Because the email is so long it will take 2 posts to include the entire content....
After I returned from a public health meeting yesterday with community leaders and school officials in Comal County and Hays County, Heather suggested I send an update to my patients in the area, because what we are hearing privately from the CDC and Health Department is different from what you are hearing in the media. Some of you know some of this, but I will just list what facts I know.
- The virus is infectious for about 2 days prior to symptom onset
- Virus spreads more than 7 days after symptom onset (possibly as long as 9 days) (this is more unusual than ordinary flu)
- Since it is such a novel (new) virus, there is no "herd immunity," so the "attack rate" is very high. This is the percentage of people who come down with a virus if exposed. Almost everyone who is exposed to this virus will become infected, though not all will be symptomatic. That is much higher than seasonal flu, which averages 10-15%. The "clinical attack rate" estimation from CDC and WHO may be around 40-50%. This is the number of people who show symptoms. This is a huge number. It is hard to convey the seriousness of this to those outside of the medical fields.
- The virulence (deadliness) of this virus is as bad here as in Mexico, and there are folks on ventilators here in the US, right now. This has not been in the media, but a 23 month old in Houston is fighting for his life, and a pregnant woman just south of San Antonio is fighting for her life. In Mexico, these folks might have died already, but here in the US, folks are getting Tamiflu or Relenza quickly, and we have ready access to ventilators. What this means is that within a couple of weeks, regional hospitals will likely become overwhelmed.
- Some of the kids with positive cases in Comal County have had more than 70 contacts before diagnosis as a minimum figure.
- There are 10-25 times more actual cases (not "possible" cases -- ACTUAL), than what is being reported in the media. The way they fudge on reporting this is that it takes 3 days to get the confirmatory nod from the CDC on a given viral culture, but based on epidemiological grounds, we know that there are more than 10 cases for each "confirmed" case right now.
- During the night, we crossed the threshold for the definition of a WHO, Phase 6 global pandemic. This has not happened in any of our lifetimes so far. We are in uncharted territory.
- They are advising President Obama to declare an emergency sometime in the next 72-96 hours. This may not happen, but if it doesn't, I will be surprised. When this happens, all public gathering will be cancelled for 10 days minimum.
- I suggest all of us avoid public gatherings. Outdoor activities are not as likely to lead to infection. It is contained areas and close contact that are the biggest risk.
Posts
