SciTech

Swine flu spreading further: But was all the initial panic worth it?

pO157.

Posted to SciTech on Wed May 13, 2009 at 06:53:49 PM EST (promoted by port1080). RSS.

The news cycle has rebooted, and initial panic has subsided. The first reports of the start of the pandemic, coupled with the World Health Organization's raising alert levels and warning of an imminent pandemic are weeks past, although some cautious behavior remains. As the number of cases rises around the world scientists and epidemiologists are starting the debate as to whether initial actions and attention were worthwhile and proper, or whether this entire event has been overblown.

The US CDC announced this week that America has suffered about 2,532 confirmed cases as of 5/11, with 104 hospitalizations and 3 fatalities. Authorities report that the actual number of cases is likely much higher due to the fact that there is a backlog in testing and not all patients are being definitively assessed for the virus. They also announced that most new cases in the United States are now linked to person to person transmission between people that have no connection to Mexico, as opposed to initial outbreak stages where most were travelers. Above all, the CDC suggested that people not ignore the flu completely and warned that it could get worse.

However, now that news media are not covering the situation 24/7 many people are beginning to calm down and take stock of the situation. Scientists are as well. In one of the first reviews since the epidemic began, Dr. Neil Ferguson of Imperial College (UK), suggests that the amount of cases may be drastically understated, and that this flu is much worse than the seasonal flu in terms of transmissible and virulence, but less so than the 1918 flu. Dr. Ferguson argues that this appears similar to the 1957 pandemic which killed about 1 to 4 million worldwide, while seasonal flu kills 250,000 to 500,000 people a year. He argues with genetic evidence that the virus likely appeared in Mexico around January 12th and is of a type never seen before. With a case fatality rate of 0.4 to 1.4% and each case resulting in about 1.5 new infections the study authors concluded that this will likely be similar to the pandemics of the earlier 20th century.

"Our early analysis would suggest this is going to be an outbreak comparable to that of 20th century pandemics regarding the extent of its spread -- it's very difficult to quantify the human health impact at this stage, however," said lead author Neil Ferguson of Imperial College, London.

Other scientists complain that the WHO was too slow in ramping up the pandemic alert to 4 and 5, respectively. They argue that there is still a slight danger of this H1N1 virus mutating to become more deadly and thus take advantage of its high transmissibility and the low innate immunity of humans to it to spread farther and cause more damage. A nightmare scenario would be re-assortment with the "bird flu" or H5N1, although all agree that this is very much unlikely to happen.

Of course, not all have analyzed the swine flu media coverage with such measured terms. Many media critics harshly chastised the press for scaring people into believing a major, immediate and deadly pandemic was occurring. Critics like Jeff Poor point to articles published by the associated press detailing  the "worst case scenario" and describing overwhelmed hospitals, destroyed economies, millions killed, etc. Even politicians like Gov. Rick Perry (R-TX) blamed the media hype for exacerbating the situation, even as local schools within his state were shut down to contain the threat.

Tags: edited by Port1080, written by pO157, politics, swine flu, pandemics, WHO, CDC (all tags)

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1

Re: 2004 Redux or, YEAAAAAAHHHH!!!!!

pO157.

Wed May 13, 2009 at 07:52:21 PM EST

5.00 (insightful)

I remember back in '04 or so everybody watching the news panicking over our imminent death from Bird Flu. A few folks in the far east were sick of an admittedly horrible ailment, and people were freaking out about it. Scientists advised cautious attention but many news networks whipped people into frenzies (admittedly it is also the freakout-ees fault to freaking out) and caused people to go nuts even though the disease was thousands of miles away. That was idiotic.

Now we have a novel virus popping up with thousands of cases to the south of the United states, and rapidly showing up in a dozen countries within days, before containment could work. Initial reports suggested this flu was a bit more scary (the normal seasonal flu has a fatality ratio of 0.1%) and much more transmissible than the regular flu. Given a highly transmissible flu now traveling by airliners, going person to person and spread across several industrialized nations what was the WHO to do? Raising the pandemic alert level to 4 and then 5 was reasonable and prudent considering the fatality rate of this flu is FOUR TO FOURTEEN times larger than the average seasonal rate.

So, the WHO was reasonable. So who wasn't? I'm going to have go with the media on this one. Instead of being reasonable and saying "Hey! A new disease is out there. It probably won't impact you for weeks, if ever, but it would be a good idea to avoid travel to Mexico and follow reasonable precautions like ensuring you have a month of food and water in your home." But did we get that? No, we got "ZOMG! DEATH AND MAYHEM! END OF DAYS! TEH PIGS WILL PWN US ALL!11!1one" Then stupid people did stupid shit. As I firmly said to co-workers and others at the time, I was more worried about being hurt from the shenanigans of people around me acting dumb in response to the flu than the flu itself. Thankfully neither happened.

Pandemics don't happen within a 24 hour news cycle. Eventually people got bored and called shenanigans. Now, weeks later we have tens of thousands of cases around the world. If these infection totals had first been reported when the story broke we'd have people building bunkers and stocking up on ammo or something, but because nobody is paying attention nobody cares. My county just had its first 3 cases in the school systems yesterday. Although this is unlikely to be the case this virus is following the pattern of the 1918 pandemic, which was mild at first in the spring, vanishing, then coming back with a vengeance in the winter. If this happens what good did it do that the media shot its proverbial wad early on this and is blaming the WHO for fear mongering? Will everybody believe the WHO's warnings in the future if something dire happens?

In conclusion, people need to have a better appreciation of risk. They need to better understand science. The media and political types need to do a better job of communicating to their constituents.

On the plus side the local store gave out insane deals on delicious delicious bacon and sausage because stupid people no longer wanted to buy it. My freezer is now overflowing. Advantage: Milhouse!

This space for rent.

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^ 1

Re: 2004 Redux or, YEAAAAAAHHHH!!!!!

shane.

Wed May 13, 2009 at 10:25:06 PM EST

3.00

Recently it was reported that Japanese tourists visiting Canada caught swine flu.  This was when we supposedly had 50 cases of swine flu. Currently we have only 389 confirmed cases.

What are the chances that a a Japanese tourist is going to come in contact with one of less than 400 people with the flu?  There are 30 million people in this country and it is VERY spread out.  With 400 cases confirmed and the knowledge that tourists to Canada are able to catch the flu, how many actual cases are likely out there?

3

^ 2

Re: 2004 Redux or, YEAAAAAAHHHH!!!!!

pO157.

Thu May 14, 2009 at 12:55:03 AM EST

none

The thing that makes the flu so fun is one of the times when you are most infectious is the 24-48 hour period before symptoms show up. So you can be spreading the virus without even knowing you have it.

Secondly, I imagine (as referenced in some of the articles in the writeup) that however many of "confirmed" cases there are that there probably are easily 10-20X more that were never diagnosed. How many people sat around at home for a week feeling like crud and then went back to work? How many people shrugged it off as a horrible cold? How many people were misdiagnosed as something else? How many people were infected but never showed symptoms? Yeah, you can see where I'm going with this.

♫For the times they are a-changin.♫

5

^ 3

Re: 2004 Redux or, YEAAAAAAHHHH!!!!!

zyxwvutsr.

Thu May 14, 2009 at 10:12:54 AM EST

none

you are most infectious is the 24-48 hour period before symptoms show up
Do you have a source for that assertion? Everything the CDC has been saying would seem to indicate the opposite.

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^ 5

Re: 2004 Redux or, YEAAAAAAHHHH!!!!!

pO157.

Thu May 14, 2009 at 11:59:32 AM EST

none

7

^ 6

Re: 2004 Redux or, YEAAAAAAHHHH!!!!!

joshv.

Thu May 14, 2009 at 01:30:12 PM EST

none

From the linked report:

"Influenza is primarily transmitted from person-to-person via large virus-laden droplets that are generated when infected persons cough or sneeze; these large droplets can then settle on the mucosal surfaces of the upper respiratory tracts of susceptible persons who are near (e.g., within about 6 feet) infected persons"

This would tend to indicate that you are most infections after symptoms appear, as you are more likely to be coughing and sneezing.

8

^ 7

Re: Not if you are too sick to move.

pO157.

Thu May 14, 2009 at 01:35:21 PM EST

5.00 (informative)

How can we spread disease when our fever is burning?

As my old virology professor used to say, sure you're more likely to be infectious with Ebola at the end stages when you are bleeding from every opening (every opening), but at that point who is going to not run away from you and more importantly, could you even make it out of bed at the end?

If you are 24 hours from symptoms with the flu you're going to be around a ton more people than you would be once that fever hits and you're hot blooded. Can't spread it if there is nobody to spread it to.

♫For the times they are a-changin.♫

9

^ 8

Re: Not if you are too sick to move.

joshv.

Thu May 14, 2009 at 03:23:22 PM EST

none

Yes, if you self-quaranteen you will be more likely to infect people during the incubation period.

But a person standing next to me displaying symptoms is much more likely to infect me than that same person standing next to me during the asymptomatic incubation period.

10

^ 6

Re: 2004 Redux or, YEAAAAAAHHHH!!!!!

zyxwvutsr.

Thu May 14, 2009 at 06:49:13 PM EST

none

Do you have a source for the assertion "are most infectious is the 24-48 hour period before symptoms show up"? That is, the CDC says 24 hours or less and does not say that is the "most infectious" period. They do say that coughing and sneezing are the most prevalent ways that influenza is spread, and asymptomatic people are not coughing or sneezing.

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^ 1

Re: 2004 Redux or, YEAAAAAAHHHH!!!!!

thefadd.

Thu May 14, 2009 at 05:08:17 AM EST

none

Or you could just change you diet so you don't get sick anymore.

God forgives. The press only forgets.

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^ 1

Re: 2004 Redux or, YEAAAAAAHHHH!!!!!

HidingFromGoro.

Sat May 16, 2009 at 04:38:18 AM EST

none

Is that YEAAAAAAHHHHH the noise that plays when David Caruso puts on his sunglasses on CSI Miami because that noise is pretty nuts.

12

Re: Swine flu spreading further: But was all the

HidingFromGoro.

Sat May 16, 2009 at 04:54:32 AM EST

none

Irrational panic over swine flu you say?  Heh.  Let me tell you noobs about a lil thing called SARS...

'Course, you young'uns probably think Salmonella at Jack in the Box is old-school news-cycle filler- but back in my day, we unnecessarily worried about the REAL threats: militias, Dungeon & Dragons (aka Satan worship), huffing, and the Unabomber.  Now those were things a man could really get worked into a minor, impotent worry over.  

13

Hombre murciιlago

Steve Urkel.

Tue May 19, 2009 at 01:06:09 AM EST

none

The original source of the outbreak has been determined.

14

Overdone so far, but...

Lou.

Thu May 21, 2009 at 02:38:13 PM EST

none

You know...things might have been very different had this bug appeared during traditional cold and flu season.  We still might not be off the hook come November.  So, for all of those folks who have thus called it "the sniffles" or made remarks that so far only fat Mexicans have died from it, it still might not be too late to get a visit from this feller.

Minty fresh

15

^ 14

Re: Overdone so far, but...

zyxwvutsr.

Fri May 22, 2009 at 03:24:26 PM EST

none

...so far only fat Mexicans have died from it...
Where'd you hear that? I'm certain that's incorrect.

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