Sunday, September 6, 2009

Flu Pandemic: Panic and Reality

Did you ever wonder what purpose is being served by fomenting panic over a mild and far from novel flu virus? Why do government agencies and WHO want to force unproven vaccinations on whole populations? Why are they spreading panic by issue general, fill in the blank internment and quarantine orders, such as the ones before the Iowa Board of Health? Why is the World Health Organization so quickly putting out a mass vaccination order? And why in the world would the govenor of Maryland call getting a flu vaccination a 'patriotic duty"?

These are questions that I have been asking myself in the past few days, as the first day of school on the East Coast has caused the media to go into hyperpanic mode about a flu for which the deathrate in the US is far lower than for the seasonal flu.

Sandy Szwarc, BSN, RN, CCP has a very cogent and calm discussion of the actual facts about this flu over at Junkfood Science. She says:

"The flu season has barely begun and yet the panic is already in full swing with 186,933 media stories about H1N1 and 47,159 news stories about the swine flu currently at Google News.* Do you know what is missing among the widespread pandemic alarm in the media and coming from government agencies, pharmaceutical and other stakeholders?
The scientific evidence being reported by medical professionals and in the medical literature

She goes on to discuss that scientific literature in detail, including an analysis out of MIT published in the British Medical Journal, and the efforts of physicians in the US and abroad to spread Common Sense about Type A Influenza Viruses. In summing up the MIT analysis, Sandy writes:

"A single, one-size-fits-all public health strategy that assumes every epidemic results in widespread catastrophic and deadly disease (type 1) is not appropriate. Some epidemics affect very few people but the infection is serious, while type 3 affects many people but with mostly mild infections. But most new viruses, he stressed, are not type 1 threats. The 1957 and 1968 pandemics, for instance, went largely unnoticed by most people and the recorded deaths during both pandemics were similar to those seen an ordinary flu season today. So, we have pandemic preparedness strategies that are based on a catastrophic (type 1) epidemic and which result in public health responses that are improperly calibrated to the threat and risk doing more harm than good. They are also seen as alarmist and erode the public trust. "

And in her discussion of Spanish physicians who blogged for flu common sense under the rubric: Gripe A: Ante Todo, Mucho Calma, she says:

"Just because the virus is infectious and spreads easily, however, does not mean that it is more serious. This virus has proven to cause mild or moderate flu and to be less severe than the ordinary seasonal flu. Most people have mild symptoms and will get no benefit from going to the doctor, the physicians stress. Most importantly, the advice for taking care of the swine flu is the same as in all types of colds and flu. Most people can care for themselves at home, just as they would any cold or flu, with keeping themselves hydrated and nourished."

In an interesting twist on this story, Sandy also provides evidence that the Google Search engines actually censor what is is out there, providing additional bias towards the big build up to this mild flu. About this, she writes:

"There was no mention of these medical articles in the Google News, even specifically searching using pertinent search terms. And any mention of the blog project was only found by searching for the participating Spanish medical blogs by name.
Google’s Health Advisory Council appears to have determined that mention of these medical articles is not relevant for you.” Google has become such a transparent social media marketing venue, it’s impossible for those who follow science and research to miss how Google’s search results prioritize what government-private stakeholders want the public to believe, not what people may want or need to know. Consumers searching Google for information, however, are largely oblivious to the degree that Google’s firewall filters their news."

I concur with Sandy here, based on my own searches for information relevant to my study of neuroscience and neuropsychology.

Sandy ends with these words of wisdom:

"Given that it’s unlikely the enormous political and financial interests behind flu pandemics will come to a screeching halt, that leaves medical professionals and consumers to be the responsible ones and get the facts, keep calm and practice common sense."

Read the whole article. Follow the links to actual, peer-reviewed scientific literature and analysis. Because Sandy is absolutely right.
As per usual these days, common sense will have to begin at the grassroots.


Lori Ellison said...

Here's what I think about this whole H1N1 pandemic thing.

"Pandemic" and it's various phases is based on declarations by the WHO (World Health Organization). It's not much more than a system of categories for how much and what kinds of aid you can get from them if you're in a bind.

Regardless of how bad you think you need it, the aid gates don't open if the WHO doesn't say it's a pandemic. So, to my mind, it's a label for/from WHO and isn't necessarily indicative of how bad things are, or how bad things might get.

H1N1 is a unique virus in that it has swine, avian and human DNA. That makes it unique. Mostly viruses pop up with only one or two species. A three species virus is quite unique. Doesn't mean it's any more deadly. Just unique. So far, it's been a very mild flu. Certainly not the worst we've seen, or the worst we will see. Most people get it and get over it.

It's worst qualities are that it strikes a younger generally more fit and healthy population. I don't think that's the virus' fault. I think it has to do with the hygiene and personal habits of the people it strikes. They're young enough to still believe in their own immortality. So they don't practice the same safeguards. What high school student wants to be seen slathering themselves in hand sanitizer?

What I hear is that the REAL worries are these:

1) That H1N1 swine flu (with a +/- 3-5% mortality rate when untreated) will get mingled with the H5N1 avian flu (with a +/- 50 - 60% mortality rate when untreated) during this winter's migration season. This would be the "Superbug" our mothers warned us about. There would be almost no defense against it.

2) That H1N1 will be pretty bad, infects lots of folks, overload our healthcare system and BANG! there will be a bioterror attack this winter at the height of the flu season. I'm not making this up. Folks at the FBI and CDC are seriously losing sleep over this.

Either way... I don't think H1N1 is the biggest concern. If it had popped up earlier, it might have been included in the regular seasonal flu vaccine. Then it really would've been much ado about nothing.

But I think it highlights the fact that people in general are not prepared for disruptions in the status quo. Not only are they not prepared, they don' even want to think about it.

I know that I see official projections for H1N1... and then I see some of the stuff that other people want to release... numbers that aren't fact based (panic-based is more like it)... numbers and even facts in some cases that are, at best, poorly stated and at worst just plain wrong.

Do they want to scare people into preparing for emergencies? Do they know about some impending crisis that will happen under the cover of H1N1? Smoke and mirrors? But for what?

As always, I'm left with more questions than answers, more concerns than certainties.

Anonymous said...

"As per usual these days, common sense will have to begin at the grassroots"

I agree.

And as the mom of two insulin dependent kids whose conditions were likely triggered by a flu like "bug" (we have no family history of T1, and our kids were each diagnosed as a part of "clusters" following widespread virus activity in our area), I'd like the same "grassroots" movement to wise up to the idea that a person with a contagious condition belongs AT HOME and ISOLATED as soon as that condition is detected. Instead, it's practically a virtue to show up to work as sick as a dog, to send our kids to school with faces swollen like hamsters and dripping cold viruses from every orifice. If we don't, in fact, we risk being fired from our jobs and we get letters from the school about how we could be cited for our child's non attendance. (We did.) Last year my daughter was hospitalized overnight because she went into DKA after being infected with the Norwalk virus, at a total cost of $8000. After insurance we had to pay $1500. If everyone had that sort of consequence from exposure to a "mild" virus, this "contagious people should carry on with their lives as usual" nonsense would come to a crashing halt. And then maybe we wouldn't need so many vaccines...


Melora said...

Thanks for this. I found the article very cheering!

Elisheva Hannah Levin said...

Lori: H1N1 is unique in itself, but as viruses go, that is par for the course. For replication of their genomes, viruses must hijack cellular machinery, and the replication is very bad. Repackaging the replicated genome into the protein capsule is also pretty inefficient. This is why most viruses change with each host that they go through. This is hardly novel, although the CDC does not explain this very well in their pages for the general public. (I used to teach undergraduate genetics and I do know something about this).In any case, none of viral components of H1N1 are novel, and that is probably why we are seeing such mild infections, and may be why we are seeing more infections in young people who have not encountered a virus in this viral family before. People like me, with other underlying health concerns, need to have the freedom to weigh the risks and make our own decisions about how to deal with them. Since I react badly to vaccinations, if there is an outbreak locally, I will probably take other sensible precautions.

With respect to the funding issue, I am not impressed with WHO. They need to reform definitions and procedures to conform to the science so as not to spread panic. Why don't they? Well, you get more grants when people panic. (I have played the BIG SCIENCE game enough to know how this works!).

Deborah: I agree that sick people belong at home, and I agree that employers should not fire people who are sick. That said, I also have special vulnerability to viruses due to a chronic, progressive autoimmune disease. It's not fair that I am more vulnerable and that both the vaccinations and the disease itself pose greater risks for me. What I want is the freedom to make my own decisions about how I will mitigate the risk.
Perhaps the silver lining here is that the recommendations are that sick children be kept home from school. Perhaps the school officials will take this seriously, and not be overzealous about absences. And perhaps we need to revist the whole truancy witchhunt . . . but that's another blog!

Melora: Glad to oblige!