By any measure A/H1N1 is a benign flu virus. According to official statements, New Zealand, for example, usually has 400 deaths from flu each year. This year there were 17, so it could be argued that the pandemic has resulted in 383 lives being saved, which makes it more effective than any flu vaccine.
It is always good politics to scare people. Create a danger from which you protect them. It’s such an old and common ploy it’s curious how well it still works. Maybe the gullibility is hard-wired.
https://www.medpagetoday.com/InfectiousDisease/URItheFlu/16220 – interesting – that there may be a role for bacteria too
Two points you’re overlooking:
1. The consequences for being wrong are pretty serious, and asymmetrical. I lived in Beijing during the SARS crisis and it was really devastating (talk to some of your grad students who were undergraduates then). For about 5 months you didn’t see any children, students were locked on their campuses, classes were canceled so there was little for them to do, and economic activity ground to a halt (on the positive side, the air pollution dramatically diminished). It was a real crisis of legitimacy for the regime, although they were ultimately strengthened by it (Only the Communist Party can defeat SARS, as a poster in Haidian said).
2. Although H1N1 seems not to be severe, it spreads really easily (40-50 students a day at the U. of Michigan showing symptoms last week, including about 1/10 of my class so far). Bird flu is very serious, but does not spread easily. In people who have both, they can swap DNA and you could end up with something that was very serious and spreads easily. So you can see why a place like China, with a really dysfunctional medical system (even compared to ours) is really worried about H1N1. They have bird flu, they’ve had a searing recent experience with SARS, and there’s a plausible nightmare scenario.
Not to go all Dick Cheney on you, but what percentage risk of the nightmare scenario would you want there to be before you started worrying, if *you* were the government of any of the countries involved?
That is the first I’ve heard of the nightmare scenario. Policy makers are taking it seriously? as for your question, maybe 0.1% — but I find it hard to believe the odds could be determined with any precision.
Check out CBC’s White Coat Black Art from September 19th (podcast here: https://podcast.cbc.ca/mp3/whitecoat_20090919_20419.mp3)
“We’ve heard a LOT about the global pandemic of swine flu in recent months. Experts are predicting a deadly second wave of the illness this fall. Accordingly, Canadian health officials are scrambling to put plans in place to handle the expected health crisis. It’s costing us millions and millions of dollars. But not everyone believes it’s necessary. This week, we ask the question: could this be a pandemic about nothing?”
Any chance that all the paranoia is actually saving those lives in New Zealand? Here in japan loads of schools are cancelled with teachers acting like postmen now. They go to the houses of their students drop off and pick up assignments from mailboxes without human contact. In additon every company, sporting event etc requires people entering buildings to use alcohol on their hands. Since these steps also prevent regular flu it could lead to a drop in mortality. Of course the general attention probably has many more people checking with their doctors instead of trying to fight it off alone.
But according to the Umami hypothesis maybe all these actions will hurt immune response.
We live in interesting times
The “Spanish flu” started out benign, too. (I gather it started as an epidemic at an army training camp in Kansas.) It’s the similarities to that flu, which preferentially killed young people with strong immune systems, that has people worried. Seth, if your immune system is as pumped-up as you hope, that should make you the more concerned.
Really, the mortality rate of Spanish Flu was much lower than plague or smallpox. It was just that so many people got it, each percentage point meant millions.
Can someone explain what it means for a flu to “preferentially” kill people with strong immune systems? It almost sounds like a contradiction.
Anthony: Lots of people are killed by their own immune system (e.g., look up lupus). Spanish flu victims died from lung congestion produced by their body’s response to the flu. The more vigorous the response, the more congestion.
Seth — I think so. Here’s the first thing I got when I searched “swine flu + bird flu” — https://www.cbsnews.com/stories/2009/05/08/health/main5001182.shtml, which isn’t the best source, but it’s something.
One problem is that when people hear the word “pandemic” they think it means “we’re all going to die.” It means many people will have the disease, which gives it more opportunities to mutate into something possibly worse.
One possible piece of good news is the idea that many of the dead in the 1918 flu pandemic were people who also had tuberculosis (because TB rates fell quite a bit afterwards, and stayed down).
Nathan — I don’t know that Seth thinks his immune system is “pumped up.” Rather, probiotic kinds of bacteria can reduce the overall level of inflammation and so decrease the chance that you’ll have the kind of overactive immune response that ends up producing auto immune attacks.
Finally, there certainly is no way of quantifying much of any of this. Which makes me more sympathetic to the people who have to make decisions about public policy in this arena.
Anthony, the second wave of Spanish flu preferentially killed young adults, unlike other flu strains. These young adults had stronger immune systems than the very old and very young. They differed in a thousand other ways as well so the notion that the Spanish flu preferred them because of their “strong” immune system is quite a stretch. Because there was a world war going on, the Spanish flu went through a very unusual selection phase where flu variants that did well among young men had a better chance of spreading than flu variants that did well among the very old and very young. Most of the time flu variants that do well among schoolchildren have a better chance of spreading because schoolchildren are together a lot. (Like soldiers during a war.) Thus they do well against young children. They do well against the old because a larger fraction of the old are already in poor shape.
Dr. Weston Price and Dr. Mellanby both showed (back in the 1930s) that ingestion of fat-soluble vitamins (A, D, and likely K2) imbued protective immunity against infections. I’m not worrying about flu shots or avoiding people with flu-like symptoms (like an undergrad in my lab yesterday). Rather, I’m upping my dose of D3, getting more mid-day sunlight, eating pastured eggs (much richer in vitamins A and D), eating more fermented foods (FAGE yogurt, kefir, kimchee, raw-milk cheese), and putting Thorne’s K2 drops in my beef stock. I’m also making kombu broth this morning. And I’m trying to get plenty of rest. I think this has been shown to be a much more effective approach to protecting oneself against communicable infections.
Kevin, I agree with Aaron’s approach: try to boost immunity (which will have many other benefits). Whereas attempts to reduce exposure have many negative side effects. Since public health officials ignore such a simple and basic point, I find it hard to be sympathetic.
I agree with it, too. But I think we use “boost immunity” in two different ways. One is the idea that you’ll have a stronger immune response. The other, which, probiotics might do, is to enlist other organisms into your immune system, so they’re outcompeting what might come in. If I understand this correctly, in one sense this means you have a weaker immune system, or at least a quieter immune system, because you have less inflammation and therefore a higher threshold for your immune system to go on the attack. But you’re less likely to get sick, which would be why you could say you have a stronger immune system. If problems arise when your immune system is too busy, it makes sense to distinguish between these two senses of having a “stronger” immune system.