July 5th, 2009

At work, Self portrait

You can panic now, or you can panic later

Constant use of 'mild' to describe swine flu misleading people about threat (The Canadian Press)

This article explains why the North American complacency about H1N1 (Mexican flu) is misguided at best. Yes, it really is true that the death rate H1N1 is similar to seasonal flu. And you've had that often enough and not panicked, so why worry now? Unfortunately, mortality is a pretty general concept. It does not reflect the difference that seasonal flu kills your grandma, while H1N1 kills your child. That is a small difference statistically, but a big one emotionally.

The deaths from seasonal flu are overwhelmingly people who were approaching the end of their life anyway, either because of old age, chronic illness or a badly compromised immune system. Something was going to off them one of these years. In contrast, it seems that a good portion of the elderly are resistent to H1N1 because of its earlier rounds in the previous century. The deaths are overwhelmingly among the young and healthy. In fact, since the deaths come not from the virus itself but from the intensity of the immune response, being young and healthy can actually get you killed.

The second point made is that the current mortality count is at a time when the virus is spreading slowly and in small, scattered outbreaks, and the hospitals are not full. When patients with acute respiratory collapse are turned away because the lung ward is full, the mortality will rise quite a bit. (Also, mortality from asthma and bronchitis will rise in the same period, but this will not be reflected on the flu statistics.)

A point the article fails to make, probably because it is more local to the USA, is the use of the word "flu" for pretty much any mild virus infection, from a severe head cold to contagious diarrhea. "It's just a flu" is not a good attitude even with the ordinary version. And since the medical community uses the word in a different meaning than the populace, it gets even harder to get the right message across.

All you needed to do was keep the virus back until a vaccine could be made. If that required a little panic, so be it. But it may be too late now.
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