Have a wonderful holiday!
Also some good news: Boris Johnson is out of the hospital. He will be recuperating further at Chequers, the official country residence of British prime ministers.
Have a wonderful holiday!
Also some good news: Boris Johnson is out of the hospital. He will be recuperating further at Chequers, the official country residence of British prime ministers.
What are you doing to keep yourselves busy?
For me it’s rather simple. I still do a lot of reading and writing and thinking (hopefully not in that exact order). That’s what I do each day anyway, and it takes up a lot of time.
As the weather gets nicer, I feel drawn to the outside more and more. But even in winter I like to walk outside and try to do it almost every day if it’s not stormy.
Walking outside is a bit more problematic these days, although perhaps even more necessary than ever. Sunshine! Light! Fresh air! Exercise! I crave these things.
But it’s not always easy to keep the proper distance. I get nervous when I hear footsteps behind me, for example. I’m a pretty fast walker, but I’m small and I don’t have a long stride, so I’m not so very hard to overtake if someone with a long stride is walking fast towards me. And if they’re behind me I can’t see them and don’t know if I can trust them to keep a good distance. It feels absurd, but sometimes if the opportunity is there I make a ninety-degree turn and go some other way – where almost inevitably I run into some other person who presents a dilemma of some sort.
And it’s not that I’m walking in a crowded area – I’m not. But nice weather draws forth some people, and with everyone at home it can happen at any time of day.
Yesterday I was walking down a fairly wide path, at least twelve feet or so across, when I heard the sound of a bicycle coming towards me from behind. I moved way to the side of the path and the rider passed me, but he was riding close to the middle of the road. And then he stopped abruptly, making his tires squeal, and turned around to face me. I have no idea why he did that – he didn’t say a word – but it unnerved me.
And then it unnerved me that it had unnerved me.
Anyway, one of my favorite activities – usually late at night – is to binge watch YouTube. Last night I discovered a few more song parodies for the pandemic and the shutdown. It warms the cockles of my heart that people are so creative.
This is one of my very favorites:
The original unfunny non-corona version:
There are so many other COVID-19 song parodies I could probably post one a day for the rest of the shutdown and not even begin to run out of them.
I do plan to post quite a few more as time goes on.
Sorry, I don’t have an answer. But I have some thoughts on it.
First of all, we have to re-open, although doing it in stages and to different degrees in different locations is fine with me. Not only is it necessary for the economy, but for people’s mental health as well.
But here’s one possibility, as expressed by commenter “Joe”:
People seem to not appreciate that flattening the curve doesn’t eliminate deaths, it just spreads them out. It’s quite likely that when Norway and Denmark loosen their restrictions they will catch up [to Sweden].
Without a vaccine, deaths won’t stop until we reach herd immunity at approx 70% of the population.
No, deaths won’t stop. But there are quite a few things that might be hopeful developments. The shutdown was instituted in order to buy time, and the delay can be helpful in multiple ways. It would be ruinous were it to go on long enough to make a working vaccine or to achieve herd immunity. But the shutdown bought time for learning more about the way the disease works, and what might impact it and reduce its severity and/or slow its spread. With some of the following elements in place, it is very possible the situation will be significantly improved from what it would have been before:
(1) The development and testing of successful drug treatments, and the production of sufficient amounts of these drugs. This is not only a US effort but a global one, with sharing of data and progress worldwide.
(2) Other helpful treatment methods (such as, for example, patients lying prone instead of supine) emerging with time and increasing experience in dealing with COVID patients.
(3) As more people contract mild cases and become immune, any disease becomes at least somewhat more difficult to spread as it becomes more difficult for the virus to find new victims – and that starts to happen even before herd immunity develops.
(4) When the health care system is overwhelmed, other methods of approach such as contact tracing are difficult to put into practice. When there are fewer cases all at once, contact tracing and isolation of contacts can be more comprehensive and therefore more effective. It helps to have quicker and more widespread testing, which we now have but didn’t have in the earlier stages of the pandemic.
(5) If we keep all the following in place – fairly widespread mask-wearing and handwashing, some social distancing, and a travel ban to and from “hot” areas – it should slow down transmission and decrease deaths in those who have contracted the disease, without overly overburdening hospitals. At the outset, those things were not in place.
Alex Berenson has been active lately on some of the Fox opinion shows, and every now and then I’ve watched his appearances. He’s an interesting guy; I wrote about him previously in this post about marijuana and its effects.
Berenson has some observations about the COVID-19 data that dovetail with some things I’ve noticed as well [emphasis mine]:
…Berenson…says that outside of places like New York there has not been a national health crisis that was predicted — nor are there signs that the level of lockdown in various states has made a difference.
“Aside from New York, nationally there’s been no health system crisis. In fact, to be truly correct there has been a health system crisis, but the crisis is that the hospitals are empty,” he said. “This is true in Florida where the lockdown was late, this is true in southern California where the lockdown was early, it’s true in Oklahoma where there is no statewide lockdown. There doesn’t seem to be any correlation between the lockdown and whether or not the epidemic has spread wide and fast.”
He has also argued, in lengthy Twitter threads, that the drop in cases seen in various states has come before lockdowns would have had an impact — since it takes a few weeks for social distancing measures to take effect due to the window between infection and symptoms…
Berenson says the correct response in the initial days of the crisis would not have been to do nothing, but instead to adopt a more measured and targeted approach.
“There was incredible pressure to do something … so these lockdowns all cascaded, every governor tried to outdo the next. And no one stopped and said ‘OK what about Japan, they don’t seem to have a terrible epidemic, they wear masks, maybe we should wear masks,” he said.
He said other measures such as protecting individuals particularly at risk, and even things such as banning large gatherings such as concerts and sporting events could have been appropriate. But now he fears it may be too late for officials to say they overreacted.
At this point I’m in agreement with Berenson, and I think I always have been.
However, I think that the effect on the economy would have been bad anyway, although not nearly as bad as it has been. Hotels and restaurants would have suffered anyway, as people would have been afraid and most would have stayed away. Hair salons and other person-to-person service businesses would also have been hurt, I’m almost sure. Doctors were already warning not to come in if the visit wasn’t essential.
Some things happen regardless of what the government does. Fear is a powerful motivator, and it was already in place before the reaction from government became so draconian. Sports events were already canceled and certain businesses were already having employees work from home. How long could life as usual gone on?
The nearly-total shutdown has also been a chance for local governments to flex their muscles and let loose with their inner totalitarian impulses. That’s an ominous sign, but perhaps another useful one. We get to see how easy it is to slip into more and more government control, particularly in a time of widespread fear. COVID-19 is a great teacher, although a harshly cruel one.
[Hat tip for Berenson article: commenter Artfldgr.]
Finally! Something on which we can agree.
Americans in both parties blame China:
Republicans and Democrats now largely agree that the Chinese government bears responsibility for the spread of the pandemic, that it can’t be trusted on this or any other issue, and that the U.S. government should maintain a tough position on China on trade and overall, especially if Beijing again falters in its commitments.
“It’s as much of a consensus issue as you can get in today’s divided world,” said Mark Penn, chairman of the Harris Poll…
Of the nationally representative sample of 1,993 American adults Harris surveyed online between April 3 and April 5, a net total of 23 percent said Xi, the Chinese president, was a trustworthy source of information related to the covid-19 outbreak, with Republicans and Democrats closely aligned.
That’s where the unity ends. We also have this:
The White House and the U.S. media rated 53 and 60 percent in trustworthiness, respectively, with Republicans tending to support the former and Democrats the latter.
Is it because they’re Democrats that they trust the media? Or is it because they trust the media that they’re Democrats?
The larger issue of not trusting China shows Trump’s prescience – or some would say his intuition. One of the pillars of his campaign and administration has been that China has – not to be too delicate about it – screwed us. He wasn’t talking about the virus, he was talking about money and trade and things connected with money and trade. But the current health crisis has only highlighted how right he was.
I believe that it has also made it clear to more people that many politicians and pundits of the liberal/left persuasion were and still are wrong about China. It may even be becoming clear to more people that the error is not just a cognitive one, but a stance motivated by self-interest – in other words, money.
There’s the Bidens, for example. And then there’s this sort of thing (from 2018):
Meanwhile, in the US, lobbyists paid by Chinese-backed institutions are cultivating vocal supporters known as “third-party spokespeople” to deliver Beijing’s message, and working to sway popular perceptions of Chinese rule in Tibet. China is also wooing journalists from around the world with all-expenses-paid tours and, perhaps most ambitiously of all, free graduate degrees in communication, training scores of foreign reporters each year to “tell China’s story well”…
The state-run English-language newspaper China Daily has struck deals with at least 30 foreign newspapers – including the New York Times, the Wall Street Journal, the Washington Post and the UK Telegraph – to carry four- or eight-page inserts called China Watch, which can appear as often as monthly. The supplements take a didactic, old-school approach to propaganda; recent headlines include “Tibet has seen 40 years of shining success”, “Xi unveils opening-up measures” and – least surprisingly of all – “Xi praises Communist party of China members.”…
In September (2018), Donald Trump criticised this practice, claiming China was pushing “false messages” intended to damage his prospects in the midterm elections…
As Beijing and its proxies extend their reach, they are harnessing market forces to silence the competition. Discourse power is, it seems, a zero-sum game for China, and voices that are critical of Beijing are co-opted or silenced, left without a platform or drowned out in the sea of positive messaging created by Beijing’s own “borrowed” and “bought” boats.
It’s a long article, but I recommend that you read the whole thing.
Trump’s emphasis on COVID-19 as “Chinese” was widely criticized as xenophobic and racist. In addition to being a reference to the virus’ origin as well as the initial Chinese coverup that facilitated its spread, he was (I believe) trying to underline China’s role in order to increase distrust of that country. I think, despite all the criticism he received, that he succeeded.
Americans seem to not be buying the Chinese line these days. COVID-19 has had very few benefits, but that may be one of them.
Regular commenter “Sharon W” is allowing me to share her COVID-19 story in her own words, which follows.
The last week of my life can’t be adequately described in words…
My husband (despite no comorbidites, normal weight, healthy, active man) never moved to a place of marked improvement. We both ran fevers ranging from 99.5 to 102 on successive days. Whereas I was able to maintain a healthy oxygen saturation level, he was not. On advice of our doctor I tried to bring him to the ER last Thursday. I had to leave him at the COVID 19 tent entry and was told to go home. I tossed him his phone and told him to call me. Making it quick, his O2 saturation levels showed 3 successive normals (after a prior full day of successive 88’s) so the doctor told him, go home drink lots of fluids. Our little device at home also recorded the 96 so it wasn’t faulty.
He never rallied, had no energy to do anything but sleep. His appetite was still non-existent, trying to force himself. (Watching someone feed himself when there is no appetite is a special kind of suffering.) Liquids were also a problem. I spend the days cleaning our bed linens, and doing my best with him. I had the Paramedics out on Saturday because of the O2 but once again his level rose to a 94 (anomaly). We were encouraged to heal at home. The following day with levels once again too low, I called the Paramedics. No high outlier this time. They offered to take him if I wanted (and he had acquiesced at this point having previously fought all hospital visits as our sons said for our sake he must relent). The Paramedic told me he wouldn’t necessarily be admitted just because they brought him. Also that they would need to spend 1-1/2 hours cleaning the ambulance should they do so. I opted to drive him myself if needed. Later that afternoon despite his best efforts to drink the Pedialyte and eat something, when I checked he was at 79!!! I rushed him over and dropped him at that tent. It took a few moments for an attendant. I was prepared for this because of my first encounter on Thursday: when you drop a loved one off at the COVID-19 unit, you have just separated yourself from their care. It is 100% out of your hands. I went home and prepared a place to sleep and begin taking care of my own case. My son called the next day (Monday).
My husband had been placed in the Telemetry Unit of the COVID-19 wing. Only yesterday did I speak to him for the first time via phone. Because of the updates my son had been receiving from the nurse I had a terribly false sense of where he is in his recovery. So when I heard his voice, my heart fell. He was the same weak kitten I’d been taking care of for those 10 days. Apparently he had presented with pneumonia so they took him off the z pak and zinc and hit him with the big guns. It took care of the pneumonia but he feels “beat up” and still no appetite. They tell him, “eat for your family”.
He was put on the arithromycin, zinc and hydroxychloroquine, for what was to be a 5 day regimen. After 1 day, the head doctor called me in the morning. He ordered another xray and the pneumonia had advanced. Doug was on maximum 15L of oxygen via the Facemask and his saturation level still lagged. By day 3 (today) it was suggested that he go on Actemra to try and deal with the inflammation and keep him from the ventilator…
As for me, I had my first night without night sweats last night. After running a fever for 11 days, I recorded a normal this morning. I have a residual cough, not unusual for me post-cold. If my normal temperature continues I should be able to emerge from the self-quarantine come Monday.
…the last 12 days have been unlike anything I have ever experienced. And literally came out of nowhere…many, many people are praying. He needs it.
So that’s the request: prayers for Sharon’s husband’s recovery.
Whenever I see a poll on Trump vs. Biden it amazes me that so many people support Biden. It shows how many people hate Trump with a white-hot passion, because otherwise the number of people supporting Biden would be limited to his immediate family, and maybe not even all of them.
Even when I was a Democrat I considered Biden a mediocrity at best, but now he’s a mediocrity who appears to be in precipitous decline. And yet unless the DNC intervenes – which it very well might – he is slated to become the presidential nominee of the Democratic Party. That it has come to this is phenomenal and a very disturbing sign.
However, I’m convinced that most people checking off that “Biden” box do not consider that he will really be the nominee, and that if he is he won’t really be the one in charge. As long as someone or something stops Trump, a huge number of people would be satisfied. Whether it be a tissue of lies (“Russiagate”) or a doddering old man (Biden) or a virus (COVID), the silver lining in all those clouds is that Trump will be gone from power. The details of who will replace him and/or who will be pulling his strings are not all that important to this group, as long as it’s a suitable liberal/leftist entity or entities.
That is the trillion-dollar question, isn’t it? And we don’t know the answer, although the US is starting to try to find out.
In line with that, take a look at this news from Chicago:
A phlebotomist working at Roseland Community Hospital said Thursday that 30% to 50% of patients tested for the coronavirus have antibodies while only around 10% to 20% of those tested have the active virus.
Sumaya Owaynat, a phlebotomy technician, said she tests between 400 and 600 patients on an average day in the parking lot at Roseland Community Hospital. Drive-thru testing is from 9 a.m. to noon and 1 to 4 p.m. each day. However, the hospital has a limited number of tests they can give per day.
Owaynat said the number of patients coming through the testing center who appear to have already had coronavirus and gotten over it is far greater than those who currently have the disease.
There are several things there that make me wary, though. The first is that I didn’t think that drive-through centers were testing for antibodies; ordinarily it’s just for the disease. The second is that this is not a random group of people without symptoms. I believe that patients have to be approved by doctors in order to qualify for testing, even drive-through testing.
But also in the article is this extremely interesting – and more seemingly more valid – news:
A recent study of 1,000 people in the Heinsberg District of Bonn, Germany found that 15% of the population had contracted the virus, many unknowingly and without symptoms.
Of those, only 0.37% died from COVID-19, a figure much lower than those previously cited.
Germany is one of the western European countries that has been doing a fair job containing COVID, and so (at least to me) a 15% infection rate at this point is rather high and in a sense rather promising. The more people who are infected and survive without problems, the better it is for the group as a whole because over time the virus should find it harder and harder to spread. On the other hand, it does mean that in the shorter term it will be harder to protect especially vulnerable groups, because for now the illness is so easily spread.
It’s only been tested on a very small number of COVID patients. But those people were all in exceedingly bad shape, and they all survived.
The patients were treated at three different Israeli medical centers for one week under the country’s compassionate use program and were suffering from acute respiratory failure and inflammatory complications associated with COVID-19. Four of the patients also demonstrated failure of other organ systems, including cardiovascular and kidney failure.
Not only have all the patients survived, according to Pluristem, but four of them showed improvement in respiratory parameters and three of them are in the advanced stages of weaning from ventilators. Moreover, two of the patients with preexisting medical conditions are showing clinical recovery in addition to the respiratory improvement.
It’s only a few people, but those are dramatic results because some of those people would ordinarily be expected to die.
Here’s a description of the treatment:
According to Pluristem, the PLX cells are “allogeneic mesenchymal-like cells that have immunomodulatory properties.” Translated, that means that they harness our own immune system’s regulatory T cells and M2 macrophages to prevent overactivation of the immune system. This helps us avoid the symptoms of pneumonia and pneumonitis from becoming fatal.
More details here:
PLX cells are available off-the-shelf and once commercialized, can be manufactured in large scale quantities, offering a key advantage in addressing a global pandemic…
For Pluristem’s compassionate use program, all the seven patients approved for treatment with PLX cells exhibited, prior to treatment, respiratory failure due to ARDS, which is a major cause of mortality and required mechanical ventilation in an ICU. Four of the patients also demonstrated failure of other organ systems, including cardiovascular and kidney failure, indicating critical disease and poor prognosis. Six patients completed one week follow up, while the seventh patient was treated on April 5 2020. Preliminary data following treatment with PLX cells demonstrated a 100% survival rate. Four out of the six (66%) patients who completed one week follow up demonstrated improvement in respiratory parameters. Three out of the six (50%) patients who completed one week follow up are in advanced stages of weaning from ventilators. Pluristem now plans to apply for initiation of a multinational regulated clinical trial program for the potential use of PLX cells in the treatment of patients suffering from complications associated with COVID-19.
A study needs to be fast-tracked in the US.
There’s a reason California is a good choice for such a test:
The team tested 3,200 people at three Bay Area locations on Saturday using an antibody test for COVID-19 and expect to release results in the coming weeks. The data could help to prove another theory, one that believes COVID-19 arrived undetected in California much earlier than previously thought.
As of Tuesday, the state had 374 reported COVID-19 fatalities in a state of 40 million people, compared to New York which has seen 14 times as many fatalities and has a population half that of California. Social distancing could be playing a role but New York’s stay-at-home order went into effect on March 22, three days after California implemented its order.
“Something is going on that we haven’t quite found out yet,” said [Victor Davis] Hanson.
Hanson said he thinks it is possible COVID-19 has been spreading among Californians since the fall when doctors reported an early flu season in the state. During that same time, travel between China and America was unfettered. Some of those visitors even arriving on direct flights from Wuhan, the epicenter of the coronavirus outbreak in China.
It makes a certain amount of sense, particularly if there really was an early flu season in California. However, it would also have to have been a particularly lethal flu season, and I would think that would have gotten more attention.
But the tests will tell the tale. I’m eager to hear the results. It’s hard to be patient with so much on the line.
He’s been moved out of intensive care:
“The Prime Minister has been moved this evening from intensive care back to the ward, where he will receive close monitoring during the early phase of his recovery,” a spokesman said on Thursday. “He is in extremely good spirits.”
I bet he is.
He has been sitting up in bed but could still be out of action for at least a month, according to reports.
For someone like Johnson, backing off from work will be hard. But he needs to be careful not to push himself.
I see it over and over: assertions that COVID-19 is just “a bad flu,” and accusations that those who say that are wrong, wrong, wrong.
Both statements annoy me – but then, maybe I’m just getting testy from being cooped up.
Or maybe I’m not just being testy, because what annoys me is that the phrases “the flu” or even “a bad flu” are rarely defined. They seem to have become protean terms that people use as they see fit.
So first I’d like to give some definitions. For “flu”:
There are two main types of influenza (flu) virus: Types A and B. The influenza A and B viruses that routinely spread in people (human influenza viruses) are responsible for seasonal flu epidemics each year.
Influenza viruses can and do change quite regularly, and the people who make vaccines try (and sometimes fail) to keep up with those changes. But the viruses remain one of those two types.
Note also that word “seasonal.” There is a flu season, and although it drifts around somewhat and varies somewhat in length, it tends to be from later in the fall to sometime in the spring.
This is part of life and happens every year. But some of these seasonal flu seasons are worse than others, so there’s a lot of variation in how many people get sick, how sick they get, how many die, and the age distribution of all of the above.
COVID-19 is a different type of virus, a coronavirus rather than a flu virus. However, just to complicate matters, this particular coronavirus causes symptoms that are very very much like the flu. But we don’t know how seasonal it is. And still another important difference is that we already have vaccines for the flu, and so it’s not so very hard and doesn’t take so very long to transform those vaccines into one for a new flu strain.
That’s not true of coronaviruses. We started to develop a vaccine for the previous one known as SARS (although COVID-19’s official name is “SARS-CoV-2,” just to complicate matters). But the process was never finished because the disease ended up being far more localized than originally thought and therefore the money was never spent to fully develop a vaccine that was considered to be unnecessary. That SARS vaccine work might be helpful in developing a vaccine against COVID, but it’s nothing like the head start we ordinarily have in developing vaccines for new types of flu.
But sometimes a flu becomes a far greater killer than it usually is even in a “bad” year. Sometimes the flu becomes a far more vicious killer around the world. These flu pandemics also vary in deadliness, although they all are nasty. In the 20th century we had three: 1918, 1957, and 1968.
You probably know that 1918 was the worst of all. I’ve written about it before:
How many people died worldwide? Estimates vary, but the most conservative state that the death toll was 25 million. Oher estimates go much higher, up to 70 million or even 100 million.
That’s worldwide, in a time when the population was much smaller than today. The US was by no means the hardest hit, but it’s estimated that we lost about 675,000 Americans back when the US population was somewhat less than a third what is today – so today’s equivalent US death toll would be approximately two million.
That was devastating, and it also was “the flu.” What’s more, that illness tended to work in a way that was somewhat strange for flu: it killed the young and old, which is typical, but it also killed a far greater proportion of young adults in the prime of life.
So there’s no “just” to “just the flu,” unless you specify something like “regular seasonal flu rather than pandemics” – which is a mouthful.
But even regular seasonal flu can be very very bad. We accept it for various reasons, though. One is that we’re used to it. Another is that the media reports on it at times but doesn’t often highlight or spotlight it. Another is that it tends to kill the very old (although COVID does the same in that regard, and yet is very much in the new). What’s more, flu deaths are mostly estimated. It’s a little-known fact (at least, I didn’t know it till recently), but patients – even those who die – are not tested for flu that often.
So all these things have combined to make the terms “flu” and even “seasonal flu” take on an aspect far more benign than they sometimes deserve.
Let’s take an example from the “bad” flu year of 2017-2018. That wasn’t so very long ago, right? So we all should remember, correct? But we don’t; I certainly didn’t, until COVID came along and I started looking this sort of thing up (the article is from early February 2018):
The amount of influenza ravaging the U.S. this year rivals levels normally seen when an altogether new virus emerges, decimating a vulnerable population that hasn’t had a chance to develop any defenses.
It’s an unexpected phenomenon that public health experts are still trying to decode.
And yet it flew under the radar for most of us, although I assume that the CDC, doctors, and hospitals were paying close attention:
The primary type of influenza this year hasn’t changed enough from previous seasons to be considered a novel strain, Schuchat said. The agency’s virologists are studying it to determine if there are any other explanations for why it’s been so hard-hitting…
Deaths from influenza and pneumonia, which are closely tied to each other in the winter months, were responsible for 1 of every 10 deaths last week, and that’s likely to rise, Schuchat said in a conference call Friday. There were 40,414 deaths in the U.S. during the third week of 2018, the most recent data available, and 4,064 were from pneumonia or influenza, according to the CDC data. The number for that week is expected to rise more reports are sent to the agency.
It gets worse. The death toll in future weeks is expected to grow even higher because flu activity is still rising…
That was written on February 10. I don’t have weekly figures for later in the season, but I’m going to assume they went up, although I doubt they ever came to rival what we’ve seen lately with COVID-19. Of course, none of these are exact figures. The flu deaths in 2017-2018 were estimates. And the deaths attributed to COVID-19 may be over- or under-reported as well (are all people with COVID who die being labeled COVID deaths no matter what they may be dying from, and/or are home deaths from COVID not being properly listed as caused by the disease?). But the figures are all we have to go on.
Here’s the CDC report on that 2017-2018 season. You can see the death rate estimates that year per 100,000 people were as follows: for ages 0-4 it was .4 (or 115 total), for ages 5-17 it was 1 (or 528 total), for ages 18-49 it was 2 (or 2803 total), for ages 50-64 it was 10.6 (or 6751 total), for ages over 65 it was 100 (or 50,903 total).
Of course, we didn’t have social distancing edicts back then. And I’m not saying that social distancing is a bad idea now, because I do think that without them, COVID would be killing a lot more people. It’s already killing plenty, and it certainly seems that it’s at least going to be equal to a “bad” flu year even with all these draconian rules in place. But the big (and so far unanswerable) questions are: at what cost? How many more deaths would there have been without the rules that are crippling the economy and causing resultant hardship?
[NOTE: This is Part I of a projected two-or-more-part series on the topic of COVID and flu. My plan is to cover the following: the 1957-1958 “Asian” flu pandemic, the 1968-1969 “Hong Kong” flu pandemic, and the “swine” flu H1N1 pandemic of 2009-2010.]