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Market Shadows: Group of writers and investors: Paul Price, Lee Adler, and Ilene.
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    By Ilene

    Previous series of swine flu updates by me here.

    Transmission of Fatal H1N1 D225G/N Accelerates Concerns

    Ukraine takes measures to combat swine flu, closes all school - Kiev

    Courtesy of Dr. Henry Niman, Recombinomics Commentary, with my comments.

    Recently released H1N1 HA sequences have significantly accelerated pandemic concerns.  These sequences have either D225G, D225N, or both and produce a case fatality rate at or near 100% in many countries.... 

    My comment: By the 100% fatality rate, Dr. Niman means that they are finding these changes in the tested fatal cases in some countries.  Keep in mind, these are small numbers of cases.  It does not mean that all cases with these changes prove fatal.  It might be more clear to say a large portion of the fatal cases show these changes in the infecting viruses.

    [the] transmission and expansion of these fatal sequences in eastern Europe, including Russia have increased concerns, as has the "low reactor" status as determined by Mill Hill for a tested Ukraine sequence.

    Some of the earliest sequences with D225G were in the United States last spring and were generally mild.  However, initial cases in the US were generally mild, which may have reflected low  viral loads infecting a naïve population...

    My comment: "Low reactors" status means that the virus is not triggering the immune response expected due to changes in the structure of certain viral proteins (here, the influenza hemagglutinin proteins).  Immune responses target specific proteins and the target proteins' structure is critical to the immune response.  Not all changes in a protein will greatly reduce its immunogenicity (ability to stimulate the immune response) but certain changes will.  The change from the wild-type (common) HA protein to the HA protein with the D225G marker appears to have this adverse effect--i.e., the altered viruses will not provoke the stronger immune response generated in response to the wild-type virus and/or the swine flu vaccine.   

    These observations are cause for concern, not alarm.  The changes in the H1N1 virus are natural and predictable; Dr. Niman predicted these changes would occur.  

    There already was interest in position 225 for a number of reasons.  D225N  was in seasonal H3N2 and linked to the fixing [establishment of widespread] of adamantine resistance (S31N), while D225G was in 1918 and 1919 samples and linked to a change in receptor binding domain specificities which would target subsets of cells in the lung.  In addition, the polymorphism [genetic change] was jumping from one genetic background to another signaling recombination and increased rise that the polymorphisms would continue to jump to new genetic backgrounds [other viruses]

    Thus, when reports from Ukraine described a high number of fatal cases associated with lung destruction and a hemorrhagic component, involvement of D225G and D225N was predicted.  However, although WHO had sent a team to Ukraine and had sent representative clinical samples to Mill Hill and CDC, WHO regional labs, they characterized the sequences changes in Ukraine as insignificant...

    The association of D225G and D225N was more directly supported by sequences from the United States, Mexico, and Sweden, which identified samples with both D225G and D225N.  Thus, once again two different changes were appended onto the same genetic background at a given location, but the background varied from location to location, supporting recombination.  Moreover, in Mexico there were fatal infections with D225G and D225N.  Both were in San Luis Potosi and collected with a day of each other, supporting transmission.

    My comment: Because these genetic changes have been found in multiple places in viruses with divergent genetics, it is highly unlikely that they result from sporadic and random mutations.  Dr. Niman's theory of recombination better explains the phenomenon.

    However, although the above data left little doubt that the receptor binding domain (RBD) changes were transmitting and jumping from one genetic background to the other via recombination, the ECDC came out with a report at the end of the year stating that the WHO working hypothesis stated that each of these changes were independent and due to copy errors within each patient, and the RBD changes did not transmit. 

    This position had no support from the data.  The changes at position 225 were only found in 1% of sequences, but were in six of six fatal cases in Ukraine.  Similarly, isolates with both changes were found in two patients at the same location at the same time in Mexico.  The WHO working hypothesis was yet another explanation genetic drift by random mutation, even though the existing data offered no support for such a claim.

    My comment: It is not likely that the same mutations are occurring randomly over and over again.  It is more likely that these altered genes are circulating among the viral pools, present generally in low levels along with the more prevalent wild-type virus.  Dr. Niman disagrees with the conclusions of the WHO, and other governmental bodies that stick with the theory that the changes are random.   

    The sequences released in the past few days further degrade the WHO working hypothesis as well as the linkage of random mutations to genetic drift.  Mill Hill released sequences from Ukraine and Moldova which also had both changes in the same patients. In Ukraine the sequences followed the outbreak, which spread to the east.  Samples from the Kyiv area were from lung and each samples had D225G andD225N.  One sample also had D225A.  This clustering of position 225 changes within individual samples is not easily explained by independent and random events...

    Thus, the recent data demonstrates a case fatality rate at or near 100% in multiple countries, with clustering of polymorphisms and patients consistent with transmission and recombination.  Moreover, Mill Hill ran an antigenicity test on one of the Ukraine samples and found it to be a low reactor, raising concerns that changes at position 225 will become more common in the next H1N1 wave, which could have catastrophic consequences, while WHO is trying to construct a defense for its outdated random mutations as an explanation of viral evolution....


    Disclosure: none
    Jan 12 12:53 AM | Link | 2 Comments
  • Organ Donations
    Organ Donations
    Everyone else gets paid–let’s pay the donors.
    View of a meat market lit up at night with a sack and a stool in the foreground


    In the following article, Alex Tabarrok discusses payment incentives for organ donations.  Offering payment for organs is an effective way to increase donations, and thereby decreasing deaths resulting from too-long waits for those on the recipient lists. A well-designed system should effectively encourage more donations while establishing safe-guards against favoritism, unfair practices and failure of follow-through care for live donors. 

    Support for this proposal includes the observation that Iran’s payment program has reversed that country’s shortage problem. From a practical standpoint, if the U.S. federal government were to pay $15,000 per kidney donation, this would be a net savings to the government, as a kidney transplant is cheaper than dialysis, which is paid for by Medicare’s End Stage Renal Disease program. - Ilene

    The Meat Market


    Harvesting human organs for sale! The idea suggests the lurid world of horror movies and 19th-century graverobbers. Yet right now, Singapore is preparing to pay donors as much as $50,000 for their organs. Iran has eliminated waiting lists for kidneys entirely by paying its citizens to donate. Israel is implementing a "no give, no take" system that puts people who opt out of the donor system at the bottom of the transplant waiting list should they ever need an organ.

    Millions of people suffer from kidney disease, but in 2007 there were just 64,606 kidney-transplant operations in the entire world. In the U.S. alone, 83,000 people wait on the official kidney-transplant list. But just 16,500 people received a kidney transplant in 2008, while almost 5,000 died waiting for one…

    Organs can be taken from deceased donors only after they have been declared dead, but where is the line between life and death?….

    Only one country, Iran, has eliminated the shortage of transplant organs—and only Iran has a working and legal payment system for organ donation. In this system, organs are not bought and sold at the bazaar

    The Iranian system and the black market demonstrate one important fact: The organ shortage can be solved by paying living donors. The Iranian system began in 1988 and eliminated the shortage of kidneys by 1999. Writing in the Journal of Economic Perspectives in 2007, Nobel Laureate economist Gary Becker and Julio Elias estimated that a payment of $15,000 for living donors would alleviate the shortage of kidneys in the U.S. Payment could be made by the federal government to avoid any hint of inequality in kidney allocation. Moreover, this proposal would save the government money since even with a significant payment, transplant is cheaper than the dialysis that is now paid for by Medicare’s End Stage Renal Disease program.

    In March 2009 Singapore legalized a government plan for paying organ donors. Although it’s not clear yet when this will be implemented, the amounts being discussed for payment, around $50,000, suggest the possibility of a significant donor incentive. So far, the U.S. has lagged other countries in addressing the shortage, but last year, Sen. Arlen Specter circulated a draft bill that would allow U.S. government entities to test compensation programs for organ donation...

    World-wide we will soon harvest more kidneys from living donors than from deceased donors. In one sense, this is a great success—the body can function perfectly well with one kidney so with proper care, kidney donation is a low-risk procedure. In another sense, it’s an ugly failure….

    Full article here.>>

    Disclosure: none
    Jan 10 6:16 PM | Link | Comment!
  • Jobs, settling, or sitting home
    Jobs, settling, or sitting home

    By Ilene

    I was parking my car the other day and briefly chatted with a well-dressed and articulate older gentleman, the parking attendant. After not agreeing to my proposed having-to-wait-in-the cold discount - never hurts to ask - he asked me if I worked in the building and I said no, but I had before, over a year ago. Then he told me he was working there because even though he had two higher degrees, there was no work in our city.

    He used to run a successful photography business, but beginning around a year ago, more and more of his clients were cancelling engagements, having found friends to take pictures for free.  This, they might regret someday, when reminiscing through their photo albums, but that was of no help to him now.  Work at the parking garage was all he could find, nine dollars an hour; and by the way, his friend in construction hadn't worked in months, besides the one-time deal on New Years. Many people he knows are "just sitting home" he told me. That's how it is. 

    How does this vicious cycle end? With so many people out of work, demand for things and services (like photography for special events) cannot increase in any substantial way, but until demand increases, lots of people will be out of work. Unless the government gives them jobs, perhaps, counting things.

    Here's more on the topic, some thoughts and charts from John Mauldin, a depressing decade-by-decade chart from Prieur du Plessis  and more thoughts by Zero Hedge's Tyler Durden.

    2010 Forecast: A Year of Uncertainty

    John Mauldin's Thoughts from the Frontline

    A challenged consumer confidence survey is not surprising, given the fact that roughly 8% of the working population is getting some form of unemployment assistance. One in eight children in this country is living on food stamps. By the way, the total number of people on unemployment is about 300,000 worse than most media accounts report. The Extended (and Emergency) unemployment claims for those out of work more than 26 weeks are not seasonally adjusted. To get the total number of people on unemployment insurance of all kinds, you have to add the non-seasonally adjusted number of continuing claims, which is currently about 300,000 higher than the seasonal adjustment. Here is a chart from Philippa, at


    She explained, "For the week ended 12/19, 10.42 million Americans were receiving unemployment benefits, With 5.44 million Extended claims (week ended 12/19) and 4.98 million Continuing claims.

    "But NSA jobless claims show a far different story. The advance number of actual initial claims under state programs, unadjusted, totaled 645,571 in the week ending Jan. 2, an increase of 88,000 from the previous week. There were 731,958 Initial claims in the comparable week in 2009... The advance unadjusted number for persons claiming UI benefits in state programs totaled 5,479,110, an increase of 388,729 from the preceding week. A year earlier, the rate was 4.0 percent and the volume was 5,317,388.

    "So the actual, the real benefits paid (Initial, Continuing, and EUC claims) hit another record of 11.268 million." (source: The Big Picture)

    Today's employment report was just terrible. The headline said we lost 85,000 jobs. That is from the establishment survey, where they call up larger businesses and ask them about their employment. They also do a household survey, where they survey about 400,000 households. That report reveals a much worse situation...

    Sidebar: As noted above, a large number of people were dropped from the official labor force. What that means is that even though the number of employed people fell, the unemployment rate did not. It will be interesting to see if a lot of those people just decided that December was not a good time to be looking, spent time with families, or decided it was too cold to get out. How many will start looking as we get into the new year? We could see a rise in the unemployment rate next month if a large number do look for work.

    Look at the chart below from my friend Greg Weldon. (It just hit my inbox.) It shows the percentage of people who are participating in the work force. ( It is sadly dropping, which means that incomes to families are dropping. The number of people I know who are looking for work or are struggling increases each week. It truly saddens me.


    Chart du Jour: A decade of no new jobs

    Prieur du Plessis

    The US Labor Department yesterday reported that nonfarm payrolls (jobs) decreased by 85,000 in December while the data for November was revised upward to show a gain of 4,000 jobs.

    For some perspective, Chart of the Day produced the graph below that illustrates the percentage increase in the number of jobs for every decade since the 1940s (the data goes back to 1939)...“This subpar job growth is particularly noteworthy due to the fact that the US population has increased by 10% in addition to a significant increase in global wealth during the same time frame,” said Chart of the Day.


    Source: Chart of the Day, January 8, 2010.

    And by Tyler Durden, a further dissecting of the data:

    The Lost Decade For Jobs

    By now everyone knows about the Rip Van Winkle effect in stocks: the "noughties" were a snoozer, with the stock market lower on December 31, 2009 than on January 1, 2000. Yet what may have escaped most people is that the decade was also a scratch in terms of employment: the country now has essentially the same number of employed people as it did 10 years ago.

    The problem, of course, is that both the total population, and the size of the workforce have not stayed flat over the past 10 years. The charts below demonstrate the Employment-To-Population ratio for all time, and, more disturbingly, for the past 3 years. This ratio is now the lowest it has been in almost 30 years.

    David Rosenberg, who made the observation, had this to say about this very troubling trend:

    We started the decade with a national payroll level of 130.8 million. We finished the decade practically unchanged at 130.9 million. Meanwhile, the total pool of available labour rose from 146 million to 159 million. In other words, we have the same number of jobs today as we did a decade ago, and yet we also have 13 million more people competing for them. It was more than just a lost decade for the equity market. It was a lost decade for the labour market. Today’s report validated the Fed’s concern over the outlook for employment, which dominated the FOMC minutes released earlier in the week. Those pundits calling for an early exit from the central bank’s accommodative stance may have some reconsidering to do.

    An even better way to visualize this, is the difference between the total number of civilians employed and the total US population (308.3 million). The number in December is a record 170.5 million. Keep in mind only 137.8 million are currently employed according to the BLS.

    There isn't much spinability here. The employment picture in America is horrendous and getting worse. In the worlds of Rosenberg again:

    The so-called ‘employment rate’ — the ratio of employment to population — fell 58.2% from 58.5% in November and the cycle peak of 63.4% in 2007. This is extremely significant because what it means is that it would take an expansion in employment of 20 million over the next five years just to get back to those old cycle highs. But here’s the problem... More here. >>

    Disclosure: none
    Jan 09 6:31 PM | Link | Comment!
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