When pigs grew wings and flu into media-driven hysteria
By Michael Fumento
Forbes Online, May 1, 2009There's panic in the streets over a flu outbreak. "Projections are that this virus will kill 1 million Americans," the nation's top health official has warned.
Copyright 2009 Forbes
The virus is swine flu. But the date is 1976. And the projection, it turns out, is off by 999,999 deaths. Direct ones, that is. The hastily developed vaccine killed or crippled hundreds. Sadly, the current hysteria outbreak threatens devastation on a worldwide scale.
A calm perspective of the current outbreak of the virus now known as influenza A (H1N1) would compare it to seasonal flu. According to the CDC, the seasonal flu infects between 15 to 60 million Americans each year (5% to 20%), hospitalizes about 200,000 and kills about 36,000. That comes out to over 800 hospitalizations and over 250 deaths each day during flu season.
Worldwide deaths are 250,000 to 500,000, according to the World Health Organization (WHO), or about 700 to 1,400 per day spread out over the year.
There's no hint that influenza A (H1N1) is either easier to transmit than seasonal flu or more lethal. The symptoms are the same, and swine flu cases so far have generally been quite mild.
As of this writing, there are 160 confirmed cases in 10 countries, plus 97 more in Mexico. Yet all eight deaths have been of Mexicans. (Yes, you've read of thousands of Mexican cases and 159 deaths, but the WHO's latest update says otherwise, and they've expressly disavowed the death figure.)
Still, why the Mexican fatalities? All infectious diseases strike much harder in underdeveloped countries, primarily because the people are less healthy to begin with. Only 322 of those 8,096 SARS cases were in developed nations.
The moniker "swine flu" clearly spooks many. But pigs, with the help of birds, routinely transmit seasonal flu to humans. "Swine flu" simply means it has genetic material from pig influenza mixed in. If that inherently made it more dangerous than a pure human flu, the 1976 strain wouldn't have caused merely 500 infections with a 0.2% death rate.No, influenza A (H1N1) doesn't threaten to become "another Spanish Flu of 1918-19," as pig flu panic purveyors claim. Nothing does. Check your calendar; that was 90 years ago. We're not hobbled by a world war, and since then, we've developed things called "antibiotics," as well as antivirals, pneumonia vaccines and other medical tools. In all flu outbreaks, including the Spanish one, secondary bacterial infections cause the vast majority of deaths.
Not incidentally, one of the "worrisome" similarities between Spanish flu and swine flu is that both strains are of the H1N1 subtype. But — ahem! — So is one of the major subtypes of the latest seasonal flu.
Another panic prompter is that so far influenza A (H1N1) appears to disproportionately affect younger people. Assuming this holds up, one explanation would be that older persons have received some immunity from previous exposure to a similar strain. Cause for alarm? In any case, the stronger immune systems of younger people could explain the apparent mildness of symptoms outside of Mexico.
It's indeed true we have no vaccine for this flu. But two years ago, it turned out that the seasonal flu shot was ineffective against the primary strain and one of the two secondary strains. There was no appreciable increase in cases or deaths. That said, it would be insurance to make swine flu one of the three strains in this fall's seasonal flu vaccine.
It's also truly reassuring to see self-important health officials grasping for straws to make the outbreak appear more serious. Keiji Fukuda, a top WHO official, invoked the dreaded "M" word (mutation). "It's quite possible for this virus to evolve," he said, whereupon it "can become more dangerous to people." Actually, evolution favors mutations that make a virus less harmful; better to adapt to a host than to kill it.
The last time a flu mutation perceptibly increased the U.S. death rate was the Hong Kong flu of 1968-69 (34,000 in a smaller population) and before that the Asian flu 1957-58 (70,000). They were bad, but hardly apocalyptic. Both occurred long before the advent of antivirals or pneumonia vaccines.
But influenza A (H1N1) hysteria is even now delivering a gut punch to a global economy, posing a serious risk of a recession within the recession.
It was SARS hysteria, and not the relatively tiny number of cases, that cost the economies of East and Southeast Asia 0.6 percentage points of 2003 GDP, according to the Asian Development Bank. And a World Bank report last year estimated that just the costs of avoiding infection during a flu pandemic — not the illness itself — would shave off 1.9% off world GDP. Some poorer parts of the world — including that containing Mexico — would lose 2.9% of GDP.
Ironically, because as we've seen in Mexico, wealth translates into health, poorer nations could well lose far more lives to the hysteria than the virus. Such are the wages of our swine flu fright fest.
By Michael Fumento
Forbes Online, May 15, 2009
Copyright 2009 Forbes
Although the "worried well" are still swamping emergency rooms, our pig flu is appearing to be a piglet. But now comes a study in Science magazine claiming the outbreak portends a pandemic. The media have gone hog wild over it. "Swine Flu Is as Severe as 1957 Pandemic," blared a typical headline, about the outbreak that killed 1 to 3 million people worldwide and 70,000 Americans.
But actually reading the study and its accompanying citations — rather than just the summary and press release, as most reporters do — shows that despite its spin, it actually supports alternate data showing both that swine flu is less contagious and far less severe than ordinary seasonal flu.
The paper has three citations in support of its "comparable" claim, again with one by the lead author. Of the remainder, one states that estimates "for pandemic influenza vary widely, ranging from 1.68 to 20." It is most definitely the low end.
Another powerful indicator of swine flu's lesser contagiousness is that the Mexican epidemic has peaked. Officials there on May 12 said they hadn't confirmed a new case in four days.
Swine flu is also proving far milder than the seasonal variety, which daily kills 700 to 1,400 people worldwide.
The widely used estimate for the U.S. seasonal flu death rate is one per one thousand infections (0.1%). For swine flu, there are currently three Americans dead — all of whom had previously been chronically ill — out of 4,714 confirmed and probable cases. (The fourth "U.S. case" was a Mexican toddler who sickened there but died here under treatment.)
But with any flu, each confirmed case represents many milder or even asymptomatic hidden infections. Indeed, the Science paper said Mexico apparently has had hundreds for each. Thus to peek below the tip of the swine flu iceberg would be to find a death rate dramatically lower than that for seasonal flu.
Could something happen to change what we're seeing?
Evolution could make swine flu "more dangerous to people," WHO official Keiji Fukuda has warned. Not likely.
Evolution favors mutations that make a virus less harmful; better to adapt to a host than to kill it. Further, swine flu is no more likely to undergo such an evolution than the numerous seasonal flu strains that go around each year.
What of warnings of a winter "second wave?" That's "when influenza viruses usually thrive," the WHO's Fukuda says. But "thrive" refers only to contagiousness; cold has no impact on severity. We certainly could see many more infections down the road, but they'll be just as mild as current ones.
It's understandable that the WHO would be feeling a bit embarrassed over its squawking since 2003 over avian flu. That virus, which the group's "flu czar" David Nabarro once said threatened to kill as many as 150 million people, has steadfastly refused to go pandemic. According to a 2007 amino acid sequencing study, it's light years away in evolutionary terms from the ability to do so.
So perhaps the organization figures that with enough bottles of Wite-Out it can just reuse all those pandemic documents by replacing "avian" with "swine."
Or perhaps sensing the public has had enough, the media will finally say "show me the beef!" Er, uh, make that "bacon."