dla pomorzaka (nie dla covidiotow)

[Reflex]

[Reflex]

Nie tlumacz się godzila, wstawileś stare g*** nie mające nic wspólnego z naszą dyskusją i dzisiejszą pandemią.
Skup się i zacznij myśleć, bo jak widać w twojej glowie nie tylko wlosów brakuje.

[godzilla]

zawsze wiedzialem zes wiejskim glupkiem zrodzon i takim zejdziesz z tego swiata...

zeby sie qrwa podstaw angielskiego przez dwadziescia pare lat udawania naturalizowanego Amerykanina nie nauczyc to wstyd...

The effect of the definition of ‘pandemic’ on quantitative assessments of infectious disease outbreak risk

Benjamin J. Singer, Robin N. Thompson & Michael B. Bonsall

Scientific Reports volume 11, Article number: 2547 (2021) Cite this article

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Abstract

In the early stages of an outbreak, the term ‘pandemic’ can be used to communicate about infectious disease risk, particularly by those who wish to encourage a large-scale public health response. However, the term lacks a widely accepted quantitative definition. We show that, under alternate quantitative definitions of ‘pandemic’, an epidemiological metapopulation model produces different estimates of the probability of a pandemic. Critically, we show that using different definitions alters the projected effects of key parameters—such as inter-regional travel rates, degree of pre-existing immunity, and heterogeneity in transmission rates between regions—on the risk of a pandemic. Our analysis provides a foundation for understanding the scientific importance of precise language when discussing pandemic risk, illustrating how alternative definitions affect the conclusions of modelling studies. This serves to highlight that those working on pandemic preparedness must remain alert to the variability in the use of the term ‘pandemic’, and provide specific quantitative definitions when undertaking one of the types of analysis that we show to be sensitive to the pandemic definition.
Introduction

In the early stages of an infectious disease outbreak, it is important to determine whether the pathogen responsible may go on to cause an epidemic or a pandemic1,2,3,4,5. There is extensive literature on determining the probability of a major epidemic given a small population of initial infected hosts6,7,8,9. This research has produced a natural mathematical definition of an epidemic, based on the bimodal distribution of outbreak sizes given by simple stochastic epidemiological models when R0

is larger than but not close to one10. The term ‘pandemic’ has no corresponding theoretical definition, and there is no consensus mathematical approach to determining the probability of a pandemic. In this study, we examine how alternative definitions of ‘pandemic’ affect quantitative estimates of pandemic risk assessed early in an infectious disease outbreak.

The term ‘pandemic’ is used extensively, appearing in phrases such as ‘pandemic preparedness’11,12,13, ‘pandemic influenza’14,15,16, and ‘pandemic potential’17,18,19. A Google Scholar search returns 25,800 results using the term ‘pandemic’ for 2019 alone.

The International Epidemiology Association’s Dictionary of Epidemiology defines a pandemic as “an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people”20. Notably this definition makes an explicit reference to national borders. Contrastingly, a World Health Organization (WHO) source makes reference to a pandemic as “the worldwide spread of a new disease”21 .The use of the word ‘new’ here is ambiguous in the context of infectious diseases. HIV/AIDS is often referred to as a global pandemic, but is certainly not new on the timescale of, say, the emergence of influenza strains22,23. A study by Morens et al. in 2009 finds that there is little in common between all disease outbreaks that have been referred to as pandemics, except that they have a wide geographical extension24.

These kinds of differences between pandemic definitions can often go unnoticed, but in certain circumstances they can cause confusion between different stakeholders (e.g. between scientists and governments, or governments and the public), who may not have a shared background understanding of the term. In 2009, the WHO declared a pandemic of H1N1 influenza, using criteria related to the incidence and spread of the virus in different WHO regions25. The criteria did not include reference to morbidity or mortality26. This fact led to some controversy over whether the declaration of a pandemic was appropriate, as the declaration prompted some governments to mount an intensive response to an outbreak that resulted in fewer yearly deaths than a typical strain of seasonal flu27,28,29,30.

International health organisations such as the WHO have not provided any formal definitions of the term ‘pandemic’, and the WHO no longer uses it as an official status of any outbreak25,31. It would, however, be hasty to dismiss the importance of the term on these grounds. Although the WHO no longer uses the term ‘pandemic’ officially, the WHO Director-General drew attention to their use of the term as recently as March 2020, to describe the status of the COVID-19 outbreak32. The Director-General cited “alarming levels of inaction” as one of the reasons to use the term, along with the caveat that “describing the situation as a pandemic does not change WHO’s assessment of the threat posed by this virus”. The WHO’s use of the term was of interest to the public, receiving extensive press coverage33,34,35. The term ‘pandemic’ clearly continues to be important to indicate serious risk during disease outbreaks.

Regardless of the extent to which the pandemic definitions currently in use do or do not agree, they are all qualitative in nature, using descriptions such as “very wide area” and “large number of people”. Perhaps as a result of this, many quantitative studies on pandemics do not make use of a quantitative definition of a pandemic, but instead focus on causally related concepts, such as sustained transmission19, or emergence of novel viruses36. Others treat the spread of a pathogen at a pandemic level as a context in which to study transmission dynamics, without paying special attention to how those dynamics might lead to a pandemic as distinct from an epidemic or a more limited outbreak37,38,39. In this paper, we examine the effects of alternative pandemic definitions on the analysis of key epidemiological questions. The results provide a foundation for deciding the appropriate quantitative definition of ‘pandemic’ in a given context.

We use a metapopulation model to investigate the effects of pandemic definition on the results of a quantitative assessment of the probability of a pandemic. Metapopulation models are commonly applied to pathogens that spread between regions of the world, and so are appropriate for modelling pandemics40,41,42,43,44,45. We represent states of our metapopulation model as states of a Markov chain, allowing us to calculate the probability of a pandemic directly, as opposed to simulating many stochastic outbreaks and recording the proportion which result in pandemics. We explore two different kinds of pandemic definition, following Morens et al. 200924, specifically:

the family of transregional definitions, where a pandemic is defined as an outbreak in which the number of regions experiencing epidemics meets or exceeds some threshold number n. We refer to specific transregional definitions as n-region transregional definitions, e.g. a 3-region transregional definition.

the interregional definition, where a pandemic is defined as an outbreak in which two or more non-adjacent regions experience epidemics.

Note that these definitions require a specific sense of ‘region’. These regions could be countries, or they could be larger or smaller than individual countries—from counties to health zones to WHO regions. Our metapopulation model (detailed in the Methods section below) can be used to model regions of any size. We have chosen not to include definitions with criteria relating to the number of people infected or killed, instead of, or in addition to, geographical extension. Extension is the only universal factor in pandemic definitions, and so is the focus of the current study24.

Three questions that help form public health policy at the beginning of an outbreak are:

Would interventions restricting travel reduce the risk of a pandemic?

Does a portion of the population have pre-existing immunity, and does this affect the risk of a pandemic?

How is the risk of a pandemic affected by regional differences in transmission?

Using our metapopulation model, we explore how changing the pandemic definition does or does not affect our answers to these questions. We show that the precise definition of a pandemic used in modelling studies can (but does not always) affect the inferred risk. The predicted effects of travel restrictions, the influence of pre-existing immunity, and the impact of regional differences in transmission can all vary when alternative definitions of ‘pandemic’ are used. This demonstrates clearly the need to consider carefully the pandemic definition used to assess the risk from an invading pathogen. This is necessary for clear communication of public health risk.
Results
Travel rates

One important question about pandemic risk is what effect inter-regional travel rates have on the probability of a pandemic occurring16,17,46,47. Here we model epidemics occurring in regions connected on a network in which the connections and their weighting can be set at fixed values representing the rates of travel between regions. We consider simple networks that can illustrate the effects of our different pandemic definitions—namely, the star network, in which one central region is connected to all others with equal weighting and the non-central regions lack any other connections, and the fully connected network, in which each region is connected to every other with equal weighting. Figure 1 illustrates that the connectivity of the full network is much higher than that of the star network. Using the star network allows us to make the distinction between adjacent and non-adjacent regions, thus allowing us to distinguish between transregional and interregional pandemic definitions.

https://www.nature.com/articles/s41598-021-81814-3

[Reflex]

Ty ciężki żalosny idioto. Artykul naukowy o definicji pandemii. Nie ma nic wspólnego z obecną sytuacją.

Cale lata nie zamieścileś tu jednego normalnego postu. Same "kurwy,"awantury, "swiat się kończy","Oni" rządzą. Pisalęś że Amerykanie sie skończyli, ze dolar juz nie istnieje a światem będzie rządzil chinski yuan. W Polsce juz 20 lat temu wedlug Ciebie miala być wojna, pieprzyleś o tym codziennie. Amerykańskie samoloty zrzucają Afganczykom trucizne zamiast żywności. Slyszaleś to podobno w pociągu, kiedy byl w tunelu Cale lata wulgaryzujesz, bredzisz jak nieprzytomny. Oczywiście wedlug Ciebie ja mieszkam w Polsce na wózku inwalidzkim, żalosny tumanie, hahaha.. Mieszkam w USA już nie 20 a 40 lat i nie w Polskim otoczeniu, ale Ty znasz angielski lepiej odemnie. Nigddy jak dlugo to forum istnieje nie napisales slowa prawdy.
Glupi, łysy, pier*** ciulu. Chocbyś sie zesral, do piet mi nie dorośniesz a Twoje kompleksy cie zadlawią.
Nie pisze tego ze zlością, ale przeginasz lysy dupku i w końcu masz to, na co zaslugujesz. Pies ci morde lizal kutasie.

[godzilla]

2016 trat Oswald in die Dienste der Bill & Melinda Gates Foundation, die auch die Entwicklung von Vakzinen finanziert. Im Frühling 2020, auf dem ersten Höhepunkt der Corona-Krise, bot er seine Dienste dem Bundesamt für Gesundheit (BAG) an und wurde der neue Delegierte für Impfstoffbeschaffung.

tutaj na szybko przetlumaczone przez google:

W 2016 roku Oswald dołączył do Fundacji Billa i Melindy Gatesów, która również finansuje rozwój szczepionek. Wiosną 2020 r., w pierwszym szczycie kryzysu koronowego, zaoferował swoje usługi Federalnemu Urzędowi Zdrowia Publicznego (FOPH) i został nowym delegatem ds. zamówień szczepionek.

a tu zrodelko: https://www.handelszeitung.ch/bilanz/ba ... -centogene

Handelszeitung to powazna gazeta szwajcarska... powazna bo Szwajcarzy pieniadze i handel traktuja powaznie....

milego dzionka tym co sie w Szwajcarii zaszczepili szczepionka kupiona u Billa

[godzilla]

Ty ciężki żalosny idioto. Artykul naukowy o definicji pandemii. Nie ma nic wspólnego z obecną sytuacją.

ma to tyle do rzeczy ze przy3.14erdalasz sie do Pomorzaka o definicje pandemii glabie...
ostatnio sie podszkolilem w wyszukiwaniu zrodel informacji...

[godzilla]

amerykanie finansowali talibow przez te wszystkie lata "wojny" a na koniec w prezencie zostawili im bron aby mogli pracowac dla nich zdalnie...

[Reflex]

No tak....Szanujcie godzille, on się ostatnio przeszkolil w wyszukiwaniu. Hahahahahaaaaaaaa..
JP. Geniusz!!! Hahahahahaaa.....

[pomorzak]

Mam ten film z niemieckim tlumaczeniem ale wiekszosc zapewne swietnie zna angielski wiec polecam.

[Reflex]

Po prostu jest mi jej żal. Inteligentna, kulturalna, ale nie umiem jej zrozumieć.
To przecież nie jest grypa, to jest zarazliwa, śmiertelna pandemia. Gdyby nie szczepionka, zginęlyby nastepne miliony, jesli nie dziesiątki milionów osób, upadlaby gospodarka świata. I tu już nie chodzi o to kto ma racje. Tylko o to, że ludzkośc zostala tym świnstwem zaatakowana i podzielona. Nie zaslużyla na to.