Down to a sunless sea

7:26am: Swine Flu, yet again
Prologue: These things are never as short as I intend at the start.

===========================================

The good news comes in several flavours...

====================================================================
I've settled all my questions about the Canadian vaccine. That took more research, because what is written in the US is not as obviously relevant to us - we took a different path on the vaccine than they did, rather more like the Europeans have for some of their seasonal flu vaccines. I managed to chase down the relevant science and data from relatively reliable sources. The 'relatively' means that I was not reading the experimental data in biological and medical journals. Given my own background - math, physics, chemistry and stats heavy, biology light - I am better off working with the data as the biologists and epidemiologists put it out anyway.

I was looking at the data about vaccination and flu vaccines in general, adjuvants in general, and the issues around mercury, the AS03 adjuvant, autism, GBS, Gulf War syndrome, vaccine reactions, risk levels, swine flu infection and mortality rates, risk factors, and infection reactions. I also tracked down the best estimates I could get for some of the variables for some of the parameters determining estimates for the rates of various possible outcomes.

Where each individual falls in the scheme of things depends on their own personal medical status, age, sex, exposure, access to medical support, willingness to promptly seek help if conditions worsen, etc. And there are still some parameters that are not completely known. But my personal estimate is (and this is 'educated gut feel', based on a fair number of calculations), that the chance of dying, depending on who you are, is about 30 to 1,000 times greater than the risk of significant complications from the flu vaccine). Note, too, that 'significant complications' includes outcomes far less serious than death, some of which may finally resolve to complete or near complete recovery - though they also include lasting disability or death in the most severe cases.

Watching the news (That I should be reduced to trying to perform analysis based on news reports! Oh the shame, the horror! I always did have a certain sympathy for the history teacher who said that we never really understand something until all the people who lived through it were dead, and we could get some unbiased analysis done.).... anyway, watching the news, it does appear that the decisions made by our government, civil service, and medical establishment was excellent. If - and that's still and if, but we are getting closer to managing it day bey day - we squeak through the closing window of opportunity to vaccinate before this thing gets most everybody, that Canada will have managed to pull off a very carefully judged and nuanced strategy.

Certainly by my analysis, we seem to have got one of the best vaccines out of several possible variations, in clearly adequate quantities. If the deliveries can be made in a suitably timely matter, we should congratulate ourselves. While the choices the Americans made let them roll out vaccine a little bit faster, their vaccines are likely to be about 30% less effective in immunizing, and less effective in the face of viral mutations.... and their production difficulties mean that many clinics have already been cancelled, while others are forced to turn away thousands because they both did not have enough vaccine overall, nor enough of the types acceptable for groups with certain medical conditions or of certain ages. It is profoundly saddening to read of people who lined up an hour before the clinic opened only to be turned away because they'd run out of injectable vaccine.

Here, Ontario has already received 700,000+ doses of the vaccine, with more coming. There are no indications we will have problems maintaining an adequate rate of production to get everyone who wants it vaccinated in a relatively short time scale - a few weeks.Medical staff were inoculated starting Friday, and high risk groups started getting vaccinated today, I believe.

(IF YOU ARE AT HIGH RISK, THE TIME TO DO SOMETHING IS NOW!)

The rest of us will be able to get vaccinations (in Toronto) starting a week today. Schedule for the first two weeks, and locations, at the bottom of this message.

Personally, I have gradually eliminated all my concerns about the safety of the vaccine, even though I had started with some personal qualms. Indeed, as a result of my research and analysis, I am now happier about seasonal flu vaccines as well, even though I had long ago decided they were the sensible choice.

To put things in perspective... unless there is a completely unexpected - (in the sense of 'there is no reason for it to happen that we can think of'', not in the 'we haven't thought about it' sense) - your chances of a significant adverse reaction to the swine flu vaccine is somewhat less than your chance of being struck by lightning.

Things keep in mind:

1. You are at higher risk if you are between 15 and 65, or female, or diabetic, have a cardiovascular problems, are asthmatic, pregnant, very obese, or have a compromised immune system. Given the respiratory nature of many of the severe cases, other conditions compromising lung function are probably bad, too.

2. If you are under 65 you probably have no immunity to this virus. If you are older, you have about a 30% chance of resistance.

3. In Canada, 70% of those dying, so far, have been women.

4. If you get this, it is vital to monitor your temperature. The fever can get dangerously high.

5. If this goes bad on you, get help fast, don't try to tough it out. Survival so far has correlated well with early hospitalization. See government health site links (below) for the signs of danger of severe illness.

6. What I have written is largely a synthesis or summary with a bit of analysis. You should really read the government health sites linked below. They have a lot more detail, qualifications I have omitted, and things I have skipped over because of space or because I think I have mentioned them in previous posts. It is not guaranteed that I posted them to you, however. Also, if you have the statistical and analytical background, you may also want to do your own calculations.

7. My observation is that 80% and probably more of what is posted on the Internet about vaccines in general and swine flu vaccines in particular is bullshit. Much of it is bad science, 'broken telephone' reportage based on flawed data, nutbar propaganda, and the
ignorant sharing their misconceptions.

{rant on} It's moments like this when I begin to feel that no one should get out of high school without four years of math and a year each of general science, physics, chemistry, and biology. Unless you already qualify, you probably don't want to know what I think should be required for university graduation! Our world is getting ever more complicated, and we really should be preparing ourselves to understand it.

The volume of sheer ignorance on the Internet tells me we are not doing so.{rant off}

8. If you get vaccinated it will still take about 10 days for the vaccination to become effective. Don't let your guard down!

--------------------------------------- LINKS ---------------------------------------------

Following the links in the recommeded sites is probably a good education on the issues... I suggest you try that.

--------------------------------------
Government web sites (recommended):

READ THIS ONE! "WHAT YOU NEED TO KNOW BEFORE RECEIVING THE
H1N1 FLU VACCINE":
http://www.phac-aspc.gc.ca/alert-alerte/h1n1/vacc/know-savoir-eng.php

http://www.phac-aspc.gc.ca/alert-alerte/h1n1/vacc/myth-mythe-eng.php

http://www.phac-aspc.gc.ca/alert-alerte/h1n1/vacc/options-eng.php

http://www.cdc.gov/h1n1flu/qa.htm

http://www.cdc.gov/h1n1flu/vaccination/gbs_qa.htm

http://www.toronto.ca/health/cdc/h1n1/index.htm

--------------------------------------

Good / interesting posts:

http://www.edmontonsun.com/news/canada/2009/10/26/11531651.html

http://afludiary.blogspot.com/2009/07/flu-math.html

http://www.webmd.com/cold-and-flu/features/is-the-h1n1-swine-flu-vaccine-safe

7:11am: Swine Flu vaccines
Affluence played a part in getting us the vaccine that can
prevent much of this illness... but assuming they get it out in time to
make a difference, the judgment of our medical establishment will also
be vindicated in a really, really big way, as will the foresight of our
government. The US has ordered 251 million doses of vaccine for 300
million people, while the Canadian government ordered 52 million doses
for 30 million people. This actually makes sense as not everyone will be
vaccinated, but at the time the vaccine was ordered it appeared that it
might require two doses to achieve effective immunization.

Subsequent testing shows good immunization after one dose, so we've got
enough for 100% coverage, if everyone wants one.

Equally important was the decision to go with an adjuvanted vaccine. The
addition of an adjuvant allows the production of doses using far less
virus material, in line with requests from WHO to use strategies to
increase world-wide production of vaccine. This turned out to be even
more important than just upping the total production, as it turns out
that 2009 novel H1N1 (= Swine Flu) is more difficult than seasonal H1N1
virus (or the other components of the seasonal flu vaccine. As a result,
you can get two doses of seasonal flu vaccine from an egg, but only half
a dose of swine flu vaccine. This has delayed production and delivery of
vaccine in the US to the point that various jurisdictions are getting
only a fraction of the doses they anticipated, forcing delays and
cancellations of clinics. As a result, the US may miss a large part of
the window of opportunity for vaccination because the disease is ahead
of the vaccination schedule. [note from today's US news: "of the 100
million-plus doses of H1N1 vaccine that were to arrive by now,
only 16 million doses were available late in the week"].

The jury is still out on how the timing will play out in Canada.
The hospitals in Toronto started vaccinating their emergency room and
ICU staff on Friday, and our clinics will start
for the public on Nov 1 (happy new year!).

Another interesting factor has come up in testing. The unadjuvanted
vaccine, which Canada ordered for pregnant women - not because the other
vaccine is thought to be unsafe, but because adjuvanted vaccines have
not been as extensively tested on pregnant women - produces an adequate
immune response in 60-65% of those vaccinated. The adjuvanted vaccine
produces an adequate immune response in ~90% of those tested.

Also, be aware that adjuvanted vaccines tend to produce a 'broader
spectrum' immune response. As a result such vaccines tend to less rapid
dissipation of immune response when a virus mutates somewhat.

Being naturally conservative, I was originally regarding the
unadjuvanted vaccine as superior as being less complicated and having
less potential for the admittedly unlikely complications. After looking
at the numbers (depending on various conservative assumptions, I figure
I'm somewhere between 30 and 300 times more likely to die than to have a
significant vaccine reaction) it doesn't really make any rational sense
to not take the vaccine unless you have a reason to believe you are more
at risk for an adverse reaction. Note that if you are female, your
chances of dying go up significantly (two thirds of those admitted to
ICU and seventy percent of those dying in Canada, so far, have been
women). Again, the median age for admittance to ICU was 32.

My own decision? Originally I thought I would hold off and see if I
could find a way of getting an unadjuvanted vaccination somehow. Now I
think I will get my ass over to a clinic on the first or second day for
an adjuvanted shot, given that it is 50% more likely to provide
effective protection than the unadjuvanted vaccine... and it will be
available a couple of weeks earlier.

The unadjuvanted vaccine is earmarked for pregnant women and children
under three, but depending on uptake and policy there may be some
available later... probably too much later.

Remember that it takes 1-2 weeks for the immune response to become 'set'
and effective - it basically takes your immune system that long to learn
to recognize the swine flu, and circulate the information to the
appropriate immune cells in your body.

The trick is to have your protection in place before the whole thing
peaks.

6:57am: Swine Flu - as of a couple of days ago
Here's another 'state of the world' update, based on what my research
has been gathering since the last one.

DISCLAIMER: I am not a doctor, epidemiologist, or biologist. Check GOVERNMENT AND ACADEMIC web sites for data. Do not believe random web posts, even if the poster claims to be, is, or claims to quote a 'doctor'.


-------------------------------------------------------------------


1. WHERE ARE WE: The 'second wave' - we haven't really had a first one
in Ontario, due to seasonal flu-suppressive effects - is starting.
According to my pandemic health friends this is probably week 0 or week
1 of an eight week wave.

2. FACTS AND MYTHS ABOUT FLU VACCINE: The H1N1 vaccine should be
available to the public as of November 1. There are 10 clinic sites
around Toronto with times announced for the first two weeks. Contrary to
what you may have read in letters to the editor or 'my opinion' type
blogs, the vaccine is almost certainly as safe as a vaccine normally is,
and that's pretty darn safe. Major problems as a result of vaccinations
of this type generally run to one or two in a million vaccinations. Your
chance of dying as a result of swine flu if you are infected is one in
thousands.... hard to pin down exactly because of factors mentioned in a
previous post. And you can get complications and lasting problems from
the flu as well as from the vaccine - and more often. One of the factors
quoted as a reason for not vaccinating was the possible side effect
(possible in the sense that it has never been proven that the cause was
the vaccine because the incidence was so low relative to natural rates
of disease, and confounding factors) of GBS. or 'Guillain-Barre
syndrome'... but you can also get GBS triggered by a flu infection
itself. The 1976 vaccine was a rush job, and primitive compared to
modern vaccines and vaccine production standards. There has been no
demonstrated association of GBS with vaccination since then.

Worried people and anti-vaccination zealots will also tell you about
'mercury' in the vaccine. Some forms do have mercury, including that
made for Canada. What they don't tell you is that the more dangerous
form is methyl mercury, while the flu shot contains ethyl mercury -
thimerosol - which is a common component of, for example, contact lens
solution. An adult flu shot has about one quarter the amount of mercury
found in a can of tuna.

The same worriers and nutbars (not every worrier is a nutbar, some are
quite sensible people who need more data, or just have a very cautious
approach to anything they put in their bodies) also worry about testing.
While it is true that this exact vaccine has never been tested - how
could it be, given the time frames and the fact it is a new disease -
all of the components have been used extensively in other vaccines, save
for the exact (2009 novel H1N1) virus, with no signs of abnormal issues.

If you have had a bad reaction to a flu shot in the past, you should
probably skip this one too, but otherwise, your chances are much better
with the shot than without it.

Your other consideration should be if you have contact with anyone who
would be at risk. Even if it is a mild disease in you, it could kill
someone else. And please, remember the domino effect.

3. IS IT JUST ANOTHER FLU? No. Because people under 65 have no
resistance, it will infect, barring widespread vaccination, about a
third of the population. My own inadequate sample? So far, 2 in 30.
Also, unlike seasonal flu it

(1) attacks people between 15 and 50 most
(2) is significantly more likely to kill women than men
(3) seems to be about 4-6 times more likely to kill people
(4) puts a bit more than 1 person in 1000 infectees in ICU, a lot of
them on ventilators.
(5) spreads much more rapidly due to the lack of resistance. Remember we
are in week zero with significant infection numbers... while normal flu
season starts around Yule.

4. IS IT SWINE FLU OR SEASONAL FLU? If you, or anyone else, has flu,
it's swine flu. Recently 97% or more (sources quote from 97% to 99%) of
the influenza virii typed in Ontario were 2009 novel H1N1 = Swine Flu.
To quote one doctor "There is essentially no seasonal flu out there".

5. PRECAUTIONS - We've gone over these...
(1) Wash hands often. When you can't wash, sanitize.
(2) Don't share food or drink.
(3) Control your sneezes and / or coughs.
(4) Avoid crowds.
(5) Two metres is a good distance between people - talking does release
droplets that could contain infectious material. Remember, however, that
the aerosols from a cough or sneeze can stay in the air for half an
hour. Remember, also, that people can be infectious for 24 hours or more
before they show symptoms.
(6) Be aware that surfaces can be contaminated and may stay that way for
many hours. That includes tables, chairs, handles, clothing, gloves,
etc, etc, etc.
(7) Don't touch your face. Or food, unless you have washed your hands or
sanitized them.

6. WHAT TO DO IF YOU GET THE FLU.
(1) Self-quarantine. Different standards are in use. Some organizations
say "stay isolated for 10 days". Others in the health care field are
using "stay isolated for seven days or until you have been symptom free,
including no fever without using drugs, for 24 hours, whichever is longer."
(2) Keep hydrated.
(3) Monitor your temperature. If it starts getting high, take steps to
control it - fever is one of the main dangers.
(4) Watch for other symptoms - pains in chest or abdomen, trouble
breathing, a bad fever that subsides, then comes back worse... see the
various reference sites for a list. If you have these seek help
immediately. In the abortive first wave, survival correlated with how
quickly someone ended up in ICU.

6:55am: Belated post???
I managed to celebrate Car Free Day yesterday (without even knowing about it!) by spending about 8 hours in my car, driving.

It was the perfect, ironic, serendipitous comment on the whole thing.










-------------------------------------------------------------------------------------------
Footnote:

What is the current listing status for carfreeday.ca?

Site is listed as suspicious - visiting this web site may harm your computer.

Part of this site was listed for suspicious activity 9 time(s) over the past 90 days.

What happened when Google visited this site?

Of the 89 pages we tested on the site over the past 90 days, 20 page(s) resulted in malicious software being downloaded and installed without user consent. The last time Google visited this site was on 2009-09-15, and the last time suspicious content was found on this site was on 2009-09-11.

10:48am: I think I am going to go back to classifying galaxies again. Not only do you get to look at pretty pictures, it's fun and useful.

6:01pm: Happy Darwin Day
It's the 200th anniversary of Darwin's birth.

It's also 150 years since the publication of "On the Origin of Species", arguably the most important scientific book ever written about the life sciences.

Celebrate!

8:45pm: If you use the internet, this may be of interest to you.

(Talk about a precisely targeted audience...)

SaveOurNet.ca

11:28pm: Quote of the Day
Yes, this is the first "quote of the day" in years... but some quotes really do deserve days.

Judge for yourself:

"A closed system has three peculiarities. Firstly, it claims to represent a truth of universal validity, capable of explaining all phenomena, and to have a cure for all that ails man. In the second place, it is a system which cannot be refuted by evidence, because all potentially damaging data are automatically processed and reinterpreted to make them fit the expected pattern. The processing is done by sophisticated methods of casuistry, centered on axioms of great emotive power, and indifferent to the rules of common logic; it is a kind of Wonderland croquet, played with mobile hoops. In the third place, it is a system which invalidates criticism by shifting the argument to the subjective motivation of the critic, and deducing his motivation from the axioms of the system itself ... In fine, the mentality of a person who lives inside a closed system of thought ... can be summed up in a single formula: He can prove everything he believes, and he believes everything he can prove. The closed system sharpens the faculties of the mind, like an over-efficient grindstone, to a brittle edge; it produces a scholastic, Talmudic, hair-splitting brand of cleverness which affords no protection against committing the crudest imbecilities."

- Arthur Koestler

11:49pm: Bloody useless interface design!
Unpleasant factoid 1401...

If you enable javascript while entering a posting in LJ to see if, for example, there is an option to spell check your post, it redraws the page and ERASES EVERYTHING YOU HAVE ENTERED!

Stupid design.




Irked! Why isn't irked a mood option?

11:57am: It's over!

Less than six weeks, and we put that election to bed. I don't know how the Americans stand their dragged-out-for-many-months elections.

4:07pm: Thinking about elections....
I never really thought that much about the mechanics of an election. Everything just happened, the way it should. Yes, I was a campaign manager in one, once, but I really only had to worry about one party in one riding, the financial regulations, and the administrative procedures around nomination... not counting running a campaign, which really has nothing to do with running an election.

This time, however, I am paying a bit more attention. And it has become abundantly clear that what an RO (returning officer) must do is far from easy. In fact, there's a long list of administrative and statutory requirements, many of which have no "give" in them with respect to deadlines.

Consider that the current election kicked off with the Governor General dissolving parliament on September 7, issuing a Writ of Election for October 14. The RO is only guaranteed 36 days for the entire conduct of the election up to the final polling day (though more has to be done after that day!)

The ROs (there's one for each riding must, in the words of Elections Canada, be available "all day, every day" from the issuing of the writ to some days after the polls close.

So, what does happen? A lot more than I can tell you, as I've never been an RO. I do know that they have only days to rent office space, set up an office, hire staff, and basically get everything up and running. They have to oversee the revision of the electoral lists, the notification of the voters, locate and secure space for polls, and provide information and support to the various candidates, in terms of documentation and services. They have to organize and run advance polls, mobile polls, and special balloting. They have to hire and arrange to train hundreds of poll clerks, information officers, revisors (not sure of the correct term) and DROs (Deputy Returning Officers). There are a few other positions "out in the field" at the polls, but I can't name them all off.

The Returning Office also needs IT staff, financial staff, trainers, etc., as well as an ARO (Assistant Returning Officer).

All this has to be done very quickly, as the advance polls will open no more than about 4 weeks after the Writ is dropped... but the parties (and individuals) have about 3 weeks for nominations, so the ballots cannot be printed until after three weeks, but must be drafted, proofed, approved, produced, shipped, and distributed in less than 4 weeks!

Then you are into the advanced polls... then the final revision of the electoral rolls, then the final poll...

All the while fighting fires, fixing problems, dealing with the candidates and their campaign staff, and meeting stringent schedules and reporting practices back to Elections Canada.

Whew! And then there is the counting of the ballots, the verification of the results, maintaining security and control over sites, ballots, etc., requesting a judicial recount if the results are too close, and finally, declaring a candidate elected, finishing the documentation, securing and delivering documentation and ballots to Elections Canada, paying all the suppliers and staff, decommissioning the office, and archiving the appropriate records.

Total elapsed time? About 40 18-hour days.... and I either glossed over or don't know about a lot of the work.

I'm glad it's not me.

3:48pm: Too good to not post...
"If DARPA was a Greek god, its temple would surely be located atop the Acropocalypse."



(brought to you after 76 consecutive weeks of musing!)

11:58am: Quote of the Day
"Naming a device designed to cut up wounded soldiers after a carrion-eating bird of ill omen seems like an odd call, but there you go."

(referring to a remote controlled surgical unit called Raven)

12:37pm: Yesterday's question on Non-Fluffy Pagans"

"In and of itself, are Otherkin fluffy? .... Is someone thinking themselves to be fairy, unicorn, angel, demon, wolf, vampire, whatevah', fluffy? Why and why not?"

My initial question, today:

"Why would anyone have to ask this question?"

My slightly later thought:

"I wonder if someone is doing a school paper on bizarre subcultural beliefs?"

2:25pm: Another note for the Microsoft file... something I didn't know.

Apparently windoze (Win 2K Professional) will allow you to create a file with a name it dislike so much that it will neither allow you to rename it, nor delete it.

As soon as I finish moving my data to a safer place, I'm taking a Linux disk and housecleaning.

DIE FILE, DIE!

1:26pm: Scary footnote of the week:

New British type 45 destroyers will have Windows computers controlling their weapons... including deciding when and if to fire them.

7:57pm: Interesting. There's a discussion going on over at NFP about "demons", but I get the feeling that most of the posters have never met one... it all seems very abstract and pseudo-academic.

Of course, maybe people who have actually met them don't often talk about it in public?

2:32am: Tempted by yet another quiz (YAQ)

1:08am: Another ritual
Well, we tried something new in ritual, and it came off rather well. The feedback was quite positive, and while I think it could be a bit better, it was pretty darn good.

I've noticed a growing desire to do something new and different - something I haven't seen before, but still within the conceptual bounds of traditional Craft. After seeing a thousand rituals, that becomes harder, but we've pulled it off a couple of times in the past year.

This time my partners in crime were two of my students, both brilliant in their own ways. It's always good to work with one of your favourite High Priestesses. One of the new God pieces that she wrote for the ritual was so good that I think we are going to have to write an upgraded Goddess piece to match it.

Of course, wrt rituals, that leaves open the question of "What shall we do next?".

11:32am: According to a telephone poll, 25% of Americans expect the second coming of Christ in 2007.

I wonder who ran the poll, and how the sample was selected.

And if that is an accurate representation of the broader population, I am truly, for the first time in years, at a loss for words.

12:39pm: Another training cycle is rolling around.

Students moving up to new levels. New things to teach...

There are moments when I wonder how anyone makes this work in an amorphous unstructured environment.

3:56pm: Online Wicca Schools.
Online Wicca schools are an endless source of amusement.

This one was brought to my attention by NonFluffyPagans, which I do watch.

If you go to the shop you can buy 4 oz. of flax seed and the "Earth Degree Initiation Manual". Apparently Wicca has five degrees, Earth, Water, Air, Fire, and Spirit.

While in an odd way, I can get why someone would buy the initation(??!!) manual on line, what's with the flax seeds?

The site is run by a "The Lady Morgaine" (remember the trick of getting a third of the women at a pagan festival to the informationn desk - "Would Lady Raven and Lady Morgan please come to the information desk?" - I do so love that essay!). I bet Lady Isis would cover at least ten percent of the rest...

This looks like another one of those things put together by someone who has read a few books, and consulted with their "inner witchiness", and is now teaching other their profound understanding of a mystery religion in which they have never experienced the mysteries.

Sigh.

3:02pm: Cats are wonderful, but cat-sitting four of them - not your own - can be a challenge, especially when they are used to having someone home almost all the time... and the cats' staff have been gone a week. Manic, manic cats.

Rule of paw... more than one cat per person is "badly outnumbered".

3:44pm: Sooner or later you read something on the net that makes you really, really glad you aren't in first level support:

---

A guy at our company asked to have Lotus Notes installed on his Mac. He said he'd be away for a couple days, and I could install it then. When I went to do it, there wasn't enough disk space, but there was about 96 megs in the trash. Ah, I thought, he's forgotten to empty it.

When the user returned to work, he came straight to see me after switching on his machine.

* Him: "Where're all my files?"
* Me: "What files?"
* Him: "The ones I was keeping in the trash."

5:52pm: "This is a test. It is only a test. If this had been
your real life, you would have been given better instructions."