Michele Wucker’s book “The Gray Rhino” describes large obvious threats that we neglect until disaster strikes. Apparently it’s a bestseller in China. I thought it was a good read.
After reading it I mostly went on doing the same things I had been doing...
While I sympathize with what you're saying regarding panic, I don't think it's the right response.
Panic: sudden uncontrollable fear or anxiety, often causing wildly unthinking behavior.
That's exactly the opposite of what is needed. Fear can be a powerful and useful motivation, but if you want to accomplish anything useful, panic isn't the way to go.
An earthquake as large as the recent earthquakes in Turkey and Haiti is almost surely going to occur in the American Pacific Northwest. The geology of that area suggests that despite more rigorous building codes, an earthquake of similar magnitude as the one in Turkey could be even more damaging.
Yes. The Cascadia subduction zone is *the* big one. And here's an example of how hard it is to get people to prepare: Throughout the time I was in Turkey, I mentioned our seismic preparations efforts to my mother probably every time we spoke. We talked over and over again about my frustration that I couldn't even get people to secure their heavy items to the wall so that they didn't become projectiles when the ground moved. I said, so many times, "I can't believe people won't do this one, simple thing. It costs nothing. It takes ten minutes." And my mother would agree with me--"Yes, it's amazing that people don't do it, what's wrong with people, etc."
Then I came home to visit and discovered that not a thing in my mother's house was secured.
It is a bit unclear whether oseltamivir (Tamiflu) protects against infection, hospitalization or death from H5N1. Papers published in 2005 suggest that this antiviral was becoming less protective but data from 2010 suggests that it may still be protective. My guess is that it will provide at least some protection which could be the difference between death and and a miserable but not fatal illness. See,
Tamiflu is widely available, generic (which means inexpensive) and has a long shelf life.
Claire’s readers should go to their providers, get a prescription and head to the pharmacy. Whether insurance reimburses for it or not, bring it home and store it in a cool, dry place in case it’s needed.
If an epidemic breaks out in humans we will all hear about it. Surely there will be a massive run on the drug and it will quickly become unavailable.
The drug works best if taken with 2 days of the onset of symptoms but it still works if taken within 5 days.
Can we be positive that it will be efficacious against human infection?
No.
But it might be and it’s better to be safe than sorry.
If there’s an epidemic, authorities fearing a run on the drug will promote a lot of lies about how dangerous it is to take the drug without a doctors orders. That’s what happened early on in COVID times when patients were taking hydroxychloroquine (aka Plaquenil). The CDC was right when they said the drug didn’t help ameliorate COVID, but they were lying when they said hydroxychloroquine was dangerous. The same thing was true about ivermectin and COVID. It was completely right to say it didn’t ameliorate COVID but complete misinformation to claim the drug was dangerous.
Tamiflu comes with a package insert that outlines potential risks and side effects. You don’t need to be a physician to get the gist of it, you just need to be reasonably intelligent. It also outlines the most consequential drug interactions.
Go buy your Tamiflu now while you can easily get it. If H5N1 never arrives, you will still have it in case you need it for more benign forms of the flu.
It looks like vaccines exist for a few H5N1 variants, some for humans and some for chickens. Ironically, some of the human ones are manufactured using chicken eggs.
Assuming the human vaccine is safe, effective against the latest strains, etc. it would be nice to have that available to those who want it.
It sure would be good to have the vaccine available and in stock if it’s needed. It is not any harder to produce a vaccine against this particular flu variant that emerged in birds than any other version of flu.
Unlike the COVID vaccine however, the currently available technology to manufacture flu vaccine is not based on messenger RNA. It’s made the old-fashioned way; as you point out, in eggs. Most flu vaccines are made from killed flu virus, though the nasally- administered flu vaccine is based on a live but attenuated virus.
Ironically, the brand new mRNA technology makes the COVID vaccine relatively easy and fast to manufacture. Claire pointed out that the technology currently used to make the flu vaccine is a bit more cumbersome and labor intensive. Sadly, it also takes longer.
A number of companies are working on mRNA vaccines for flu including perhaps someday, a universal vaccine that will deal with all variants. In the United States, It’s a double-edged sword though. As a result of the incompetence and poor messaging of the CDC and FDA during COVID, millions of Americans no longer trust vaccines based on mRNA; they simply won’t take them. If we want near-universal uptake, we will have to use the slower, old-fashioned technology. Making vaccines in chicken eggs hardly seems very technologically advanced, does it?
Still, it works.
A deadly flu pandemic is likely to look different than the COVID pandemic. With COVID, the very old and very sick were at dramatically higher risk than younger people. With a flu pandemic, the old and sick will still be at high risk but younger populations, especially children, will be highly vulnerable. Middle aged and even younger senior citizens have been exposed to influenza through illness and vaccination many times. This will provide some immunological protection. The younger a flu patient is, the more immunologically naive they will be making poor outcomes more likely. The death toll from a serious pandemic of avian flu might be far higher than the death toll from COVID as younger people join older people in the hospital and morgue.
As I mentioned, Tamiflu (and perhaps other flu anti-virals) may or may not provide protection against an emerging avian flu. But you can be sure that if it does provide protection it is likely to be in short supply. Government stockpiles will quickly be exhausted.
When that happens, federal authorities are likely to do what they did during COVID; deliberately publish false information to discourage hoarding. It’s easy to predict the Government will claim how dangerous it is to take Tamiflu without talking to your doctor first.
The inevitable result will be that many people, if they can get Tamiflu at all (which for most will be impossible because of the drug’s shortage) will only take the drug outside of the five day period of efficacy.
Even during the past flu season, which was a bit worse than usual, some pharmacies ran short of Tamiflu. We are coming out of flu season and stocks are being replenished. It’s better to get some for you and your family now, while it is readily available.
All medicines have side effects. The threat of side effects need to be weighed against the threat of the disease that they treat. There are certain contraindications for the administration of drugs and certain drugs can interact negatively with each other. All of this is spelled out in the package insert for Tamiflu. Anyone intelligent enough to follow Claire’s interesting posts is more than intelligent enough to understand the package insert.
Ask your doctor for a prescription. It might not be covered by insurance (if you’re an American) because at the time it’s prescribed you won’t actually have the flu. Don’t let that deter you. Pay out of pocket.
If the medicine ends up working against the flu variant in question, you will have it in your medicine cabinet while everyone else is searching desperately for a pharmacy that has it. If it proves to be ineffective against the variant in question, you will be out a small amount of money.
Let me mention one more thing, Aaron. It would be the height of foolishness to take advice from some person you never met just because you read a comment at a Substack that you enjoy. The single best thing you can do is do your own research and come to your own conclusions.
While you do, please keep Claire’s admonition in mind. Our Governments (wherever in the world that we live) are prone to making the same mistakes over and over again. Learning from experience, especially disasters is not something governments specialize in.
Relying on Government experts may lead to a positive outcome, but often it doesn’t.
That’s why protecting ourselves and our families is mostly up to us.
Michele Wucker’s book “The Gray Rhino” describes large obvious threats that we neglect until disaster strikes. Apparently it’s a bestseller in China. I thought it was a good read.
After reading it I mostly went on doing the same things I had been doing...
Had not heard of this book. Looks interesting. Acquired the ePUB format. Thank you for your referral.
While I sympathize with what you're saying regarding panic, I don't think it's the right response.
Panic: sudden uncontrollable fear or anxiety, often causing wildly unthinking behavior.
That's exactly the opposite of what is needed. Fear can be a powerful and useful motivation, but if you want to accomplish anything useful, panic isn't the way to go.
An earthquake as large as the recent earthquakes in Turkey and Haiti is almost surely going to occur in the American Pacific Northwest. The geology of that area suggests that despite more rigorous building codes, an earthquake of similar magnitude as the one in Turkey could be even more damaging.
See
https://www.newyorker.com/magazine/2015/07/20/the-really-big-one
and
https://www.theatlantic.com/science/archive/2016/08/a-major-earthquake-in-the-pacific-northwest-just-got-more-likely/495407/
Yes. The Cascadia subduction zone is *the* big one. And here's an example of how hard it is to get people to prepare: Throughout the time I was in Turkey, I mentioned our seismic preparations efforts to my mother probably every time we spoke. We talked over and over again about my frustration that I couldn't even get people to secure their heavy items to the wall so that they didn't become projectiles when the ground moved. I said, so many times, "I can't believe people won't do this one, simple thing. It costs nothing. It takes ten minutes." And my mother would agree with me--"Yes, it's amazing that people don't do it, what's wrong with people, etc."
Then I came home to visit and discovered that not a thing in my mother's house was secured.
She lived in Seattle.
It is a bit unclear whether oseltamivir (Tamiflu) protects against infection, hospitalization or death from H5N1. Papers published in 2005 suggest that this antiviral was becoming less protective but data from 2010 suggests that it may still be protective. My guess is that it will provide at least some protection which could be the difference between death and and a miserable but not fatal illness. See,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835509/
and
https://www.science.org/content/article/more-tamiflu-resistance-bird-flu
Tamiflu is widely available, generic (which means inexpensive) and has a long shelf life.
Claire’s readers should go to their providers, get a prescription and head to the pharmacy. Whether insurance reimburses for it or not, bring it home and store it in a cool, dry place in case it’s needed.
If an epidemic breaks out in humans we will all hear about it. Surely there will be a massive run on the drug and it will quickly become unavailable.
The drug works best if taken with 2 days of the onset of symptoms but it still works if taken within 5 days.
Can we be positive that it will be efficacious against human infection?
No.
But it might be and it’s better to be safe than sorry.
If there’s an epidemic, authorities fearing a run on the drug will promote a lot of lies about how dangerous it is to take the drug without a doctors orders. That’s what happened early on in COVID times when patients were taking hydroxychloroquine (aka Plaquenil). The CDC was right when they said the drug didn’t help ameliorate COVID, but they were lying when they said hydroxychloroquine was dangerous. The same thing was true about ivermectin and COVID. It was completely right to say it didn’t ameliorate COVID but complete misinformation to claim the drug was dangerous.
Tamiflu comes with a package insert that outlines potential risks and side effects. You don’t need to be a physician to get the gist of it, you just need to be reasonably intelligent. It also outlines the most consequential drug interactions.
Go buy your Tamiflu now while you can easily get it. If H5N1 never arrives, you will still have it in case you need it for more benign forms of the flu.
It looks like vaccines exist for a few H5N1 variants, some for humans and some for chickens. Ironically, some of the human ones are manufactured using chicken eggs.
Assuming the human vaccine is safe, effective against the latest strains, etc. it would be nice to have that available to those who want it.
It sure would be good to have the vaccine available and in stock if it’s needed. It is not any harder to produce a vaccine against this particular flu variant that emerged in birds than any other version of flu.
Unlike the COVID vaccine however, the currently available technology to manufacture flu vaccine is not based on messenger RNA. It’s made the old-fashioned way; as you point out, in eggs. Most flu vaccines are made from killed flu virus, though the nasally- administered flu vaccine is based on a live but attenuated virus.
Ironically, the brand new mRNA technology makes the COVID vaccine relatively easy and fast to manufacture. Claire pointed out that the technology currently used to make the flu vaccine is a bit more cumbersome and labor intensive. Sadly, it also takes longer.
A number of companies are working on mRNA vaccines for flu including perhaps someday, a universal vaccine that will deal with all variants. In the United States, It’s a double-edged sword though. As a result of the incompetence and poor messaging of the CDC and FDA during COVID, millions of Americans no longer trust vaccines based on mRNA; they simply won’t take them. If we want near-universal uptake, we will have to use the slower, old-fashioned technology. Making vaccines in chicken eggs hardly seems very technologically advanced, does it?
Still, it works.
A deadly flu pandemic is likely to look different than the COVID pandemic. With COVID, the very old and very sick were at dramatically higher risk than younger people. With a flu pandemic, the old and sick will still be at high risk but younger populations, especially children, will be highly vulnerable. Middle aged and even younger senior citizens have been exposed to influenza through illness and vaccination many times. This will provide some immunological protection. The younger a flu patient is, the more immunologically naive they will be making poor outcomes more likely. The death toll from a serious pandemic of avian flu might be far higher than the death toll from COVID as younger people join older people in the hospital and morgue.
As I mentioned, Tamiflu (and perhaps other flu anti-virals) may or may not provide protection against an emerging avian flu. But you can be sure that if it does provide protection it is likely to be in short supply. Government stockpiles will quickly be exhausted.
When that happens, federal authorities are likely to do what they did during COVID; deliberately publish false information to discourage hoarding. It’s easy to predict the Government will claim how dangerous it is to take Tamiflu without talking to your doctor first.
The inevitable result will be that many people, if they can get Tamiflu at all (which for most will be impossible because of the drug’s shortage) will only take the drug outside of the five day period of efficacy.
Even during the past flu season, which was a bit worse than usual, some pharmacies ran short of Tamiflu. We are coming out of flu season and stocks are being replenished. It’s better to get some for you and your family now, while it is readily available.
All medicines have side effects. The threat of side effects need to be weighed against the threat of the disease that they treat. There are certain contraindications for the administration of drugs and certain drugs can interact negatively with each other. All of this is spelled out in the package insert for Tamiflu. Anyone intelligent enough to follow Claire’s interesting posts is more than intelligent enough to understand the package insert.
Ask your doctor for a prescription. It might not be covered by insurance (if you’re an American) because at the time it’s prescribed you won’t actually have the flu. Don’t let that deter you. Pay out of pocket.
If the medicine ends up working against the flu variant in question, you will have it in your medicine cabinet while everyone else is searching desperately for a pharmacy that has it. If it proves to be ineffective against the variant in question, you will be out a small amount of money.
The way I see it, it’s well worth that risk.
Let me mention one more thing, Aaron. It would be the height of foolishness to take advice from some person you never met just because you read a comment at a Substack that you enjoy. The single best thing you can do is do your own research and come to your own conclusions.
While you do, please keep Claire’s admonition in mind. Our Governments (wherever in the world that we live) are prone to making the same mistakes over and over again. Learning from experience, especially disasters is not something governments specialize in.
Relying on Government experts may lead to a positive outcome, but often it doesn’t.
That’s why protecting ourselves and our families is mostly up to us.