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Wednesday, April 29, 2009

OK, this public service ad is from the 70s, but still...

This is just to demonstrate to those who think this thing is being 'managed' and 'contained' just how difficult it is to do either in a world where people are so mobile.

Just to make sure everyone knows what we are up against, here's a good overview from the CDC:

Hat tip to my friend Dave for sending this my way

Posted by David Bogner on April 29, 2009 | Permalink

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The vaccine used in the 70's was linked to Guillain-Barré syndrome which causes paralysis. I liked the second half of the commercial - waching the virus spread so easily. Gives me the chills.

Posted by: Chedva | Apr 30, 2009 4:25:55 AM

No one has any doubt that it isn't something to be concerned about, David. Obviously this new strain is here for good. But given the aggressive measures being taken and the new treatments available, I'm not worried about another 1918-scale flu epidemic. 50 million people aren't going to die. We're probably talking about thousands, tens of thousands of deaths from the swine flu - but for a new worldwide flu virus, that's about par for the course. It's not the end of the world.

Posted by: matlabfreak | Apr 30, 2009 7:19:19 AM

Chedva... I know they don't have a vaccine now. My point is that many people seem to be putting too much faith in the government, CDC and WHO... and not enough on common sense.

matlabfreak ... You know I like and respect you, right? You come to the table with facts and figures and solid information to back up your opinions. I like that. But stop and reread your comments over the past few days. Now think about even ten of (only!?) those tens of thousands who will likely die... and put the faces of ten of your friends or family on those bodies. Now tell me how this isn't worth getting worried and upset over. Sometimes you can be a little too removed in your analysis. A pandemic that claims thousands of lives is worrisome. Heck, think about all the people who play the lottery... their odds of being killed by swine flu are far better than their odds of retiring on the winning numbers.

Posted by: treppenwitz | Apr 30, 2009 8:33:14 AM

Approximately 36,000 people die each year from the "normal flu." I am not saying that we shouldn't be concerned, but it needs to be measured and balanced.

Posted by: Jack | Apr 30, 2009 9:58:23 AM

Hundreds of thousands of people die every year from the flu, David. We don't really have good numbers on the developing world, but even in the Western world we're talking about at least 100-200k every year (on average), even with modern medicine. It's a terrible disease which is far deadlier than diseases that get high profiles... that's probably because it only kills a small percentage of those who are infected, and is considered 'common' and easily survivable. In reality, though, influenza is far harder to effectively eradicate than many other diseases that we've largely vanquished in the Western world - polio, TB, smallpox, etc (even HIV, which gets so much bad press, could theoretically be eradicated in a generation). It kills more Americans than suicide or homicide, and is up there with sepsis and pneumonia, the other two major infectious disease killers in the US.

The CDC and its parallels in the rest of the world are well aware of the dangers posed by influenza. We spend large sums of money every year in vaccination programs, epidemiology research, etc. specifically to mitigate the effects of this disease. There are obvious concerns about the emergence of an entirely new strain of flu that can rapidly infect large numbers of people who have no prior immune defenses. This has happened on a number of occasions since the famous 1918 outbreak, and the results are always different - the infectivity is different, its lethality and ability to be treated varies, etc. Partly because of the rapidly-changing nature of influenza and its unpredictability wrt the behavior of new strains, we spend a lot of brainpower and money trying to deal with it. The upside of all of this is that now we have unprecedented tools at our disposal to deal with new strains: we've already sequenced a handful of the new viruses, we have detailed data on their response to available antivirals (of which we have a couple kinds because of prior research), etc.

In this context, let's think about the actual situation rationally. Will this new strain be eradicated by quarantine and the like? Hardly; as with most viruses like this, by the time anyone noticed something was wrong, the cat was out of the bag. That being said, the entire world's health system is prepared for this kind of eventuality, and new cases are being quickly identified and treated - and we learn exponentially more about the virus every day. With adequate treatment, it seems like mortality is not likely to be appreciably higher than any other flu season - on the order of 10^3 or 10^4 worldwide casualties, not 10^6 or 10^7. Not to be heartless, but most of these deaths are going to happen in countries with substandard healthcare systems as well.

It's terrible, yes. So is the normal flu and a whole host of other medical scourges. I work in biomedical research specifically because I think we should make every effort to minimize human suffering and death from preventable causes. But that being said, we need some perspective on the issue. The swine flu is something that we should certainly be worried about - that's why people whose job it is to worry about it are doing the right things to minimize its impact. Being worried is fine - but panicking is entirely another. The media, abetted by the willing ignorance of much of the public, is blowing this into a ridiculously big deal. You know that PSA you posted? Well, it was tied to a massive overreaction to the last swine flu scare 30+ years ago. The government (rightly) acted aggressively to mitigate the spread and effects of the virus, and the whole panic fizzled.

This disease is almost certainly not going to kill millions or destroy the economy - and more importantly, our panic isn't going to make anything better. Responding calmly is much more effective and reasonable.

I guess we're just coming at this from different perspectives. In the medical world, it's a given that lots of people are going to die from various respiratory infections every year, despite our best efforts. From a public health perspective, we can't think about every single patient who dies, but rather at the cumulative impact of this new variant. Is it going to fundamentally change the equation and the mortality numbers? Not bloody likely. With aggressive diagnosis and treatment, it will probably have a relatively minor impact, especially once the new vaccines roll around for the next flu season.

Posted by: matlabfreak | Apr 30, 2009 10:21:25 AM

David,

http://hotair.com/archives/2009/04/30/on-second-thought-dont-panic/

Could you please relax a little bit?

Posted by: Ruth | Apr 30, 2009 9:56:20 PM

Did you ever read the book "The Plague"?

Posted by: Rivka with a capital A | May 1, 2009 2:41:29 AM

Camus was not an epidemiologist - and the novel has absolutely nothing to do with how this situation is being treated. We're hardly complacent.

Posted by: matlabfreak | May 1, 2009 6:46:46 AM

Glad you "enjoyed" it.

If you're in the mood for 1970's TV commercials, check out this gem:

http://www.youtube.com/watch?v=uDBJ2ktSZpI

Posted by: Dave (Balashon) | May 1, 2009 12:30:41 PM

I think a lot of the fear and panic associated with the Swine Flu, AKA Swine Influenza Virus (H1N1), could be mitigated through the use of a humorous appellation.

I propose calling it "Chazzer Choleria."

Posted by: Elisson | May 1, 2009 8:43:47 PM

The problem isn't the virus, it's Dotty and Betty. They're killers.

Posted by: Alice | May 1, 2009 10:43:58 PM

I liked the way King described it in "The Stand"

Captain Trips....

Posted by: triLcat | May 3, 2009 10:13:04 PM

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