The biology of a pandemic is the least important part

[Ausmumof3]

This is a statement that Dr Norman Swann has made a couple of times on coronacast.  In full 

“Pandemics, the biology of a pandemic is the least important part of it, it's how we behave that creates a pandemic.”

 

Does this sound true to you?  Does covid reflect this?

[SKL]

No, I don't agree with it.  I think a much more important factor is how easily the bug spreads, how, and among whom.

The fact is that some people can't and shouldn't hide away from bugs.  The idea that it is all about choice is simplistic IMO.

[Farrar]

Yes. The history of pandemics is the history of human behavior and choices. The shape a pandemic takes is greatly influenced by human behavior. Considering our understanding of biology at this point, it's the human factors that are driving this, not our lack of understanding.

[Not_a_Number]

1 hour ago, Ausmumof3 said:

This is a statement that Dr Norman Swann has made a couple of times on coronacast.  In full 

“Pandemics, the biology of a pandemic is the least important part of it, it's how we behave that creates a pandemic.”

Does this sound true to you?  Does covid reflect this?

Yes, I think that's true. 

There's a vast gulf between our behavior and our scienttifc understanding of the virus. That vast gulf is what is creating the pandemic. 

[SKL]

If this was true, then we would have pandemics in the US 100% of the time.  Every year's flu and common cold would be a pandemic.

[Not_a_Number]

Just now, SKL said:

If this was true, then we would have pandemics in the US 100% of the time.  Every year's flu and common cold would be a pandemic.

Well, we can argue that the flu IS a pandemic. It's just that it doesn't kill as many people 😉 . 

[Ausmumof3]

I keep thinking about it and I think it states a truth - that behaviour is important.

41 minutes ago, SKL said:

No, I don't agree with it.  I think a much more important factor is how easily the bug spreads, how, and among whom.

The fact is that some people can't and shouldn't hide away from bugs.  The idea that it is all about choice is simplistic IMO.

I kind of understand this view because I grew up like this.  Staying home or resting up when you were sick was seen as a kind of weakness too.  But I wonder if we’d have this discussion if it was bubonic plague for example?  At some point there has to be a threshold.  We don’t go handle wild animals without taking precautions against disease for example.  Is that living in fear?

[Not_a_Number]

Just now, Ausmumof3 said:

I kind of understand this view because I grew up like this.  Staying home or resting up when you were sick was seen as a kind of weakness too.  But I wonder if we’d have this discussion if it was bubonic plague for example?  At some point there has to be a threshold.  We don’t go handle wild animals without taking precautions against disease for example.  Is that living in fear?

I guess the interesting point is that the psychological toll of precautions we're not used to is higher than precautions we're used to. 

[Carrie12345]

To me, the biology is certainly important.
But each human behavior begets another, whether to build up dominoes or knock them down.  We could have had a safer course. Now we’re reacting to our failure to make one.

[vonfirmath]

1 hour ago, Ausmumof3 said:

I keep thinking about it and I think it states a truth - that behaviour is important.

I kind of understand this view because I grew up like this.  Staying home or resting up when you were sick was seen as a kind of weakness too.  But I wonder if we’d have this discussion if it was bubonic plague for example?  At some point there has to be a threshold.  We don’t go handle wild animals without taking precautions against disease for example.  Is that living in fear?

Even with bubonic plague -- the rich fled and everyone else dealt with it and moved on.

 

What is more -- because they didn't realize it was being spread by rats, everything they did didn't help that much.

[Bootsie]

A disease that quickly kills the person who is infected is not nearly as likely to spread as a disease for which someone is asymptomatic, but contagious, for a longer period of time.  A disease that has a longer incubation period is more likely to spread and more difficult to track.  A disease which is spread by surfaces, which can be mitigated by hand washing, is much less likely to spread than a disease that is spread, unknowingly, by someone breathing.  Not only does the biology of the disease itself impact the probability of spread and the speed of spread, it impacts how effective particular changes in human behavior are.  

[Ausmumof3]

8 minutes ago, Bootsie said:

A disease that quickly kills the person who is infected is not nearly as likely to spread as a disease for which someone is asymptomatic, but contagious, for a longer period of time.  A disease that has a longer incubation period is more likely to spread and more difficult to track.  A disease which is spread by surfaces, which can be mitigated by hand washing, is much less likely to spread than a disease that is spread, unknowingly, by someone breathing.  Not only does the biology of the disease itself impact the probability of spread and the speed of spread, it impacts how effective particular changes in human behavior are.  

Yes I think that’s along the lines of what bothering me about the statement.  Yes the behaviour is important but it’s the interaction of the behaviour and the biology that makes the pandemic not one or the other.

[Corraleno]

I agree with the statement. He's not saying that biology has zero effect on outcome, just that it's the "least important" compared to behavioral issues. Sweden and Norway provide a pretty dramatic illustration of that: you have genetically and demographically similar populations (so there aren't biological factors there that would necessarily predispose one country to a higher death rate) and yet the exact same virus has killed 7500 Swedes and 380 Norwegians. Per capita, Sweden's death rate is more than 10 times higher than Norway's. Sweden didn't get a mutant strain that's 10 times deadlier, the difference is behavior.

[caffeineandbooks]

3 hours ago, Not_a_Number said:

Well, we can argue that the flu IS a pandemic. It's just that it doesn't kill as many people 😉 . 

The flu is not a pandemic, it is endemic.  It's a disease that's always around, and always affects a roughly similar number of people.  It would be an epidemic if it suddenly became more intense in a particular area and infected or killed many more people than before.  It would be a pandemic if, like the 1918 flu or the current virus, there was an intense outbreak across national borders.

Perhaps if Norman Swann had been writing his thoughts down and reflecting on them before publication, instead of firing off whatever came into his head in a podcast, he would have chosen a more nuanced view like @Bootsie 🙂 You need the right interface between the virus' characteristics and normal human behaviour for a pandemic to occur.

[Laura Corin]

It's a combination.  I was in Hong Kong during Sars 1. Because that was not very infectious and people got sick quickly, human behaviour was not so much of a factor.  Yes, patients were isolated once sick, and people mostly stopped shaking hands, but most of life continued as normal. It was the nature of the virus that it put few demands on human behaviour. 

[Ausmumof3]

24 minutes ago, caffeineandbooks said:

The flu is not a pandemic, it is endemic.  It's a disease that's always around, and always affects a roughly similar number of people.  It would be an epidemic if it suddenly became more intense in a particular area and infected or killed many more people than before.  It would be a pandemic if, like the 1918 flu or the current virus, there was an intense outbreak across national borders.

Perhaps if Norman Swann had been writing his thoughts down and reflecting on them before publication, instead of firing off whatever came into his head in a podcast, he would have chosen a more nuanced view like @Bootsie 🙂 You need the right interface between the virus' characteristics and normal human behaviour for a pandemic to occur.

I’m sure he would because he’s pretty thoughtful generally.  And I probably didn’t get the whole context.

I also wonder if as doctors and epidemiologists it’s a way to remind themselves because they’re more likely to focus on the biology.  Because if your deep in the biology side of things it’s easy to assume that once people know the science of the virus they will follow it instead of recognising that human behaviour is a whole science in itself.

[vonfirmath]

7 minutes ago, Ausmumof3 said:

I’m sure he would because he’s pretty thoughtful generally.  And I probably didn’t get the whole context.

I also wonder if as doctors and epidemiologists it’s a way to remind themselves because they’re more likely to focus on the biology.  Because if your deep in the biology side of things it’s easy to assume that once people know the science of the virus they will follow it instead of recognising that human behaviour is a whole science in itself.

My husband likes to say that economics is the science of human behavior. It certainly can be applied that way and not just to finances.

 

[Bootsie]

36 minutes ago, Corraleno said:

I agree with the statement. He's not saying that biology has zero effect on outcome, just that it's the "least important" compared to behavioral issues. Sweden and Norway provide a pretty dramatic illustration of that: you have genetically and demographically similar populations (so there aren't biological factors there that would necessarily predispose one country to a higher death rate) and yet the exact same virus has killed 7500 Swedes and 380 Norwegians. Per capita, Sweden's death rate is more than 10 times higher than Norway's. Sweden didn't get a mutant strain that's 10 times deadlier, the difference is behavior.

I have recently seen some research that suggests that the differences in Norway and Sweden are more pronounced than at first glance.  Things such as Sweden has a much larger immigrant population; 1/3 of the residents of Sweden have at least one parent born abroad.  These immigrants in Sweden are much more likely to live in multigenerational households and densely populated areas.  I am not sure if living conditions like that are classified as "behavior", or if behavior here is referring to behavioral response to the presence of the virus.  

[Ausmumof3]

4 minutes ago, Bootsie said:

I have recently seen some research that suggests that the differences in Norway and Sweden are more pronounced than at first glance.  Things such as Sweden has a much larger immigrant population; 1/3 of the residents of Sweden have at least one parent born abroad.  These immigrants in Sweden are much more likely to live in multigenerational households and densely populated areas.  I am not sure if living conditions like that are classified as "behavior", or if behavior here is referring to behavioral response to the presence of the virus.  

I think it references everything. Availability of health care, poverty, availability of sick leave, living density, willingness of people to work together and cooperate.

[Bootsie]

50 minutes ago, Corraleno said:

I agree with the statement. He's not saying that biology has zero effect on outcome, just that it's the "least important" compared to behavioral issues. Sweden and Norway provide a pretty dramatic illustration of that: you have genetically and demographically similar populations (so there aren't biological factors there that would necessarily predispose one country to a higher death rate) and yet the exact same virus has killed 7500 Swedes and 380 Norwegians. Per capita, Sweden's death rate is more than 10 times higher than Norway's. Sweden didn't get a mutant strain that's 10 times deadlier, the difference is behavior.

The issue I have with the statement is the bolded "“Pandemics, the biology of a pandemic is the least important part of it, it's how we behave that creates a pandemic.”"  How deadly a pandemic is in one place relative to another is likely to be highly related to behavior.  Many health issues are related to behavior--many simply to what we eat and drink.  But it seems to me that it is the biology that creates the pandemic.  A sudden change in behavior did not occur that caused this pandemic.  

[bookbard]

I'll disagree with both sides, lol.

Yes, it's not just the biology of the virus (ie, the scientists can understand the virus very well, and yet it will spread).

No, it's not just individual behaviour. As I've said before, Swedish people aren't 'worse people' than Norwegian; American people aren't 'worse people' than Taiwanese. 

It is up to the government response. Do they pay people to stay at home so they don't have to go out? Do they fine people who refuse masks or sneak across borders? Those leadership decisions led to the virus being extinguished (or whatever the word is) in Victoria (Vic, Australia). 

I don't think it's a big mystery, we know how humans work; we do the best we can. It is the job of governments to support people to do the best they can. 

[Corraleno]

17 minutes ago, Bootsie said:

I have recently seen some research that suggests that the differences in Norway and Sweden are more pronounced than at first glance.  Things such as Sweden has a much larger immigrant population; 1/3 of the residents of Sweden have at least one parent born abroad.  These immigrants in Sweden are much more likely to live in multigenerational households and densely populated areas.  I am not sure if living conditions like that are classified as "behavior", or if behavior here is referring to behavioral response to the presence of the virus.  

I can't find comparable figures on immigration for  Norway, because all the stats I can find only count immigrants and those who were born in Sweden but have two immigrant parents and 4 non-Norwegian grandparents. Aparently they don't consider someone as having an "immigrant background" if one parent was born in  Norway. So according to those definitions, 18% of Norwegian residents were either born abroad or both their parents were born abroad, and the figure is 33% in Oslo. So the demographics are probably not all that different — certainly not different enough to account for more than a fraction of the vastly higher death rate in Sweden.

 

[Not_a_Number]

1 hour ago, caffeineandbooks said:

The flu is not a pandemic, it is endemic.  It's a disease that's always around, and always affects a roughly similar number of people.  It would be an epidemic if it suddenly became more intense in a particular area and infected or killed many more people than before.  It would be a pandemic if, like the 1918 flu or the current virus, there was an intense outbreak across national borders.

Perhaps if Norman Swann had been writing his thoughts down and reflecting on them before publication, instead of firing off whatever came into his head in a podcast, he would have chosen a more nuanced view like @Bootsie 🙂 You need the right interface between the virus' characteristics and normal human behaviour for a pandemic to occur.

Depends how you define a pandemic. For example, here’s one plausible definition:

 

A pandemic is defined as “an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people”. The classical definition includes nothing about population immunity, virology or disease severity.

 

By that definition, the flu causes pandemics. You could argue that’s not the RIGHT definition, but what is the right definition?

[Corraleno]

17 minutes ago, Bootsie said:

The issue I have with the statement is the bolded "“Pandemics, the biology of a pandemic is the least important part of it, it's how we behave that creates a pandemic.”"  How deadly a pandemic is in one place relative to another is likely to be highly related to behavior.  Many health issues are related to behavior--many simply to what we eat and drink.  But it seems to me that it is the biology that creates the pandemic.  A sudden change in behavior did not occur that caused this pandemic.  

If a new disease emerges and is quickly contained, it will never become a pandemic to begin with. What transforms a viral outbreak into an actual pandemic is that it's spread over a wide geographic area by human behavior — people fly to other countries, meet in large groups, shake hands, have parties, sing and dance, hug and kiss each other, etc. The deadliest virus on earth can't cause a pandemic if it never leaves a petrie dish. 

[Bootsie]

3 minutes ago, Corraleno said:

I can't find comparable figures on immigration for  Norway, because all the stats I can find only count immigrants and those who were born in Sweden but have two immigrant parents and 4 non-Norwegian grandparents. Aparently they don't consider someone as having an "immigrant background" if one parent was born in  Norway. So according to those definitions, 18% of Norwegian residents were either born abroad or both their parents were born abroad, and the figure is 33% in Oslo. So the demographics are probably not all that different — certainly not different enough to account for more than a fraction of the vastly higher death rate in Sweden.

 

This Striking settlement pattern differences among immigrants in Norway and Sweden (sciencenorway.no) doesn't provide percentage of population that are immigrant numbers, but here is one article discussing differences in immigration patterns (this article is pre-COVID so it is not being used to explain COVID differences).  Not only does it point to more immigrants in Sweden, but a difference in that in Sweden they are more congregated in more densely populated rental areas.  

A large percentage of the COVID deaths in Stockholm (40%) and within Sweden (18%) come from the Somalian population. When Religion and Culture Kill: COVID-19 in the Somali Diaspora Communities in Sweden – Homeland Security Today (hstoday.us). Yet, that population is only about 0.5% of the Swedish population.  

 

[wathe]

34 minutes ago, Not_a_Number said:

Depends how you define a pandemic. For example, here’s one plausible definition:

 

A pandemic is defined as “an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people”. The classical definition includes nothing about population immunity, virology or disease severity.

 

By that definition, the flu causes pandemics. You could argue that’s not the RIGHT definition, but what is the right definition?

I always understood endemic to mean that a disease occurs at a baseline level in a particular region, and is restricted to that region.  Implying that there are other regions that don't have the disease (eta don;t have the disease in a sustained way, not that there are never cases).  Ie malaria is endemic to the tropics.  No such thing as world-wide endemic anything - that would be self-contradictory.

Pandemic flu is generally understood to be a new strain that spreads world-wide, and makes more people sicker than usual seasonal flu.  H1N1 of 2009 is an example.  Usual seasonal flu is not generally described as pandemic.

I think part of the definition of pandemic has to include the idea of a new or novel pathogen (ETA or strain) that spreads world-wide.   For example, AIDS was classed as pandemic (it was new and novel), but now WHO calls it epidemic (it's not new anymore).  The numbers of global cases aren't better than they've been in the past, I don't think, but they have become somewhat more stable over time, I think.  (I am do not have data to support this, this is my impression only)

Edited December 13, 2020 by wathe

[Corraleno]

16 minutes ago, Not_a_Number said:

Depends how you define a pandemic. For example, here’s one plausible definition:

 

A pandemic is defined as “an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people”. The classical definition includes nothing about population immunity, virology or disease severity.

 

By that definition, the flu causes pandemics. You could argue that’s not the RIGHT definition, but what is the right definition?

And there have been numerous worldwide influenza outbreaks that were explicitly labeled as pandemics, like Asian flu in the 1950s, Hong Kong flu in the 60s, and Swine Flu in 2009. Obviously "flu" isn't a single disease any more than coronaviruses are a single disease, and there are new mutations and new strains every year. There was an especially virulent strain that circulated in 2017-18 that killed more than 60,000 in the US. That was more widespread and deadly than many other diseases that are labeled as pandemics, but we're so used to "flu pandemics" that we don't label them as such.

[Not_a_Number]

7 minutes ago, wathe said:

Pandemic flu is generally understood to be a new strain that spreads world-wide, and makes more people sicker than usual seasonal flu.  H1N1 of 2009 is an example.  Usual seasonal flu is not generally described as pandemic.

Yes, I know 🙂. But I wonder if that’s partially because we take severity into account as well as range? Truth be told, I don’t think there IS a single standard definition of a pandemic...

[Corraleno]

13 minutes ago, Bootsie said:

This Striking settlement pattern differences among immigrants in Norway and Sweden (sciencenorway.no) doesn't provide percentage of population that are immigrant numbers, but here is one article discussing differences in immigration patterns (this article is pre-COVID so it is not being used to explain COVID differences).  Not only does it point to more immigrants in Sweden, but a difference in that in Sweden they are more congregated in more densely populated rental areas.  

A large percentage of the COVID deaths in Stockholm (40%) and within Sweden (18%) come from the Somalian population. When Religion and Culture Kill: COVID-19 in the Somali Diaspora Communities in Sweden – Homeland Security Today (hstoday.us). Yet, that population is only about 0.5% of the Swedish population.  

 

Unless you believe that Somalis carry some genetic or biological factor that makes them 80 times more likely to die of covid, then the reason for the higher death rate is... behavior.  Which is exactly the point that Norman Swann was making.

[Spy Car]

15 minutes ago, Bootsie said:

This Striking settlement pattern differences among immigrants in Norway and Sweden (sciencenorway.no) doesn't provide percentage of population that are immigrant numbers, but here is one article discussing differences in immigration patterns (this article is pre-COVID so it is not being used to explain COVID differences).  Not only does it point to more immigrants in Sweden, but a difference in that in Sweden they are more congregated in more densely populated rental areas.  

A large percentage of the COVID deaths in Stockholm (40%) and within Sweden (18%) come from the Somalian population. When Religion and Culture Kill: COVID-19 in the Somali Diaspora Communities in Sweden – Homeland Security Today (hstoday.us). Yet, that population is only about 0.5% of the Swedish population.  

 

Subtract the Somali dead you still have 6,150 Swedish dead vs 380 Norwegians.

That's an appalling record.

At nearly 300,000 we should be deeply ashamed of this country's response to Covid. We have a behavior problem, for sure.

Bill

 

[TravelingChris]

1 hour ago, vonfirmath said:

My husband likes to say that economics is the science of human behavior. It certainly can be applied that way and not just to finances.

 

I call economics the science of human choices.  Because yes, it can be used very effectively in other fields than monetary.

[wathe]

12 minutes ago, Not_a_Number said:

Yes, I know 🙂. But I wonder if that’s partially because we take severity into account as well as range? Truth be told, I don’t think there IS a single standard definition of a pandemic...

I think a bit of a continuum, I think - the edges are blurred.  But I think the key features for a pandemic are novel strain, more people sick, sicker than usual, and world-wide.

Maybe I'm wrong though.  Something that's not new, but previously obscure, might go pandemic (I'm thinking like Ebola) maybe?

Edited December 13, 2020 by wathe

[Bootsie]

17 minutes ago, Corraleno said:

If a new disease emerges and is quickly contained, it will never become a pandemic to begin with. What transforms a viral outbreak into an actual pandemic is that it's spread over a wide geographic area by human behavior — people fly to other countries, meet in large groups, shake hands, have parties, sing and dance, hug and kiss each other, etc. The deadliest virus on earth can't cause a pandemic if it never leaves a petrie dish. 

People flying to other countries, meeting in large groups, shaking hands, having parties, singing, dancing, hugging and kissing can't create a pandemic without a virus.  Those behaviors have taken place every day for years, many of centuries, without leading to a pandemic in MOST situations.  It is the introduction of the virus to that existing behavior that allows for a pandemic to be created. 

I would think that you could have a mosquito-or another animal--spread a virus and if the virus was wide enough spread through the animal population you could have enough people infected for a pandemic to occur that was not related to human behavior.   

[Bootsie]

9 minutes ago, Corraleno said:

Unless you believe that Somalis carry some genetic or biological factor that makes them 80 times more likely to die of covid, then the reason for the higher death rate is... behavior.  Which is exactly the point that Norman Swann was making.

I don't know if there are genetic or biological factors at play.  My point is that I am not sure that comparing Norway and Sweden is comparing as genetically and demographically similar populations as what they appear to be at first glance. 

[vonfirmath]

5 minutes ago, Bootsie said:

People flying to other countries, meeting in large groups, shaking hands, having parties, singing, dancing, hugging and kissing can't create a pandemic without a virus.  Those behaviors have taken place every day for years, many of centuries, without leading to a pandemic in MOST situations.  It is the introduction of the virus to that existing behavior that allows for a pandemic to be created. 

I would think that you could have a mosquito-or another animal--spread a virus and if the virus was wide enough spread through the animal population you could have enough people infected for a pandemic to occur that was not related to human behavior.   

This was the case for bubonic plague -- carried by fleas. Bubonic plague: the first pandemic | Science Museum

[TravelingChris]

6 minutes ago, Corraleno said:

Unless you believe that Somalis carry some genetic or biological factor that makes them 80 times more likely to die of covid, then the reason for the higher death rate is... behavior.  Which is exactly the point that Norman Swann was making.

There are 5 genes so far that have been located that confer extra vulnerability to having severe cases of COVID.  I don't know who is looking at what genes provide protection though I do know that a gene I have that causes my ankolysing spondyloses and others Crohns. Psoriasis, Reactive Arthritis, etc, (HLAB27) also gives us extra protection a few types  of viruses including flu, COVID, and a lot of colds.  But that gene is less common in people from sub-saharan Africa and also some of the Native American tribes.

Somalia is south of Sahara so just talking about one protective factor, they probably don't have that.  As to the five genes that make COVID more dangerous, I have no idea about ethnic representations of those factors.  

[Bootsie]

10 minutes ago, TravelingChris said:

I call economics the science of human choices.  Because yes, it can be used very effectively in other fields than monetary.

The textbook definition of economics is often "the allocation of scarce resources".  Because resources are scarce we have to make choices--whether that resource is water, time, oil, diamonds, etc.  Much of economics isn't really about money.  

[TravelingChris]

8 minutes ago, Bootsie said:

People flying to other countries, meeting in large groups, shaking hands, having parties, singing, dancing, hugging and kissing can't create a pandemic without a virus.  Those behaviors have taken place every day for years, many of centuries, without leading to a pandemic in MOST situations.  It is the introduction of the virus to that existing behavior that allows for a pandemic to be created. 

I would think that you could have a mosquito-or another animal--spread a virus and if the virus was wide enough spread through the animal population you could have enough people infected for a pandemic to occur that was not related to human behavior.   

I don't know how far ZIka spread, but that was mosquitos.  West Nile is mosquitos and has spread across continents.  Dengue fever is also has spread far.  And we can go on and on about animal spread of diseases.  

[Bootsie]

3 minutes ago, vonfirmath said:

This was the case for bubonic plague -- carried by fleas. Bubonic plague: the first pandemic | Science Museum

I think Bubonic plague is a bacteria.   There are definitely historic examples of bacterial outbreaks that rose to the level of being a pandemic that were spread by non-human animals or by water.  I do not know if there have been any documented viral pandemics spread that way.  Have there been?  I do think it could plausibly occur.  

[TravelingChris]

No I don't agree with the statement at all.  Why?  Because there are all too many cases of people doing everything that health officials tell them to do and they get COVID.  Furthermore, I think that talking about immediate deaths from COVID is too simplistic.  Because I believe and so do many medical professionals, that the delays in medical care and screenings that are occuring are going to cause increased death rates in other diseases and conditions.  All too many people are skipping necessary vaccines, general screenings, visits to physicians, etc, etc, etc.  I have heard of people who are stopping taking medications against the advice of their doctors because they are so scared of the virus.   I have heard of people wanting to delay very necessary surgeries and procedures because they are so afraid of COVID.  

And also, the news just keeps talking about COVID like it is one disease. Apparently there are some different strains and some are more deadly than others.  

Then there is the fact that some of us are already taking medicines that are used in treating COVID and the fact that we are taking these medicines may be protecting us --- yes, that is a behavior but one that has nothing to do with COVID>  

The most important fact of this disease is its biology-- specifically that is a very small virus and spreads through the air.  It isn't just spread by droplets like many viruses.  It is in the air.  And most people do not have very protective masks which is why even in cities where everyone is masking, you can still have a lot of cases.

[Corraleno]

14 minutes ago, TravelingChris said:

I don't know how far ZIka spread, but that was mosquitos.  West Nile is mosquitos and has spread across continents.  Dengue fever is also has spread far.  And we can go on and on about animal spread of diseases.  

Zika and West Nile have never been considered pandemics. I don't know about dengue fever. But I think it was pretty clear that Swann was talking about pandemic diseases with human-human transmission, not diseases that cannot be transmitted without an animal vector. 

[Spy Car]

2 hours ago, Bootsie said:

The issue I have with the statement is the bolded "“Pandemics, the biology of a pandemic is the least important part of it, it's how we behave that creates a pandemic.”"  How deadly a pandemic is in one place relative to another is likely to be highly related to behavior.  Many health issues are related to behavior--many simply to what we eat and drink.  But it seems to me that it is the biology that creates the pandemic.  A sudden change in behavior did not occur that caused this pandemic.  

 It was a lack of change in behavior that caused the pandemic. 

How is that not plainly obvious?

Bill

 

 

[Spy Car]

48 minutes ago, TravelingChris said:

No I don't agree with the statement at all.  Why?  Because there are all too many cases of people doing everything that health officials tell them to do and they get COVID.  Furthermore, I think that talking about immediate deaths from COVID is too simplistic.  Because I believe and so do many medical professionals, that the delays in medical care and screenings that are occuring are going to cause increased death rates in other diseases and conditions.  All too many people are skipping necessary vaccines, general screenings, visits to physicians, etc, etc, etc.  I have heard of people who are stopping taking medications against the advice of their doctors because they are so scared of the virus.   I have heard of people wanting to delay very necessary surgeries and procedures because they are so afraid of COVID.  

And also, the news just keeps talking about COVID like it is one disease. Apparently there are some different strains and some are more deadly than others.  

Then there is the fact that some of us are already taking medicines that are used in treating COVID and the fact that we are taking these medicines may be protecting us --- yes, that is a behavior but one that has nothing to do with COVID>  

The most important fact of this disease is its biology-- specifically that is a very small virus and spreads through the air.  It isn't just spread by droplets like many viruses.  It is in the air.  And most people do not have very protective masks which is why even in cities where everyone is masking, you can still have a lot of cases.

The FDA has warned people not to take hydroxychloroquine and pushing it on this forum is reckless and irresponsible IMO.

Bill

[Ausmumof3]

1 hour ago, vonfirmath said:

This was the case for bubonic plague -- carried by fleas. Bubonic plague: the first pandemic | Science Museum

Well true although I always learned that people throwing rubbish in the streets meant more rats and more fleas so arguably human behaviour was a factor.  But my knowledge of that is not in depth, so I may be wrong.

[Ausmumof3]

Another factor where I think human behaviour maybe came in to it was in the initial stages where the virus appears to have got started and distributed due to it being covered up in Wuhan.  And presumably the initial jump from animal species was in some way driven by human behaviour although we still don’t know how of course.

 

[Ausmumof3]

I figured it was kind of unfair to Dr Swan to quote him without the context so here’s the transcript from the interview the first time I heard him say it

https://www.abc.net.au/radio/programs/coronacast/it-is-coronavirus-do-over-time-what-would-we-do-differently/12961254

[Pawz4me]

4 hours ago, Spy Car said:

The FDA has warned people not to take hydroxychloroquine and pushing it on this forum is reckless and irresponsible IMO.

Bill

@TravelingChrismay be referring to something other than HCQ. Other medications that are used to treat autoimmune inflammatory conditions have shown promise in reducing the severity of Covid, particularly in preventing the development of cytokine storms. TNF inhibitors are one example; there may be others. My rheumatologist, who is a careful, sane practitioner and who was very much against the HCQ fiasco, believes that the studies on TNF inhibitors show promise.

[wathe]

10 hours ago, Ausmumof3 said:

Well true although I always learned that people throwing rubbish in the streets meant more rats and more fleas so arguably human behaviour was a factor.  But my knowledge of that is not in depth, so I may be wrong.

Plague is a good example of human behaviour (or rather human social conditions)  causing pandemics*, I think.  Squalor and crowded conditions -> more rats -> more fleas -> more plague.  And the rats traveled by ship.  Conditions at the time were ripe for plague to take-off in human populations.  Plague is still out there, but will never likely be pandemic again because of changes in human factors (sanitation, less crowding being the most important, and also knowledge/antibiotics, of course).  The disease hasn't changed.  The vectors haven't changed either; rats and fleas are the same as they ever were.

Even the mosquito borne diseases like Zika and WNV have human factors.  Zika, climate change.  West Nile, airplanes.

Though I suppose historical plague was epidemic - I don't think it was truly world-wide.

Edited December 13, 2020 by wathe

[Corraleno]

Here is the full quote from the transcript:

"The biology of a pandemic organism is almost the least important part of the pandemic. Lots of different organisms can cause pandemics, it's human behaviour that causes a pandemic. It's the way we live, the way we act, the way politics works, the way international travel works, that's what creates a pandemic."

 

[Not_a_Number]

11 minutes ago, Corraleno said:

Here is the full quote from the transcript:

"The biology of a pandemic organism is almost the least important part of the pandemic. Lots of different organisms can cause pandemics, it's human behaviour that causes a pandemic. It's the way we live, the way we act, the way politics works, the way international travel works, that's what creates a pandemic."

 

That seems pretty unobjectionable.