Sunday, May 17, 2009

SWINE FLU AND YOU


Eternal Optimist received an interesting and thoughtful reader comment about the Swine Flu article. The comment was long, and Eternal Optimist’s response longer, but an edited version goes like this:

Reader: A pandemic would look a lot like the current version of the Swine Flu when it started. A few people getting sick with an unfamiliar strain of virus in a nondescript area of a nondescript country; the disease sickening people reasonably slowly to allow transmission. Then it slowly spreads, until world health organizations start taking notice and sounding the alarm.

EO: No, if you are going to equate it to the Influenza Pandemic of 1918, it would look like this: world-wide, tens of millions of people dead (25 million dead in the first 25 weeks), horrifying symptoms, whole populations infected, and waves of infection that last 2 years. It spreads very fast and kills lots of people very quickly. That is, a Pandemic a la 1918 doesn’t look anything like the Swine Flu at all.



Reader: A pandemic is a lot more likely than it was in 1918, given the overuse of antibiotics, the advent of widespread and nearly instantaneous international travel, and agricultural practices that are more unhealthy than ever.

EO: I disagree. In 1918 the average lifespan was about 50, nutrition was worse, pollution was worse, sanitation was worse, and health care abysmal. Tens of millions of soldiers were demobilising after four years of living in inconceivable squalor. A world war had ground down the health of huge swaths of the world's population.

Reader: Are you suggesting there should be higher standards for raising alarms? In Mexico, there were 42 deaths per 100 million, or .4 deaths per million. Where would you put it? 40? 400? 4,000? It is not wise to pooh-pooh the warnings, even if this turns out not to be the “Big One.”

E.O. I am indeed suggesting there should be some discernible standard. We lost 675,000 U.S. citizens to the flu pandemic in 1918, out of a population of about 100 million, a rate of about 1 person in 150. We've lost 5 so far to the Swine Flu, out of 300 million, a rate of 1 person in 60,000,000.

Here is what the 1918 pandemic did to life expectancies in the United States in 1918:

YEAR MALE FEMALE
1917 48.4 54.0
1918 36.6 42.2
1919 53.5 56.0

There is no excuse for WHO and newspapers to exaggerate the danger of the current Swine Flu epidemic by equating it with the 1918 Pandemic. A true pandemic could certainly happen again, but Swine Flu just does not measure up.

Here are some interesting web sites:

HHS website on the Flu Pandemic.

Wikipedia entry on the Flu Pandemic.

Stanford University site on the Flu Pandemic.

9 comments:

  1. Dear E,
    How did the weekend go? Waiting to hear about your "furthering of your pharmaceutical experiments and enlightenment for the entire world." Did you know that Lafayette Ronald Hubbard, sci-fi author, wrote on the same quest? I will not attain any sort of "advanced universal enlightenment" even if I DO take his course! I have got way too much laundry to do!
    Good luck on your quest!

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  2. Thank you for the L. Ron Hubbard shout-out. As soon as I am done seeing my probation officer I will let you know more about all that.

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  3. I think EO is being bit disingenuous here. I am by no means suggesting that the current Swine Flu has become the pandemic that was feared (and yes, certainly fearmongered as well).

    I am suggesting that it is insane to wait until people are dropping like flies until an emergency is declared. As EO himself recalls, .75% of the US population died within a single year in 1918. Let's assume for a moment that something EO might call a 'real' disease entered the population now, something that might conceivably do that kind of damage. What would EO's advice to CDC etc. be for deciding that the threat is real? And what would EO's preference be for when alarm bells should start ringing?

    I am posing these as direct questions to EO, not just as oppurtunities for mockery of the current administration or scornful comparisons to past epidemiological events. I'd really like to know what you think.

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  4. I do not think it is wise to ignore the flu. I think it is unwise to yell "pandemic" and deliberately invoke the 1918 Flu Pandemic when the information available does not support the false alarm. By the time WHO yelled pandemic in late April the problem was already leveling off in Mexico.

    I understand a desire not to be "wrong" and fail to sound the alarm. My point is that there are serious costs to being "wrong" when you sound the alarm. People tend to ignore you next time. That's bad.

    When you are in charge of alarms, you have a moral responsibility to get it right. You can't slough it off by saying "no harm, no foul" when you ring the bell and you are wrong.

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  5. Sorry to keep at this, but once again, I am asking you what you think the threshold should be for ringing the bell. If you are not willing to put it on the line and say how many people need to die or get infected before CDC et al should start issuing warnings, then you are simply a Monday morning quarterback and all your scorn and sarcasm are worth less than nothing.

    In fact, I notice in EO's posts something that pervades most conservative propaganda (and probably most liberal propaganda as well, but the Dems are in power so the conservatives are the guilty ones now): a deafening babble of attacks, sarcasm, and hatred accompanied by a deafening lack of ideas. I would love to see EO and other pundits accompany their diatribes with positive ideas or suggestions. Say, for every "That's so stupid" they present one cogent way to handle it better, one that takes the people into account (remember 'by the people, for the people?'), not just the commentator's cronies.

    Sounds crazy I know...

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  6. P.S. We definitely agree that the fires were stoked too hot with this Swine Flu. My contention is that the CDC acted reasonably by issuing warnings and that the media did their utmost to create panic and sell it as the pandemic at our throats. The media (especially television), I have long contended, does everything in its power to keep us scared, keep us buying, keep us watching. The culture of fear reigns supreme in the US, and the Bush administration played that game as hard as it could. You are correct when you bring up the Boy Who Cried Wolf. But don't start blaming the Dems or the Obama administration (yet!). That's just silly.

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  7. When you're in charge of the alarms, you ring the alarm when a) you see smoke, and/or b) reports of fires are recieved from professionals in the field. The problem is not the CDC or WHO. What they did was alert health professionals that there was a new flu strain in the pipeline, and advised caution until its severity could be determined. The media screamed EVERYBODY PANIC. People responsible for public health on a local level freaked out over the hysteria and instituted ridiculous preventive measures as CYA -- they're worried about their jobs.
    The media deserve scorn for selling fear. But they're whores because we buy what they're selling. A little common sense would go a long way.
    And just out of curiosity, have you read And the Band Played On?

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  8. An update: According the the Starting Point blog on Yahoo,

    "The H1N1 flu, which is commonly known as the swine flu, has killed 2,837 people, Reuters reported. According to the World Health Organization, that number is up from 2,185 deaths reported on Aug. 28. To date, about a quarter of a million cases of H1N1 have been confirmed worldwide."

    It's puttering along.

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  9. Swine Flu update, 12/5/2011: it was a fraud designed by large pharmaceutical companies to sell vaccines. The vaccines were useless, and the swine flu was less dangerous than ordinary seasonal flu.

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