Whats next for the Swine Flu alert level: 4 or 6?

Level 4 means "Level 4 and lower" ?

From the CDC:

"Sing 'Happy Birthday' to Fight Swine Flu"

http://usgovinfo.about.com/b/2009/05/01/sing-happy-birthday-to-fight-swine-flu.htm

Scientists starting to believe swine flu outbreak won't be so bad

http://news.sympatico.msn.cbc.ca/abc/world/contentposting.aspx?isfa=1&feedname=CBC-WORLD-V3&showbyline=True&date=true&newsitemid=swine-flu-research

@hfl13 Yep level 4 or lower, but i doubt they would drop it two levels at once?

Check out this line up of masked detainees at The Smoking Gun!

http://www.thesmokinggun.com/archive/years/2009/0501093mugs1.html?232

A clear case of Pandemic Panic in my opinion :-)

@meanderinsearcher: while the deadliness of the flu may not be as bad as feared--thank goodness or God or whatever/whoever--pandemic status relates to the ability of the virus to spread from person-to-person in more than one region. It's widely thought that, with that criteria in mind, the WHO may raise the pandemic alert level to Phase 6 as early as this weekend.

WSJ 5/2 @ 1011 EDT (http://online.wsj.com/article/SB124126480414780235.html?mod=googlenews_wsj):

'A growing number of cases in Spain, New Zealand and other countries -- where travelers brought the disease home and could be spreading it to others -- means that sustained transmission of the disease is likely to take hold soon in more countries, Scott Dowell, head of the Centers for Disease Control and Prevention international team, said in an interview Friday. That development -- community outbreaks in more than one region of the world -- would fit the World Health Organization's criteria for its highest global alert level, phase 6. "It's going to happen imminently," he said."

"WHO still believes flu pandemic is imminent"

Michael Ryan, WHO Director of Global Alert and Response, said it remained probable that the alert level would be raised from its current level of 5 to the top of the 6-stage scale. "At the present time I would still propose that a pandemic is imminent, because we are seeing the disease spread," Ryan said. "At this point we have to expect that phase 6 will be reached..."

02 May 2009 @ 15:55:36 GMT (http://www.alertnet.org/thenews/newsdesk/L2710434.htm)

"WHO still believes flu pandemic is imminent"

or

"WHO still believes flu pandemic is imminent?!"

;-)

WHO cares (?)

WHO does.

WHO: Swine flu spread 'not sustained'
May 3, 2009 | BBC News

There is no evidence of the swine flu virus spreading in a sustained way outside North America, a top World Health Organization official says. Dr Michael Ryan, WHO Director of Global Alert and Response, praised European nations' handling of cases and said events did not seem out of control. Mexico has cut its suspected death toll by 75 to 101, indicating the outbreak may not be as bad as initially feared.

The country has ordered a five-day shutdown in a bid to contain the virus. Mexican Health Minister Jose Angel Cordova told the BBC that, based on samples tested, the mortality rate was comparable with that of seasonal flu. Dr Ryan, meanwhile, said that there was "no evidence of sustained community spread outside of North America".

http://news.bbc.co.uk/2/hi/americas/8030859.stm

Oh, who to believe (or is that WHO to believe?):

WHO Expecting to Move to Designate Flu Outbreak as Pandemic (http://www.bloomberg.com/apps/news?pid=20601080&sid=a8eran5FGYrg&refer=asia)
WHO Official Expects to raise Flu Alert to Highest level (http://www.pennlive.com/newsflash/index.ssf?/base/national-4/1241314103215750.xml&storylist=health)
WHO: Highest alert level is likely (http://www.upi.com/Top_News/2009/05/02/WHO-Highest-alert-level-is-likely/UPI-93331241278775/)

Dire warnings were premature, experts suggest
Caution is prudent, officials say, but virus isn’t as lethal as first feared
By TODD ACKERMAN
Copyright 2009 Houston Chronicle
May 2, 2009, 11:59PM

Remember, pandemic status isn't an indicator of a virus's lethality; it merely indicates that a particular disease has been found capable of sustained human-to-human transmission in at least two regions. A/H1N1 is, of course, doing just that in North America (Canada, the U.S., and Mexico), and is suspected of doing that in South America (namely Brazil) and/or Europe (namely Spain and the UK).

"WHO chief prepares for pandemic" (http://online.wsj.com/article/SB124135130674780783.html)

"WHO head indicates full flu pandemic to be declared" (2009-05-04 09:53:10 GMT - http://www.forexpros.com/news/forex-news/update-1-who-head-indicates-full-flu-pandemic-to-be-declared-50884)

"The World Health Organisation is likely to raise its flu alert to the top of its six-point scale and declare a pandemic, its director-general indicated in an interview published on Monday. In remarks setting the scene for another alert increase, but without saying when, WHO chief Margaret Chan warned against over-confidence following a stabilisation in the number of new cases of the H1N1 strain that has proved deadly in Mexico. "Level 6 does not mean, in any way, that we are facing the end of the world. It is important to make this clear because (otherwise) when we announce level 6 it will cause an unnecessary panic," she told Spanish newspaper El Pais."

15 lead changes in 5 days! What a roller coaster ride this question is.....

By their guidelines, a level 6 pandemic has sustained human-to-human transmission in two regions...it clearly already has that in the Americas region (that's why we're up to level 5) and seems to have it in the Europe region as well. The levels aren't a sign of the severity of the illness, but of how widespread it is. Level 6 is imminent.
http://www.who.int/csr/disease/avian_influenza/phase/en/

another "fear" story by the media... since when do 100 people dying over 2 months from a flu make a story? thousands died just last month from the regular flu right here in the US.

... so Pooh looks down at Piglet with his tiny neck scarf and says,...

did I just make it 16?

... oh, and the winter flu season is just starting in the southern hemisphere ...

http://www.google.com/hostednews/afp/article/ALeqM5hQNWA8B7IZMKmE3_1Vw1o_Jh7swQ

As the virus is still spreading pretty efficiently and rapidly throughout Mexico, Canada, and the United States, A/H1N1 would have to suddenly disappear from view in North America (and elsewhere) for the level to be dropped to 4, and that's not likely to happen in the next eight weeks. As jeopardy noted, phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region (basically, one continent); that's what A/H1N1 is doing now. A shift to phase 6--which is anticipated--would only require that one other WHO region outside North America have the same sort of sustained human-to-human spread that North America has. With the still-growing (although slowly) number of human-to-human cases in Europe (mainly Spain and the UK)--and, also as jeopardy has noted, the onset of flu season in the southern hemisphere, where the virus is already--the WHO only needs to consider that growth 'sustained', and a 'pandemic' will be called. IMO, that's far more likely than the virus inexplicably stopping in its tracks throughout North America, meaning a quick return to phase 4...

...but on the other hand north america is heading into summer when flu tends to die down and swine flu isnt really on the loose in many southern hemisphere countries?

That's true. However, according to the WHO, because of underreportage--that it, people who become ill who don't bother seeing a doctor (I seldom do), or small-town doctors who don't bother reporting flu-like symptoms to some regional health authority, or people with other diseases which mask A/H1N1 symptoms, etc.--the actual number of cases is almost certainly far higher, and spreading. And if that's happening, as believed, such underrportage would tend to make people less vigilant, and thus more susceptible to contracting a contagious disease.

By the end of the day today, the flu will be confirmed in nearly 40 states and most Canadian provinces, as it's still spreading. There are no travel restrictions on people from those two countries...meaning that they're free to spread the virus wherever/whenever they want. Meaning? Just because a certain nation may have just one or two mild cases now doesn't mean the virus can't/won't be introduced into that country in a few months, or weeks, or days...

Finally, remember this: the Spanish Flu pandemic of 1918 was very mild in the late spring when it first appeared. After 'simmering' for several months, it blew up into a full-scale killer of millions in the fall. That's what has the WHO worried...

WHO flu chief Keiji Fukuda said quarantines were a "long-established principle" that makes sense in the early phases of an infectious disease outbreak. The WHO has yet to declare a full outbreak - or Phase 6 alert - though it has said this would likely only be a matter of time as the virus appears to be spreading to more and more countries around the world.
"As we get later on into Phase 6 then these sorts of measures will become less useful because there will just be more infections around and you can't quarantine everyone in the world," he said.

Source: http://cnews.canoe.ca/CNEWS/World/2009/05/04/9345956-cp.html

Hmm both good points, there's definitely two points of view on this, which probably goes some way to explaining the shape of the graph at the top of the page ;)

Anyone know what the highest total wagered on any one question is? This one's at $350,000 with seven weeks to go.

@jeopardy: I could be wrong, but I believe the most wagered is $2,347,481 (http://www.hubdub.com/e/Market/Who_will_be_the_next_President_of_the_US_2047). This one has a long way to go. (My own A/H1N1 market--http://www.hubdub.com/m39738/Will_Influenza_A_H1N1_aka_swine_flu_grow_into_a_pandemic_in_2009_as_feared--should make it over the $1 million mark in a few days, but I seriously doubt whether it'll even make close to half what the President question did...)

wow, i just cashed in a $500 bet and moved the level 4 slider 17%!!!!

Yep, this market seems unusually sensitive to even modest movements in money in and out. I'm guessing that $370k of activity is total money that has gone in, not subtracting the amount out and there are a lot of nervous folks putting money in, but pulling it right back out.

Very odd. My recent $500 buy here made the market jump way more than the same sized buy on a market that says it has $33k in activity that I did just a few minutes ago.

@sql - thx!

We had a similar thing with an earlier question and posted on a forum thread trying to figure out why - chris said the total activity didnt make a difference to the amount that the slider moves, but some questions definitely seem more volatile than others...

Does WHO need to declare flu a full pandemic?
Thu May 7 7:27am EDT (http://www.reuters.com/article/newsOne/idUSTRE5462MN20090507)

"The United Nations agency's guidelines state that as soon as the virus starts spreading freely in two regions of the world, its six-point pandemic alert should be raised to the top notch. With infection numbers rising in Europe, public health experts are struggling to decide whether it is worth sounding the full alarm over H1N1, which is treatable with existing drugs and appears less severe than seasonal flu in most cases.

"Under the rules, just one country outside the Americas needs to have a community-level outbreak of the new strain to trigger a Phase 6 designation indicating a global pandemic is under way.

"Some experts believe Britain is especially vulnerable to a community-wide outbreak, given the flu strain is propagating inside some schools. Spain also has a relatively large cluster of infections, with 73 according to the latest WHO tally.

"No one country, however, is likely to want to be seen as tipping the scale toward a pandemic declaration, especially with discontent rising about whether public health experts have exaggerated the risks of the H1N1 strain. That leaves the WHO in a difficult spot, given many disease experts anticipate the new virus could rebound with a vengeance later this year when winter temperatures conducive to the spread of flu return to the populated northern hemisphere."

If you like headlines that are designed to scare you, you'll love this one:

Report: H1N1 Could Infect 2 Billion

EVERYONE PANIC!!!
http://www.cbsnews.com/stories/2009/05/07/health/main4998549.shtml?source=RSSattr=HOME_4998549

Then it goes on to say:
"WHO flu chief Keiji Fukuda says the number wasn't a prediction, but that past experience with flu pandemics indicated one-third of the world's population gets infected."

Obviously CBS's news ratings are down relative to last week.

"Expert Warns Of Swine Flu-Bird Flu Mix"

...when pigs fly!

In Nathaniel Hawthorne's words: (In Septimius)

"Alarum! alarum! alarum! The red-coats! The red-coats! To arms! alarum!"

And trailing this sound, far waving behind him, like a pennon, the eager horseman dashed onward to the village.

05/09: For those interested, here are a few excerpts from today's CDC press conference (featuring Dr. Anne Schuchat of the CDC):

--"The virus has moved into the southern hemisphere, where influenza season is just beginning, and could mix with circulating seasonal flu viruses or the H5N1 avian influenza virus to create new strains. 'This is a very unusual circumstance,' Schuchat said."

--"We think this virus is in most of the United States," Schuchat said. "The individual numbers are likely to be a very great underestimate."

--"More Americans are seeing doctors for influenza-like illnesses at a time of year when such visits are usually on the decline."

--"It would be futile to try to stop the virus in the United States because it was only identified after person-to-person transmission had taken place for weeks before it was identified. 'Our indications are that it is still accelerating,' Schuchat said. Mexican officials have said outbreaks there are on the wane but Schuchat disagreed. 'In some parts of that country they may see a decline,' she said. But fresh outbreaks were occurring in other parts, she said."

--"'This particular virus has all of the hallmarks that we look for with a possible pandemic,' Schuchat said. It's a new strain capable of spreading easily and killing people."

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

In other flu news:

--Thailand reported its first case of A/H1N1 today. That comes on the heels of Japan and Australia, which both confirmed their first cases yesterday.

--There was a death in Costa Rica from the swine flu announced today, making that country the fourth with a confirmed fatality from the virus.

--Nearly 4,400 cases of the virus are now confirmed in 29 countries on five continents, with the EU the hardest hit after North America. That number is up 4,500% in the past two weeks.

--Cases in the U.S. continue to grow; the virus has been confirmed by the CDC in 43 states, and probable cases are awaiting confirmation in at least four others.

Stay tuned...

so my grandmother years ago said that there would be a black US president when pigs fly. Obama has been in office for 100 days and what do you know....

swine flu!

Argh....this flu has certainly spawned a pandemic of bad puns - if nothing else!!

05/11 A/H1N12 Update:

--The CDC says that the number of cases is growing too quickly to count, and that there are many more cases than have been reported. "I think the cases we’re confirming are the tip of the iceberg,” said Dr. Anne Schuchat of the CDC. (http://www.msnbc.msn.com/id/30398682/)

--This year's virus is, according to epidemiologists, a bit more dangerous than the one that caused the last pandemic (in 1968). Those same scientists also speculate that somewhere in the vicinity of 32,000 people already had the virus in Mexico before the end of April when the global community became aware of it. (http://www.alertnet.org/thenews/newsdesk/N11538600.htm)

--In a normal year, about 10% of the population gets sick with the seasonal flu; scientists project that this virus--which is "substantially more transmissible" than seasonal flu "clearly has pandemic potential", and may eventually infect two to three times the average number (http://www.timesonline.co.uk/tol/tools_and_services/mobile_times/swine_flu/article6269046.ece)

--The WHO says that the virus has "potential" for pandemic. "Most cases in Europe, Asia and South America are linked to travelers bringing the virus home with them, but there is a possibility the disease will become established there too," said WHO's flu chief Keiji Fukuda. (http://www.pr-inside.com/who-potential-for-swine-flu-spread-r1244908.htm)

--Worldwide, the number of confirmed cases of the flu "nearly doubled" over this past weekend. (http://www.un.org/apps/news/story.asp?NewsID=30761&Cr=+flu+&Cr1=)

--In La Gloria, Mexico, where the virus was first found running rampant, reasearchers believe the virus was transmitted there over 14 to 73 generations. That is, one person infected another, who infected another, and so on, up to 73 times. (http://www.alertnet.org/thenews/newsdesk/N11538600.htm)

--So far, at least, A/H1N1 is spreading at a more or less logarithmic pace, doubling in the number of confirmed cases roughly every four or five days. If the current rate of sperad were kept up, there'd be more than one million cases somewhere around the last few days of June. (http://en.wikipedia.org/wiki/File:Influenza-2009-cases-logarithmic.png)

Have you folks looked at the betting chart? It looks like a heart Chart

It's just red noise.

nice charts sql,
everything looks better on a logarithmic chart... :)

05/12: Professor Neil Ferguson of the World Health Organization (WHO) said today that a study just completed by a group of scientists at London's Imperial College hints that A/H1N1 possess "full pandemic potential", and will "likely spread around the world in the next six to nine months." (Or, in the breathless headline screaming from The Sun, "Swine flu will 'rip through globe!'")

http://news.sky.com/skynews/Home/World-News/Swine-Flu-First-In-Depth-Study-Of-H1N1-Says-One-Third-Of-World-Could-Be-Infected/Article/200905215280099?lpos=World_News_First_Home_Article_Teaser_Region_4&lid=ARTICLE_15280099_Swine_Flu%3A_First_In-Depth_Study_Of_H1N1_Says_One_Third_Of_World_Could_Be_Infected
http://www.redorbit.com/news/health/1686994/london_study_maintains_flu_has_full_pandemic_potential/
http://www.thesun.co.uk/sol/homepage/news/article2424699.ece

Place your bets... :-|

5/13 Influenza A(H1N1) - update 27 (from WHO website http://www.who.int/csr/don/2009_05_13/en/index.html)

13 May 2009 -- As of 06:00 GMT, 13 May 2009, 33 countries have officially reported 5728 cases of influenza A(H1N1) infection.

Mexico has reported 2059 laboratory confirmed human cases of infection, including 56 deaths. The United States has reported 3009 laboratory confirmed human cases, including three deaths. Canada has reported 358 laboratory confirmed human cases, including one death. Costa Rica has reported eight laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Argentina (1), Australia (1), Austria (1), Brazil (8), China (3, comprising 1 in China, Hong Kong Special Administrative Region, and 2 in mainland China), Colombia (6), Cuba (1), Denmark (1), El Salvador (4), Finland (2), France (13), Germany (12), Guatemala (3), Ireland (1), Israel (7), Italy (9), Japan (4), Netherlands (3), New Zealand (7), Norway (2), Panama (29), Poland (1), Portugal (1), Republic of Korea (3), Spain (98), Sweden (2), Switzerland (1), Thailand (2), and the United Kingdom (68).

http://www.nytimes.com/reuters/2009/05/15/world/international-us-who-flu-chan.html

ongoing outbreak

a death in Texas

Update 29 (from WHO website http://www.who.int/csr/don/2009_05_15/en/index.html)

As of 6:00 GMT, 15 May 2009, 34 countries have officially reported 7520 cases of influenza A(H1N1) infection.

Mexico has reported 2446 laboratory confirmed human cases of infection, including 60 deaths. The United States has reported 4298 laboratory confirmed human cases, including three deaths. Canada has reported 449 laboratory confirmed human cases, including one death. Costa Rica has reported eight laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Argentina (1), Australia (1), Austria (1), Belgium (1), Brazil (8), China (4), Colombia (10), Cuba (3), Denmark (1), El Salvador (4), Finland (2), France (14), Germany (12), Guatemala (3), Ireland (1), Israel (7), Italy (9), Japan (4), Netherlands (3), New Zealand (7), Norway (2), Panama (40), Poland (1), Portugal (1), Republic of Korea (3), Spain (100), Sweden (2), Switzerland (1), Thailand (2), and the United Kingdom (71).

Update 30 (from WHO website http://www.who.int/csr/don/2009_05_16/en/index.html)

As of 07:00 GMT, 16 May 2009, 36 countries have officially reported 8451 cases of influenza A(H1N1) infection.

Mexico has reported 2895 laboratory confirmed human cases of infection, including 66 deaths. The United States has reported 4714 laboratory confirmed human cases, including four deaths. Canada has reported 496 laboratory confirmed human cases, including one death. Costa Rica has reported nine laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Argentina (1), Australia (1), Austria (1), Belgium (2), Brazil (8), China (4), Colombia (11), Cuba (3), Denmark (1), Ecuador (1), El Salvador (4), Finland (2), France (14), Germany (14), Guatemala (3), Ireland (1), Israel (7), Italy (9), Japan (4), Netherlands (3), New Zealand (9), Norway (2), Panama (43), Peru (1), Poland (1), Portugal (1), Republic of Korea (3), Spain (100), Sweden (2), Switzerland (1), Thailand (2), and the United Kingdom (78).

It seems to be spreading person to person in Japan now...this article is talking about a sharp jump in cases to 70, mostly from people who hadn't left the country.

http://www.stuff.co.nz/world/asia/2419198/Teenage-swine-flu-explosion-in-Japan

World Health Organization May Raise Alert Level as Swine Flu Cases Leap in Japan - "The number of swine flu cases in Japan soared over the weekend, raising the likelihood that the World Health Organization will soon have to raise its pandemic alert level to 6, the highest level."

http://www.nytimes.com/2009/05/18/world/asia/18flu.html

Here is the current count of new flu cases in Latin America, according to http://www.eltiempo.com/vidadehoy/salud/nuevagripa/ya-son-98-los-casos-de-nueva-gripa-en-america-latina-sin-incluir-mexico_5206312-1

Panamá (55), Colombia (11), Brasil (8), Costa Rica (8) y un fallecimiento, El Salvador (4), Guatemala (3), Cuba (3), Argentina (1), Perú (2), Ecuador (1) y Chile (2)

(That list excludes Mexico)

The interesting thing about the alert levels (well in my opinion anyway) is that if it goes to level 6, that means the WHO puts it on 'highest alert' but at the same time, it means that it has become so widespread that countries without it may well decide that screening at the airport is impossible, and in countries that do have it, other measures like sanitising schools etc start to seem a bit pointless...you cant scrub every school and quarantine every plane passenger with a head cold......so if the virus moves to the highest alert phase, doesn't it seem like the precautions taken would likely become less?

horatio,
I disagree with one of your quotes, you said the flu chief said:
"As we get later on into Phase 6 then these sorts of measures will become less useful because there will just be more infections around and you can't quarantine everyone in the world," .

We can quarantine everyone in the world, just disallow interplanetary travel -- and also space station travel, etc., although they are only in near earth orbit, so maybe that 's ok, anyway.

Talk about moving the goal line: the World Health Organization had previously been stating--nearly ad nauseum--that in order to declare H1N1 a pandemic, they had only to see sustained human-to-human transmission in a WHO region apart from the Americas, and the severity of the flu wasn't even a factor. Well, that has happened, of course, with Japan now reporting nearly 300 cases after seeing its first case just last Friday. Until Monday, that was enough to cause WHO to raise the alert level.

Almost.

But then on Monday, many nations pleaded with WHO to not raise the level, as it would be bad for tourism, bad for business, and bad for the economy as a whole. And today in Geneva, the head of the WHO, said the following: "For Phase 5 to Phase 6 I need to satisfy myself that this is a global phenomenon...I [need to] see more signals coming from the virus itself or the spread of the disease, including severity." She's reportedly going to be "...looking for signs of sustained spread in the Southern Hemisphere first".

Upshot? The pandemic call will almost certainly come...though it may not happen for some time. These markets may yet be open for a while...

(It's also come to the attention of WHO that some nations have been intentionally underreporting their case numbres as a way to hold onto tourism dollars. Whether that will be a factor is anyone's guess.)

(P.S. - I posted this on the big three H1N1 markets this morning, so you'll likely see it again.)

@BigKen1,
Not sure if you said this in jest or not.
I respectfully disagree with your assessment of the use of quarantine. My interpretation of the flu chiefs quote is regarding how to stop the spread of disease on our planet. The way I read your reply, is that it is OK to let everybody on earth contract any number of diseases, as long as they do not travel outside of our gravitational pull. Our first priority is to isolate the people with the flu, so that we can try and contain it, best as possible.

BTW, I have been wondering about your profession. I don't like to sound ignorant, but I really have no idea what a Solar Physicist does?
(Requesting a layman explanation please.)

Wondering why it's not being called a pandemic yet, even though it is a pandemic? http://www.nature.com/news/2009/090521/full/news.2009.501.html

OK ... so .... what happens to this and the other s/flu questions if WHO changes the definition of Stage 6 (pandemic)?

Void and start over?

Thats what I hope happens. But then again, you could argue that it's just another event that decrease the likelyhood of it reaching level 6 anytime soon.

Oh. And WHO raising the line on pandemics seriously lowered the amount of level 6's didn't it? :-P

Here are a few different scenarios:

1) The current 6-phase system stands, but WHO changes the criteria for raising to the highest level. For now, that's sustained human-to-human transmission in at least two WHO regions...and we've got that already (or very nearly so). There's talk that the new criteria would be that the CFR (case fatality rate) would need to be over a certain percentage. At any rate, that would seem to leave this market viable.

2) There's talk that WHO might further subdivide phase 6 into different degrees based on CFR. A First Degree Phase 6 pandemic might be about where we are now; Second Degree might be akin to the 1957 and 1968 pandemics; and a Third Degree pandemic might be similar to the 1918 Spanish Flu one. (Of course, a Fourth Degree pandemic would be like something from I Am Legend, The Stand or 28 Days Later.) In such a case, anything in phase 6 would still be a pandemic, so this market would still seem to be viable.

3) There's talk that WHO might just add additional higher phases: a Phase 6 pandemic would be what we have now, Phase 7 would be like 1957 or 1968, and Phase 8 would be like 1918. (And Phase 9 would be from a Hollywood horror/disaster flick.) Here, again, Phase 6 would still be a pandemic, so this market would still stand.

4) Against the advice of physicians, WHO may continue to cave into requests from its member states by stating that a pandemic is really only a pandemic when a politician--not an epidemiologist or virologist--says it is. That would keep this at Phase 5 for many, many months, even to the point of infecting a few billion people while killing "only" 2 to 3 million. That would leave this market intact.

5) WHO could just entirely scrap their current 6-phase plan and go with something entirely different. If that were to occur, that would make this market unviable, and likely call for a void (though not necessarily).

I reckon we'll see...

Thanks for the clarification sqlman, I agree with those thoughts and since its all spelt out well before any decision by the WHO it should give people plenty of chance to move their bets around if it changes their thinking...this market moves around so much you should be able to get your money out at pretty much any price

From today\'s WSJ - http://online.wsj.com/article/SB124346642019860251.html\\r
\\n\\r
\\nOver the next several months, the new H1N1 flu virus is likely to continue to spread around the world, reaching into the southern hemisphere along with winter, then possibly staging a resurgence in the northern hemisphere come fall.\\r
\\n\\r
\\nHundreds of thousands of people could fall sick, and some will die. Public health officials will scramble to minimize the damage, as governments and drug makers continue to invest millions of dollars in a potential vaccine.\\r
\\n\\r
\\nYet the public, after an initial spasm of fear and concern, has turned its attention away from a strain that seems less serious than first advertised. The complacency is increasing the challenge for health officials who are trying to track and limit the spread of a disease that can still make people seriously ill even if it isn\'t deadly for most.\\r
\\n\\r
\\nAs of Wednesday, the virus had sickened at least 13,398 people in 48 countries from Argentina to the U.S., and 95 people have died, according to the World Health Organization. In the U.S., 7,927 probable and confirmed cases in 47 states and the District of Columbia have been reported to the Centers for Disease Control and Prevention, with at least 11 dead. Officials believe thousands more -- at least 100,000 in the U.S. -- have had the virus, but weren\'t tested or sick enough to visit a doctor.

I had written several days ago speculating as to what change(s) in WHO\'s Pandemic Alert Level might be forthcoming. (WHO says in \"a week or two\" they\'ll make any such changes after comsulting a large number of high-level epidemiologists and virologists.) One of the schemas I talked about was maintaining the current six-phase program, but subdividing one or more phases--especially Phase 6, aka \"The Pandemic Phase\"--into smaller and more logical chunks.\\r
\\n\\r
\\nAt the time I wrote that, I wasn\'t aware of the US CDCs \"Pandemic Severity Index\", which--as it turns out--was pretty much exactly what I had in mind. This index--the PSI--breaks down pandemics into five distinct categories based on CFR (case fatality rate), along with the number of projected US deaths:\\r
\\n\\r
\\nCategory 1 Pandemic: CFR < 0.1% / Projected deaths: < 90,000 (yellow)\\r
\\nCategory 2 Pandemic: CFR 0.1% - < 0.5% / Projected deaths: 90,000 - < 450,000 (orange)\\r
\\nCategory 3 Pandemic: CFR 0.5% - < 1.0% / Projected deaths: 450,000 - < 900,000 (red)\\r
\\nCategory 4 Pandemic: CFR 1.0% 0 < 2.0% / Projected deaths: 900,000 - < 1,800,000 (purple)\\r
\\nCategory 5 Pandemic: CFR >= 2.0% / Projected deaths: >= 1,800,000 (black)\\r
\\n\\r
\\nBased on current projections, the H1N1 outbreak would be classified as a Category 2 pandemic. Seasonal flu is a yearly Category 1 pandemic (really), the 1957 and 1968 pandemics were Category 2, and 1918 was a Category 5. (The US has had no Category 3 or 4 pandemics in the past 110 years.)\\r
\\n\\r
\\nThe question is, then, will WHO adopt a similar scheme? That is, will they indeed keep their six-level system but subdivide Phase 6? If they decide to do so a week or so from now, they would likely call a pandemic fairly quickly, given the rapid spread of the virus in the Southern Hemisphere.\\r
\\n\\r
\\nIt\'ll be interesting to watch. (Here\'s a great article from the New England Journal of Medicine*: http://content.nejm.org/cgi/content/full/NEJMp0904380 And you can read about the PSI here: http://www.pandemicflu.gov/plan/community/community_mitigation.pdf) (PDF)\\r
\\n\\r
\\n* - That 1918 flu was a doozy; note the part where it\'s stated that the number of reported cases doubled every three days. Yikes!\\r
\\n\\r
\\nP.S. - I\'m cross-posting this on the three big H1N1 markets.

05/28: WHO chief Dr. Margaret Chan said today the world is moving closer and closer to a pandemic. \"We need to look at whether or not the criteria for phase 6 is met,\" she said.\\r
\\n\\r
\\nhttp://news.xinhuanet.com/english/2009-05/29/content_11451166.htm

great job sqlman. I come here for my updates on swine flu!!! \\r
\\nYou take these long winded reports filled with mumbo jumbo and boil them down and extract the essence.\\r
\\n\\r
\\nI would recommend you as a new reporter!! Thanks for all the updates.

First we had mad cow disease, then bird flu and now swine flu.\\r
\\n\\r
\\nWhat the hell is this?\\r
\\n\\r
\\nFarmageddon?

whats up with all this \\\n and \\\r stuff? is it just some kinda code that i'm not seeing or what?

\\\n = new line
\\\r = return

06/02: Here's some interesting news: according to the well-respected Bloomberg, WHO plans to change the pandemic alert level to Phase 6 sometime in the next two weeks.

"The Geneva-based agency, sometime in the next 10 days, will declare the first flu pandemic in 41 years, said the people, who spoke on condition of anonymity because the WHO’s deliberations are private. WHO is using the time before the announcement to help member states prepare...Following yesterday’s discussion, [WHO Director Dr. Margaret] Chan is considering changes that would allow the agency to describe the situation as pandemic phase 6a, leaving the WHO two more levels -- b for moderate and c for severe -- if a more deadly bug emerges, according to the people familiar with the organization."

http://www.bloomberg.com/apps/news?pid=20601087&sid=aT9sIzRoUnNo&refer=home

"Phase 6 is a declaration that many member countries have long feared could mean economic disaster."

.... as well as an economic disaster for some HD users. ^_~

OK -- is the decision that "6a" will answer this question "Yes"?

No doubt, 6a is a 6. Hopefully. If not, that would mean economic desaster for me ;-)

I wrote the question, but I don't think its up to me to clarify...obviously it will affect how people vote and needs to be cleared up, and whatever the decision is it will sting people who wagered along different lines. Probably needs a word from the category editor?

Yes- clarification is that 6a is still a level 6.

@Tisha - are you also the category editor for the other two big H1N1 questions? and if so, will the answer be the same for the other H1N1 questions? That is, that a "6a" declaration will be viewed as the declaration of a "pandemic"?

For what it's worth, WHO says it will likely declare A/H1N1 to be a moderate pandemic, or 6b.

http://www.upi.com/Health_News/2009/06/03/WHO-ponders-Phase-6-flu-alert/UPI-60471244007867/
http://www.bloomberg.com/apps/news?pid=20601124&sid=abFpa.MBcrYo

Here's an interesting website collecting H1N1 flu information worldwide
http://flutracker.rhizalabs.com/

yes and yes to your questions jeopardy - I'll add the clarification now.

From the WHO website:
The WHO Director-General convened a third meeting of the International Health Regulations (IHR) Committee on 5th June 2009. The purpose of the meeting was to update the Committee on the global situation and seek advice on proposals to introduce severity assessments in any future announcements of pandemic phase changes by WHO.
http://www.who.int/csr/disease/swineflu/3rd_meeting_ihr/en/index.html

The World Health Organization said Tuesday a spike in swine flu cases in Australia may push it to finally announce the first flu pandemic in 41 years. It also expressed concern about an unusual rise in severe illness from the disease in Canada.

"On the surface of it, I think we are in phase 6," or a pandemic, said Margaret Chan, WHO's director-general. Chan said it was important to verify the reports that the virus is becoming established outside North America before declaring a pandemic. "The decision to make a phase 6 announcement is a heavy responsibility, a responsibility that I will take very seriously, and I need to be convinced that I have indisputable evidence," she said. [She] said she will hold a conference call with governments Wednesday in order to verify some of the reports she has received before making a formal announcement. "Once I get indisputable evidence, I will make the announcement," she told reporters in Geneva.

http://www.google.com/hostednews/ap/article/ALeqM5jTkkEKE5LtPih_5Jcc-3MpD0gOYQD98NDCQ80
---------------------------

So: Australia's case load has exploded to more than 1,000; Chile's has more than doubled in just two days to nearly 1,000 itself; the EU announced 184 new cases today (including a number of cases with patients who had no known exposure to anyone with A/H1N1), its biggest one-day increase in cases since the outbreak began; cases in the Southern Hemisphere are growing at a more rapid rate than cases in the Northern Hermisphere, a good sign that the disease has taken hold; today the WHO's assistant director stated at a news conference that "we are really very close" to declaring a pandemic; and now the director herself has stated that she's only waiting on "indisputable evidence" to make the call...and there's a lot of such evidence.

IOW: the call may come as early as tomorrow (06/10) or Thursday (06/11).

NZ seems to be only just holding it at bay - we've seen a number of school and workplace quarantines in the last couple of days...with it spreading in australia everyone seems to accept that its only a matter of time before it pops across the ditch.

1,000,000+ question. Congratulations!!!
I've seen only one other at this level. Does anybody know how many such questions had been in the history of hubdub?

Woooo H$1mil thanks bgrigore...i dont think it will catch sqlman's pandemic question, given that they'll prolly both settle in the next couple of days. I'll miss this q tho it's been a good lil earner for me :D

It certainly looks as though tomorrow (06/11) is most likely the day the pandemic alert level will be raised. Dr. Margaret Chan--director of the WHO-- talked with health officials from several of the hardest hit nations today, and has called an emergency meeting of the WHO's influenza experts committee for 10:00 GMT tomorrow. Dr. Chan previously met with that committee before raising the pandemic alert level to phases 3, 4, and the current 5.

@bgrigore: I'm not sure how many questions have made more than $1 million, but I do know that at least one US Presidential election question took in somewhere around $2.5 million...a million above my own H1N1 market. Congrats to cookietime on this one, though!

I think if the WHO doesn't go to level 6 in the next 3 weeks there are going to be some hubdub bankruptcies...possibly myself included :P

HK to close primary schools for two weeks -
http://www.bloomberg.com/apps/news?pid=20601087&sid=ak5.89nIKSxo

06/11: WHO director Dr. Margaret Chan is holding a press conference at 6:00 PM Geneva time (noon EDT) today at which she will almost certainly announce a move to Phase 6 and officially declare A/H1N1 a pandemic.

http://www.thaindian.com/newsportal/health1/who-concludes-emergency-meeting-pandemic-declaration-expected_100203728.html

Yeah! I can finally delete my google alert for "WHO level 6"

settlement?