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I think I can one-up our government's fear-mongering by saying that every year 36,000 Americans - that's about 100 a day - die from flu. And 200,000 get sick enough to need hospitalization. Just imagine how many more die or get seriously ill worldwide. How many more people have to die from the "regular flu" before we call it a pandemic? Do we call it a pandemic when a large enough number of healthy adults die, rather than the usual very young, very old, or immunocompromised victims? I think this is a fair question, considering how many of us see the flu as not much more than an annoying interruption to going to work or having to keep kids out of school. What is it about the swine flu that makes it so much more potentially dangerous than 36,000 deaths?
There may be a reason to panic, or at least feel great concern, but the news reports, even those from the CDC and the WHO, seem designed to create fear and confusion rather than to inform and clarify. In a report yesterday from the respectable PBS Newshour, the director for the CDC made these points:
1) This is a strain that appears to be spreading from person to person. I know it's presumptuous of me to explain to the CDC how flu works, but all human flus are contagious to other humans.
2) It appears to be new and people don't have immunity. Every year we are exposed to multiple new flu viruses for which we don't have immunity. The same goes for cold viruses. In general, you can't catch the same flu or cold virus twice. This is why we go to the trouble and expense of making new flu vaccines each year, and even then we can't make vaccines for all the different viruses that will come.
3) It appears to cause disease. I love this point! Imagine a flu virus that didn't make you sick!
The director made a final point that the swine flu is, thankfully, susceptible to our current arsenal of anti-viral medications. But that only makes me wonder even more about the near-panic level of concern over this flu virus. Even President Obama, a cool head under most circumstances, is talking about closing down entire schools if even one kid seems to have the flu. I can easily imagine that if a few more people get sick in New York we'll quarantine the entire state. Give my regards to Broadway!
Samaphore,
You may be close to right about the magnitude of the numbers although the death RATE may be higher for this hybrid flu strain. That would be enough to urge more caution.
But, I think the main reason for the fear is the exponential growth in the number of cases. Using your numbers, all other flus can be predicted to hospitalize 200,000 each year, a zero-growth rate, which has a sufficient care infrastructure in place. That is probably because a general amount of immunity in the populace. The exponential growth rate is bad in and of itself, but also makes it to predict what numbers we will see tomorrow, let alone at what level compared to 200,000. And, part of this exponential growth rate is due to the lack of immunity in the populace.
So, the common flu is not the model to use. Rather, the pandemic flu after WWI is really the better model. Study that (I know few details) and then tell us how fearful we should be.
Emmett
the death RATE may be higher for this hybrid flu strain. That would be enough to urge more caution.
Exactly so, Emmett. But of the more than 90 cases of swine flu in the US so far, one person has died, and that one person was a 23-month-old infant visiting with family from Mexico. And no one else in that infant's family has come down with this flu. Regarding the "exponential growth" of flu outbreaks, that is "normal." Every year there are exponential outbreaks. That is why flus spread so rapidly and why they kill 36,000 Americans and hospitalize 200,000 more. These numbers are averages, so some years are better, or worse, than others, but there are always many thousands of deaths in the US, and many, many more deaths worldwide. A lack of immunity to flu viruses is nothing unusual; it is precisely this lack of immunity that drives our efforts to make new flu vaccines every year.
If the current swine flu is not a "common flu," then you are right, we can't use that model. (At some point we'd have to draw the line between common and uncommon flus, but not now) But nothing in the CDC reports have indicated why this flu might not be a common flu. They say 150 people have died in Mexico and one person has died in the US, without giving us any other context. Well, if 100 people die each day from a normal flu virus in the US, in a normal year, then what can be said about 150 Mexicans dying from flu in a period of 11 days? Moreover, there is nothing in the CDC reports that indicate why we should use the 1918 pandemic as a model. I think it's worth noting that when we talk of pandemics, we most often are referring to the millions of deaths in 1918, which is why calling the current swine flu a potential pandemic is a bit alarmist unless there is real evidence for it. I suppose I'm expecting the CDC to tell us what, if anything, makes this flu uncommon and potentially more dangerous than the various flus we face every year.
Perhaps I should have named this discussion "The Confusing Language of News Reporting." I get my news from many different sources, and the reporting on this swine flu continues to be lacking in clarity. I'm not saying that I expect scientists to have all the answers right now, but I do expect to be told what it is about this strain of virus that has caught their collective attention and created such a stir. So far, for example, no report has bothered to say whether the death rate of this flu virus seems to be higher than a "regular" flu virus (of course, we'd need some kind of definition of what a regular flu virus is and its associated death rates). I find it nearly unforgivable that the news media and the CDC has not provided this basic information. Emmett is correct to point out that a higher death rate would be enough to urge more caution.
An article in the Christian Science Monitor offers a tantalizing clue. It quoted a communicable-disease specialist as saying that they're seeing a "big change" in the virus's genetic makeup. Okay! What kind of change are they seeing, and what are the possible implications? We already know that viruses change all the time, such as when they make the jump from birds or pigs to humans. When they do that, is that considered a small or a big change? When a virus makes a change so that it kills people at a high rate, does that involve a small or a big change in terms of the virus's genetic makeup? Many of my questions have more to do with background information than with the current swine flu. The news media should be doing a better job at providing this background information, so that we will be better prepared to put the swine flu into its proper context, once we know more about it. But there is plenty we already know about it that is just not being reported, and that is inexcusable.
I'm sorry if it seems like I'm obsessed or ranting about this. I am admittedly very disappointed with the news media and with the CDC. It's hard for me to stand by and watch the panic and the economic impact that this kind of reporting is causing in the world and not know the scientific reasons behind it. I see this as an example of the power of our "Way With Words."
I'll be reading the latest edition of The Economist later today, and I already know that it features an article on the flu. I'll let you know if they do any better.
Now I've learned that my "reporting" was not erroneous, not on my part, at least. The news media about which I am complaining reported that 150 Mexicans had died from the swine flu, but more careful analysis showed that only 12 of those had died from the swine flu. Apparently most of the others had died from run of the mill seasonal flu. Anyway, I guess this drives my point even further home.
Road incidents result in the deaths of an estimated 1.2 million people worldwide each year, and injure about forty times this number (WHO, 2004). This however is never a reason for the media to spread fear amongst their readers, viewers and listeners. Maybe because you don't get ill at first, you just don't come home from your car trip.
Martha Barnette
Grant Barrett
Grant Barrett
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