came down with symptoms. I everywhere I've called tells me they are only testing patients at a high risk for complications, because otherwise they'd be swamped with people coming in for tests. Supposedly this is the government guideline. So how is the CDC expecting to actually track this thing if the government isn't allowing people to be tested?
And Look at How Useful It Is! (Score:5, Informative)
But in all seriousness their report does have some decent data on it [cdc.gov].
Re:And Look at How Useful It Is! (Score:5, Funny)
Uh. Dood. According to the CDC, there was no report of any kind received from the Virgin Islands. That's right, silence! Now what do you suppose *that* means, eh? That's right, EVERYONE in the Virgin Islands has already died from the flu and probably turned into hideous flesh-eating monstrosities!
Do NOT go there.
It would be bad.
Parent
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And more specifically, alien invasion.
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Re:And Look at How Useful It Is! (Score:4, Insightful)
Are they correlating this data with the fear of people [slashdot.org] of getting H1N1 in an airplane?
I recently sent an e-mail to a local radio station after they read a news item stating that, so far this year, 12 people have died from the swine flu in my state. I sent them a letter because that's all that the news item said. It did not mention that about 1600 die of the regular old influenza every year. With all the hysteria about this issue I think some perspective is very badly needed. It's just piss-poor journalism to report a raw figure with no context like this.
Your comment about the fear of H1N1 made me think about the various ways that it's being encouraged. To me that's just media sensationalism, which is not really unusual because it sells. Is H1N1 a threat to some people? Probably so; I am not a doctor so I should not say too much on that. Do I personally feel threatened by it? Not in the slightest. It'd be a nuisance to me, but not a threat. There's no way I am going to cower in fear and alter my life over it. It is their own damned laziness but the fact is most people aren't going to do their own research on this one. If there were more perspective and context in media reports about H1N1, it would be much easier for others to make up their own minds as I have done.
Even if this is or were a true threat to life and limb, acting like a bunch of panicked animals is the wrong way to reduce a threat.
Parent
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It'd be a tragedy, and I might loose a couple good friends, but the golden lining of the pandemic killing a couple million people in Western countries would be that it's more likely the dead would be the ones prone to believing in conspiracy theories and the like. The rest of us having gone and gotten immunized.
Finally -- Darwin Awards on a massive systematic scale.
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I had an epiphany while trying to describe attitudes like yours to someone else yesterday. I was trying to put into words why it aggravates me so much when it suddenly hit me. I was watching 3 or 4 live streams last year when the outbreak was first detected, and we were being bombarded with press conferences as one state after another started announcing how many cases they were treating. As it happens, I was in the middle of making my first serious attempt at writing a novel about a pandemic and all the hysteria it may cause. Of course, now that we're in the middle of one, there's really no point to finishing the book. Having said that, I had researched dozens of reports, information sites from both government and non-government entities, and other things like various states' emergency response plans. It was actually pretty cool having the various states' plans open while "following along" through live streaming on the net. Then someone wrote a post somewhere that aggravated me to my core. He wrote, "call me when there are 36,000 dead because that's how many die every year."
What his, and apparently your, thoughts about this don't take into account is that we may pass the typical number of fatalities on a single day as the body count rises from say, 28,000 to 42,000. In that hypothetical situation, you and that guy are ready to start caring. What are you going to do the next day when the count climbs from 42,000 to 60,000? At what point do you shit yourself? I watched a symposium on pandemic flu given by the NIH as part of my research, and I learned an interesting fact. During the 1918 Spanish flu outbreak, approximately 4,500 people died in the City of Philadelphia during the course of *one week*.
Yet you two don't want to do anything until the death toll passes the normal annual figure. Please don't take my word for it. Do your own research. Spend just a little bit of time reading up on the topic. Think about the logistics, and hopefully you will form an opinion that you feel is well-informed and is something you can defend. But just turning your back and calling it scaremongering is irresponsible and dangerous. A lot of people are going to die during the second wave. If we wait until you suggest before taking action, it will be way too late.
It was way before my time, but if I had lived during the 1950s-1960s I would have voluntarily accepted a polio vaccine. Why? Because polio is a horrible crippling illness that can maim someone for life. That's a real threat.
For what I am about to say now, it must be understood that I am speaking only for myself. I am not a doctor. Therefore, I would not dream of telling someone else what they should do about a medical issue. You as an individual must handle this as you see fit, which is exactly wha
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Re:And Look at How Useful It Is! (Score:5, Insightful)
Why on earth does the CDC need to use flash for a still, non interactive image??
Parent
Re:And Look at How Useful It Is! (Score:4, Funny)
You don't have clearance to see the flashy dots from the tracking beacons we were injected with.
Parent
Re:And Look at How Useful It Is! (Score:4, Insightful)
At first I thought the map updated dynamically via an xml, but it seems we have a flash movie that dynamically loads a big JPEG image and shows it - nothing more.
Improper use of a technology, nothing new.
Should I also count how many times I've seen a big js framework like jQuery being used for a trivial thing? I mean, load an entire 100Kb library to do something that could be done with 2-5 lines of javascript anyway...
Parent
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Well, if that's done by the people, who are advising us on what they believe to be a life-and-death decisions, their improper use of technology is noteworthy, even if not, indeed, "new".
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or.
you could just look at the google trends to see what CDC will be reporting next week
The really nice thing about this... (Score:2)
is GE can then take the database info and use it to go after their credit card customers who might be sickest, that way ensuring they'll get their dough before the patients croak.
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Here's the thing: Why the fuck would anybody have a GE credit card?
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Because its the only one they could get after their other nine cards were maxed out?
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Oh, so the evil the mega-corporation did was to loan someone who wanted money some money. What bastards.
(I use a credit card, but I don't carry a balance, I think people who do are crazy, the idea that someone would max out 9 credit cards out of 'necessity' isn't very credible, clearly they need to find a way to spend less money, or to earn more money)
GE Healthcare (Score:2)
General Electric Healthcare?
Re:GE Healthcare (Score:5, Informative)
Yes.
They are a very big division of GE, that makes equipment, like X-Ray machines, and software, such as electronic medical record software...
Interestingly enough, someone there has recently said that as profitable as GE Healthcare is, it doesn't bring in as much money as GE as a whole pays for healthcare for its employees.
Parent
Re:GE Healthcare (Score:4, Funny)
GE is actually a suprisingly diverse company:
http://www.nbc.com/30-rock/exclusives/30R_GEWigChart.pdf [nbc.com]
Parent
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And Immelt is one of the big time White House visitors [nytimes.com]. With the health care division, and the "green" products, they stand to make a killing from this influence peddling. Not to mention their extension of the communications office, NBC News/MSNBC.
Excellent! (Score:2)
What, that's not what the map shows?
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Well, after all, quote [medicalnewstoday.com]:
"Swine Flu Should More Accurately Be Called North American Flu".
CC.
Almost caught up to google (Score:2)
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One interesting thing I have noted in the trends is how 'off the chart' the flu trends are this year - I suspect google may not be able to apply an appropriate media hype attenuator to the results this year. But this is a good thing, as google will probably aggregate the search data with media reporting data and adjust their hype-limiter so that when the next overhyped pandemic / outbreak occurs the results will be more accurate and timely than the current official sources.
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Crash it (Score:5, Funny)
Already built (Score:2)
OK... (Score:2)
so where are the pretty graphics? Say a map of the US with color codng for hotspots?
Real Science (Score:2)
Re:Good data? (Score:4, Funny)
If it's antidotal, he's probably cured now.
Parent
Re:Good data? (Score:5, Interesting)
The thing is, this will lead to overprescribing, and also is probably likely to encourage people to self certify themselves ill when they aren't - so they can have a week off work (no sicknote required for Swine Flu, as you can't get in to see your doctor) and get their supply of Tamiflu in before stocks run out...
Parent
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Have you not looked at the raw statistics?
Right now, if you have flu, you have swine flu. Only something like 1/1,000 flu cases is "some other" flu. 99% of all cases tested, test positive for swine flu.
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The thing is, this will lead to overprescribing, and also is probably likely to encourage people to self certify themselves ill when they aren't - so they can have a week off work (no sicknote required for Swine Flu, as you can't get in to see your doctor) and get their supply of Tamiflu in before stocks run out...
I know more than a few doctors and after the initial panic (in the USA), they mostly just stopped testing for H1N1.
Taking Tamiflu sucks almost as bad as the H1N1 flu (which I learned from one of my Doctor friends)
and both will put you out of rotation for ~10 days.
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You're right. CDC guidelines don't suggest testing everyone. Really just the sickest patients. The problem being that 1) it's expensive 2) the rapid tests are really pretty bad with significant false negative rates and the better tests take too long to be useful.
So you are seeing H1H1 + some percentage of seasonal viral illnesses of various types. The interesting thing to me as an ER doc
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Even if the doctors are telling the CDC it's verified who is checking that they actually did the tests?
Yeah, the thing that caught my eye was the claim in the summary: "The medical data is normalized so that fir example reports of hypertension, HTN, and high blood pressure all mean the same thing when a researcher enters a query against the data."
"Mean the same thing", eh? To whom? Meaning is a verb: it is what knowing subjects do with data, information, raw stuff.
People mean anything they want by anyt
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Back in July, the CDC told the states to not to bother to test people for H1N1; they should just count people that appear to have H1N1 symptoms as a positive test result since it is a "OMG! We're all fucked! Pig are flying and they have teh flu!" situation.
Of course, the fact that this overestimates the reported occurence of H1N1 by a factor of 5 to 50 times [cbsnews.com] is of no concern to us peasants.
It's not meant to be a sampling, more of a census. (Score:2)
This is purely antidotal but a colleague got sick and when to the doctor. The doctor, without testing, said he had H1N1.
This is actually a reasonably diagnosis.
From statistical sampling of the population (with strain typing) that's been done so far, the normal seasonal flu strains are not really circulating yet, while H1N1 has been observed to be spiking in frequency. I think there's some diagnosis guideline out there that your family doctor should assume any flu case is H1N1, at this time of the year.
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Right now, something like 1% of all flu in the US that is attempted to be subtyped is NOT H1N1. See http://www.cdc.gov/flu/weekly/ So basically, if the person has the flu, it is almost definitely H1N1.
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What I've heard from doctors and nurses around the DC area is that if you have flu-like symptoms outside of the flu season (which starts week 40), then they can be reasonably certain (99%) that it is H1N1.
Gimme a break. EVERY cold I've ever had in my life matched the symptoms of H1N1. The symptoms we are told to look for are so vague and all-inclusive that they would fit nicely into the newspaper astrology section. --And guess what? I've had plenty of colds which hit me before "week 40".
-FL
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No, genetic testing of the virus is EXPENSIVE and generally not needed at this point as we are so early in the normal flu season that it is obvious on the face that the majority of cases are related to H1N1.
I've decided that anybody who prefaces some idiotic statement with the word, "Obviously" is more than likely an ignoramus trying to sound more informed and intelligent than they really are.
Please do some research before you open your mouth and advance the agenda of planned hysteria.
H1N1 Cases Overestimat [cbsnews.com]
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Please mod the AC up. I was exposed to someone with a confirmed case of H1N1 and came down with symptoms. I everywhere I've called tells me they are only testing patients at a high risk for complications, because otherwise they'd be swamped with people coming in for tests. Supposedly this is the government guideline. So how is the CDC expecting to actually track this thing if the government isn't allowing people to be tested?