{"id":27484,"date":"2009-11-03T11:06:31","date_gmt":"2009-11-03T11:06:31","guid":{"rendered":"http:\/\/scienceblogs.com\/gregladen\/2009\/11\/03\/how-many-people-does-it-take-t\/"},"modified":"2009-11-03T11:06:31","modified_gmt":"2009-11-03T11:06:31","slug":"how-many-people-does-it-take-t","status":"publish","type":"post","link":"https:\/\/gregladen.com\/blog\/2009\/11\/03\/how-many-people-does-it-take-t\/","title":{"rendered":"How many people does it take to make a baby really sick?"},"content":{"rendered":"

We have an interesting conundrum. Our offspring (______<\/a>) is due on November 20th. This places the likely date of birth just prior to Thanksgiving. This causes many people to get very excited because they get to see and play with the new baby. I wonder how mad at me all those people are going to get when they find out I might not let that happen?
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\nI’m not entirely sure what we are going to do postpartum. I’m quite interested in advice, so please do make your suggestions below. I’d especially like the advice of the MD’s<\/a> and Public Health Scientists<\/a> in the vicinity. Or anyone with relevant experience<\/a>.<\/p>\n

The reason advice is needed is two-fold. First, although I’ve raised a child before, I’ve not had charge of an infant during a pandemic. Second, few other people have either, and the nature of advice, common knowledge and practice about things in general and health related issues in particular is not usually rational, in my opinion.<\/p>\n

We’ve already decided to skip the usual Huge Thanksgiving Get Together<\/a> for the simple reason that there will be thirty or forty people there, and it simply does not make sense to wander into a crowded house full of people with a new baby during a flu pandemic.<\/p>\n

An alternative has been suggested. This is a smaller, more limited Thanksgiving dinner with just a few family members, and that’s all. But there are three problems with this emerging, at least in my mind: 1) At least two people who will be there have rather proudly declared (and I love you guys, but you are way off on this one …) that they don’t do vaccines. They are not denialists, they just think the vaccines will make them sick. And of the other people who might visit I’m not sure who or who else might have the vaccine; 2) There will be at least one, possibly two, other vulnerable individuals who will also be at the get-together, so this may not be a good idea for them either. (Though they are older than what seems to be a high-risk cutoff for Novel A\/H1N1 Swine Flu, and by that time will have been vaccinated.); and 3) I’m not sure that spending five hours in a house with one person who is sending out flu infectoids is much different than spending five hours in a larger house, more densely crowded, with, maybe, a dozen people sending out the infectoids. In fact, the way social events like this work, it is quite possible that the expected number of people woud grow rather than shrink. Will it be eight people? Ten? Fourteen? All these numbers are less than 30 (the best guess for the main Thanksgiving event) but I’m not sure if I care about that difference. Yes, I understand that exposure for longer periods and to more infectious sources should be more highly correlated with actual infection across many instances, statistically, so the probabilities are different. But …<\/p>\n

We are talking about my baby. If I had a hundred babies, I might not mind so much if two or three of them died of the flu. But with just one …. I’m not so sure that aggregate values and probabilities are of any great interest to me. My baby does not get to be several thousand dots on a graph only a few of which will get sick. He is allowed to be only one dot.<\/p>\n

My current plan is to monitor the situation, and consider a visit that falls short of staying around for hours and having dinner, but would allow the people to see the child and visa versa. Although the unvaccinated will be wearing those scary masks and everyone will be washing their hands every few minutes.<\/p>\n

As I suggested above, there is likely to be a certain amount of irrationality in a decision making process like this one. I’m not sure what will emerge in this particular case, but for the more general circumstance of family meeting baby vs. limiting exposure to baby, here’s a few items that come to mind:<\/p>\n

First, if you read the “how to not screw up your baby” literature, you’ll see a common question addressed: When is it “safe” or advisable to “take your baby out” after it is born?<\/em> The answer in this literature strongly implies that new parents are often too shy about going out with baby. It is perfectly OK to cart around a properly swaddled new-born. Just don’t let sick people touch it, and be smart about what you are doing. In fact, you will see comments in this expert advice literature such as “It is probably healthier to get your baby … and yourself! … out of the house early and reasonably often! Don’t be a hermit.” and so on.<\/p>\n

And of course, that is all true. But, this advice addresses a question other than: “When is it safe to bring my baby into contact with other people who may have the Pandemic Flu?”<\/p>\n

And, the advice does not specifically mention my<\/em> baby. Here, we are talking about my<\/em> baby. If I had a hundred babies, I might not mind so much if two or three of them died of the flu because I took them out because some FAQ on taking care of new borns told me to. But with just one …. I’m not so sure….<\/p>\n

A second feature of this sort of discussion is the necessity and importance of the family visit, of the “coming out” of the new born for all to meet and stuff.<\/em> Obviously, this is a very important thing to do, but it is possible that the importance of everyone getting to meet and greet the new baby is not quite as great as the baby surviving his first several weeks of life, despite one’s desire to avoid social awkwardness of any kind<\/a>.<\/p>\n

Let me be quite stark about this: Cousin Jeeter may feel great about meeting the new baby now, but how is Jeeter going to feel if the next day he suddenly comes down with the flu, and two weeks later finds out that he probably gave the flu to his infant cousin, who has died, and no, Jeeter is not invited to the funeral. I understand that dead baby comments are in bad taste and there will be people mad at me for making the stark link between this decision and that outcome.<\/p>\n

Tough. We are talking about my baby. If I had a hundred babies, I might not mind so much if two or three of them died of the flu. But with just one …. I’m not so sure that someone’s sensitivity to facing the stark reality that this flu … this pandemic flu we are having now … appears to be potentially deadly to anyone under 18 years of age is of any great interest to me. Yes, the chances that an infant will die from the flu are low. A week or two in the NICU should take care of him, and organ damage caused by such a major infection early in life won’t matter for … decades, if at all. But we are talking about my baby, so I might be a little picky about this.<\/p>\n

A third fallacy that is of great importance is that if everyone washes their hands, there won’t be any problem.<\/em> While it is good to wash hands a lot to reduce flu transmission, this only reduces transmission to some extent. The flu is transmitted very nicely by flying through the air. Even if an infected person coughs into his or her sleeve, the air that comes out of the person’s mouth has a zillion tiny saliva spaceships each occupied by thousands of eager flu viruses, which blow around the sleeve and into the air. Those tiny, microscopic droplets float around in the air for many minutes, possibly hours. They are then breathed in by other people in the room. They can also land on surfaces such as … candy in a candy dish, the rims of drinking glasses, the nipple of a baby’s bottle, the cat, or on someone’s hair.<\/p>\n

Yes, a really good way to get the flu is if an infected person coughs slimy stuff into his hand, and shakes your hand thus putting the slimy stuff on your palm, then you wipe your nose with the palm of your hand or maybe you lick your palm or something. But for the most part, the way flu actually gets from one person to another is when there are two people in a room, one is infected and the other not, and they both breath for a while, with the infected person coughing or sneezing now and then.<\/p>\n

Am I exaggerating the air borne infectious nature of this flu? Maybe, maybe not. Conditions vary, the flu varies, it is all a game of complex interconnected probabilities, so there is certainly a calculable probability of infection via direct hand to hand (to mouth) contact vs. airborne only.<\/p>\n

But we are talking about my baby. If I had a hundred babies, I might not mind so much if two or three of them died of the flu transmitted via the air. But with just one …. I’m not so sure that aggregate values and probabilities are of any great interest to me.<\/p>\n

I feel very lucky that all the close and more distant family members in our case will be totally understanding and supportive of whatever decisions we make (though everyone really should get vaccinated). The problem is, what exactly should that decision be?<\/p>\n

So, what are you doing for Thanksgiving? What do you think we should we do?<\/p>\n","protected":false},"excerpt":{"rendered":"

We have an interesting conundrum. Our offspring (______) is due on November 20th. This places the likely date of birth just prior to Thanksgiving. This causes many people to get very excited because they get to see and play with the new baby. I wonder how mad at me all those people are going to … Continue reading How many people does it take to make a baby really sick?<\/span> →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"1","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[4806,4823,103,4894,4047],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"","jetpack_shortlink":"https:\/\/wp.me\/p5fhV1-79i","jetpack_likes_enabled":true,"_links":{"self":[{"href":"https:\/\/gregladen.com\/blog\/wp-json\/wp\/v2\/posts\/27484"}],"collection":[{"href":"https:\/\/gregladen.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/gregladen.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/gregladen.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/gregladen.com\/blog\/wp-json\/wp\/v2\/comments?post=27484"}],"version-history":[{"count":0,"href":"https:\/\/gregladen.com\/blog\/wp-json\/wp\/v2\/posts\/27484\/revisions"}],"wp:attachment":[{"href":"https:\/\/gregladen.com\/blog\/wp-json\/wp\/v2\/media?parent=27484"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/gregladen.com\/blog\/wp-json\/wp\/v2\/categories?post=27484"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/gregladen.com\/blog\/wp-json\/wp\/v2\/tags?post=27484"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}