2009 April 25 Saturday
Higher Absolute Humidity Would Slow Flu Spread?

Looking for ways to cut your odds of getting influenza? A February 2009 PNAS paper by Jeffrey Shamana Melvin Kohn points toward a way: a decline in absolute humidity might explain much of the increase in incidence of flu during the winter.

Influenza A incidence peaks during winter in temperate regions. The basis for this pronounced seasonality is not understood, nor is it well documented how influenza A transmission principally occurs. Previous studies indicate that relative humidity (RH) affects both influenza virus transmission (IVT) and influenza virus survival (IVS). Here, we reanalyze these data to explore the effects of absolute humidity on IVT and IVS. We find that absolute humidity (AH) constrains both transmission efficiency and IVS much more significantly than RH. In the studies presented, 50% of IVT variability and 90% of IVS variability are explained by AH, whereas, respectively, only 12% and 36% are explained by RH. In temperate regions, both outdoor and indoor AH possess a strong seasonal cycle that minimizes in winter. This seasonal cycle is consistent with a wintertime increase in IVS and IVT and may explain the seasonality of influenza. Thus, differences in AH provide a single, coherent, more physically sound explanation for the observed variability of IVS, IVT and influenza seasonality in temperate regions. This hypothesis can be further tested through future, additional laboratory, epidemiological and modeling studies.

Humidifiers in offices and other closed spaces might cut the incidence of the flu. If you live by yourself them a humidifier at home probably isn't going to lower your risk much unless you have visitors. However, stores, businesses, and government offices could probably reduce the spread of flu by keeping the air much more humid.

What other changes do we experience in winter that might account for winter flu outbreaks? Our blood vitamin D levels drop and vitamin D is an immune system modulator. Also see here. So make sure you get enough vitamin D if the swine flu that has crossed over into humans in Mexico turns into a big pandemic.

Update: Check out a Google Maps views of H1N1 swine flu spreading in humans. Note that the first map isn't actually a case map. Check out links on left.

Update II: Here is a Google map of real and suspected human H1N1 swine flu cases. This tracking by individual cases will become unwieldy in a few days. But for now it gives a good sense of how this flu is spreading.

By Randall Parker    2009 April 25 10:43 PM   Entry Permalink | Comments (8)
2006 May 07 Sunday
Pandemic Influenza Costs Estimated

Health economist Martin Meltzer of the US Centers for Disease Control and Prevention says depending on the severity of the strain an influenza pandemic's cost would range between tens of billions and trillions of dollars.

According to a 1999 study by Meltzer and colleagues, a flu pandemic where 35% of people are attacked by the virus would cost the US alone a total of $166 billion. A milder 1968-like pandemic, with only a 15% attack rate, would cost the US $71 billion. He notes that these are “conservative” estimates and do not account for work days lost due to panic or parents staying home with their children because schools are shut.

However, he points to a recent study by an Australian economist which models the impacts of scenarios from mild to an “ultra-1918” type pandemic. In this worst case scenario, the cost to the world could run into trillions of dollars.

Ideally if one could estimate the probability of each type of pandemic then could multiply that probability times the total estimated cost to get a sense of the value to be gained from developing methods to stop or decrease the severity of a pandemic. But for a repeat of the 1918 severity pandemic or something even more deadly it is hard to come up with a reasonable probability for its occurrence.

Meltzer compares bird flu to the SARS outbreak that encompassed a much smaller number of companies and thinks once the pandemic passes the economy will recover very rapidly.

The biggest impact of an influenza pandemic, which would likely last less than four months depending on the size of the countries affected, would probably hit growth for just one to two quarters, Meltzer said.

"After that, I expect to see a great rebound," he said. "People will return and we will see normal growth rates."

A more lethal strain would leave more lasting effects because it would shrink the population and cause decreased demand for housing. Plus, the problem of handling so many wills and estates would slow the changing of ownership of assets of the deceased.

The World Bank has yet another cost estimate but it is unclear what level of lethality they assumed for this estimate.

The World Bank has estimated a yearlong flu pandemic would cost the world economy US$800 billion. That's nearly 27 times the cost of SARS, which was estimated at US$30 billion, according to the World Health Organization.

Anyone know what sort of flu strain they assumed in their model?

By Randall Parker    2006 May 07 06:57 PM   Entry Permalink | Comments (1)
2006 May 02 Tuesday
Most American Corporations Expect Flu Pandemic

American companies expect a more lethal influenza strain to break out into the human population. But they aren't doing enough to prepare.

More than half of U.S. companies think there will be a global flu epidemic in the next two years. Two-thirds think it will seriously disrupt their operations as well as foment social unrest. But two-thirds also say they aren't prepared. One-third of executives surveyed say nobody in their organization has been appointed to plan for a pandemic; another one-quarter couldn't or wouldn't answer the question.

"Corporations are looking at this like deer at headlights," said Tommy G. Thompson, who spent much of his last two years as secretary of health and human services sounding the pandemic alarm and is now doing the same as a private consultant. "They are very skittish. They don't know which way to go. They are hoping the car is not going to hit them."

Some parts of SAIC are ready to shift toward telecommuting.

On a Saturday two months ago, SAIC tested its telecommuting capability with a unit that operates in Northern Virginia, Hawaii and several foreign countries to see whether everyone could work outside the office with all necessary functions, programs and communications. Several software problems arose.

Preparations for a massive shift to telecommuting would help a great deal. But for facilities which require people on-site (e.g. power plants, factories, warehouses, rail yards) I promote an approach I call workplace cocooning. Have a group of workers quarantine themselves into a factory or warehouse or computer facility with futons to sleep on, refrigerators, microwaves, and other gadgets to make the place suitable for staying in for weeks and months without leaving and without direct contact with humans outside the facility. Methods could be developed for bringing parts in and shipping finished products out without humans from the outside coming into direct contact with those inside.

Since tourism will collapse lots of hotels will sit empty. Well, hotels make good candidates to be turned into quarantined live-in office buildings. White collar teams that need to work together in person could move into hotels with their computers and other needed equipment. Then they'd isolate themselves from the outside except to receive packages delivered and left at the door for their later retrieval.

Many types of businesses could rapidly restructure to eliminate long chains of exposure via which viruses can spread. Telecommuting and workplace cocooning could allow the economy to function while greatly reducing the ability of a pandemic influenza virus to spread into company workforces.

By Randall Parker    2006 May 02 10:24 PM   Entry Permalink | Comments (6)
2005 November 17 Thursday
Businesses Start Taking Pandemic Preparedness Seriously

The news reports about H5N1 avian flu have filtered up to corporate board rooms. BusinessWeek reports that some large corporations are taking pandemic preparedness seriously.

POSSIBLE SCENARIOS. Increasingly, though, the threat of a global pandemic is beginning to creep into executive suites. "It's a giant leap from a year ago, when it wasn't on the business community's radar screen," says Dorothy Teeter, director of public health for Seattle & King County, Wash. DuPont formed a 20-person pandemic team in May. With avian flu spreading, the team stepped up its pace in October and now meets every week.

French construction-materials company Lafarge, which lost 200 employees in Indonesia during last December's killer tsunami, has launched an avian flu intranet site to send information to distant operations. Pitney Bowes (PBI ) in Stamford, Conn., is ensuring that large numbers of employees can work from home. And 17 U.S. airports have or are setting up quarantine programs. The lesson from past megadisasters is that "you have to think the unthinkable," says Christian Crews, director of futures strategy at Pitney Bowes.

Businesses could reduce the disruption and risk from a highly lethal pandemic by what I call "workplace cocooning". Basically, some workplaces could be converted into live-in quarantine areas where groups worked together but isolated from the outside world. For more on this see my previous post "Economic Collapse Avoidable During An Influenza Pandemic". Even short of a full quarantine one step businesses could take during a pandemic would be to partition people up into workgroups that rarely come into contact with other workgroups. Instead of putting people into large rooms full of cubicles put them in smaller rooms with just the people they need to work with. Also, stagger hours so that fewer people are in a building at the same time. The general goal should be to reduce the number of times people have to come into contact with other people and reduce number of different people from different groups that each person needs to come into contact with.

Businesses could do many other things to reduce disease transmission risk during a pandemic. Many of those changes could be made in advance of a pandemic with the added benefit of reducing the rate of infectious illness spread in workplaces. First off, encourage sick people to stay at home. Far too many people bring diseases to work and reduce the productivity of others who then get the diseases. Second, make physical changes in workplaces to reduce the amount to which workers have to touch common work surfaces which can transmit viruses. For example, make doors openable without the use of hands to turn door knobs. Also, make water at sinks controllable without the use of hands to touch knobs.

Workplaces could also be structured to reduce the distance that cough droplets can travel. Raise up cubicle walls all the way to the ceiling for example. Make it easier for individual workers to isolate themselves from people who they do not have business needs to come into contact with. When workers do come in coughing either suggest they go home or hand them face masks.

How about offering free flu vaccines in workplaces? Just get up from your desk and get a shot in 5 minutes instead of having to make a doctor's appointment or having to hunt down a clinic offering shots. Businesses also ought to lobby for the development of vaccines against rhinoviruses and other causes of the common cold. Costs are there to be eliminated. We need to treat diseases as costs that are in urgent need of elimination.

Normal colds and flus are costly enough and unpleasant enough that businesses ought to change their practices to reduce the incidence of infectious diseases even before considering the potential threat from avian flu.

By Randall Parker    2005 November 17 09:20 PM   Entry Permalink | Comments (3)
2005 September 30 Friday
Economic Collapse Avoidable During An Influenza Pandemic

Sherry Cooper and Donald Coxe of Canadian brokerage BMO Nesbitt Burns paint a very bleak economic picture should a dangerous flu such as the H5N1 avian flu develop into a deadly human pandemic strain.

They warn investors the economic fallout out of a pandemic would inflict pain across sectors and around the globe.

Airlines would be grounded, transport of goods would cease, the tourism and hospitality sectors would evaporate and the impact on exports would be devastating, Cooper wrote.

I agree the tourism and hospitality sectors would shrink to very small sizes. Also, gardener services would probably be banned as would most home maid services and lots of other home services that risk bringing workers into contact with lots of different residents. But the collapse of transportation is avoidable by reorganizing society into a large number of cocoon mini-societies that have very little contact with each other but which still move goods between the isolated nodes. I call this idea "workplace cocooning".

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, agrees with Cooper and Coxe that an influenza would have a huge impact on trade volumes (at least that is my interpretation of his statement).

"All the other catastrophes we've had in the world in recent years at the very most put screen doors on our borders. This would seal shut a six-inch steel door," Osterholm said.

Certainly resorts, hotels, and the airline industry will take huge hits from a hihgly lethal pandemic. But I do not buy this argument for all industries. Yes, if people panic so far out of their minds that they act really dumb then all transportation would cease and economies would collapse. But operators of transportation equipment can still work without getting exposed to influenza during a pandemic. It just takes some thoughtful reorganization of how things work.

The best approach I can see for reducing a pandemic disease's economic disruption and death toll is to have people live in workplaces for extended periods of time under quarantine conditions. I call this "workplace cocooning".

Take container ships and oil tankers as examples. The operators of those massive vessels do not need to get off the ships when in port. They also can avoid having port workers get on those ships. Container ships get off-loaded with huge cranes. The ship crews could hook cabling on containers to offload the containers if necessary. The food and other supplies for the ships could be replenished using cranes to lower supplies onto decks. Ship crews could stay on the ships for months ("workplace cocooning") without getting anywhere near local people when in ports.

Granted, the sailors would be fairly isolated for months. But look at teams of scientists in the Antarctica who stay down there for months. Oh how about explorers on ships in previous centuries. They were even more isolated and with far harsher and more dangerous conditions. Oil tanker crews similarly could just stay on board for months and visit many ports while staying safe distances from locals in ports.

Sailors do not want to stay on ships for many months. But they do not want to be unemployed or dead either. Sailors will face a choice of either signing up to get paid for long stretches on ships or being left on land and unemployed. Given those choices plenty of sailors would sign up for long stretches of work that allowed them to escape possible death from a pandemic sweeping the world. To get crews onto ships without chance of influenza spreading from an infected crew member the crews will need to initially go into a quarantine facility for perhaps 10 or 12 days to make sure none of them are already infected. But once they've gotten through their initial quarantine period in quarantine areas set up in port facilities they can get sent onto ships.

What about port workers? Simple enough: At the beginning of pandemics ask port workers to volunteer to move inside the gates of ports to live and work basically in a quarantined port isolated from the surronding society. Again, workplace cocooning. National Guard or police could enforce a policy of very limited exit and entry at each port. Most containers could be brought in via trains and the train operators could be under strict orders to never leave their trains while in ports.

What about train operators? Similar story to the port workers. Train operators would rarely leave their trains except at places selected for them to live isolated from the surrounding populations. Put some travel trailers or mobile homes in some train yards and arrange for food and other needed goods to be brought to the communities of train workers.

What about truck drivers and warehouses? Warehouse workers could also live in quarantine. Add some cots, futons, microwave ovens, refrigerators and the like to warehouses. Then the people who work in warehouses could stay in them for 24 hours a day and 7 days a week for weeks and months at a time.

Truck drivers could back trucks up to warehouse entrances but truck drivers would be required to keep their windows rolled up and not to exit their vehicles while getting loaded and unloaded at warehouses. Truck drivers could also live in isolated communities. Forget about going into restaurants at truck stops. Food could be cooked up by heavily covered and masked cooks and delivered out to places where the truckers could pick it up after delivery people have left. Or the truckers could just carry lots of sealed food that they eat cold or cook in their own microwave.

The basic pattern here is that personnel in each link in transportation chains could work without ever coming into close proximity with personnel who work in other links. The touching of surfaces touched by workers from other stages of transportation or breathing air which has cough droplets put there by workers from other stage can be made extremely unlikely. Methods of delivering food and other supplies could get worked out. If someone who operates a transportation company or trade association can't figure out how to greatly reduce exposure between workers who would basically be in different quarantine groups then that company should hire me as a consultant. I'll come up with procedures and techniques to reorganize businesses to operate as cocooned quarantine work groups.

Economies can reorganize to reduce human-to-human exposure by orders of magnitude. The workers will have to live and work in isolated groups for long stretches of time and many workers will have to say good bye to their families and live in workplaces for many month stretches. But economies do not have to collapse. Production and distribution of most types of goods does not have to stop.

In future posts I'll address retail food and goods distribution and also expand on other ideas for creating lots of isolated business units that can still carry on producing and distributing goods.

By Randall Parker    2005 September 30 01:27 AM   Entry Permalink | Comments (70)
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