Adventures in Ethics and Science

This, our first week of classes of the Spring semester, also marked the return of regular publication of the daily student newspaper. Since I’m not behind on grading yet (huzzah for the first week of classes!), I picked up yesterday’s copy and read one of the front-page articles on my way to my office.

And dagnabbit if that article didn’t angry up my blood.

The trouble is, I’m having a hard time figuring out where properly to direct that anger.

The article, which appeared below the fold, was titled “U.S. Health Secretary urges vaccinations”. It drew from a January 26, 2010 conference call between U.S. Secretary of Health and Human Services Kathleen Sebelius and college newspapers about the novel H1N1 flu virus, the prospects for an uptick in novel H1N1 flu in January, the availability of vaccine, and the vulnerability of younger people to this virus. (The article cited Sebelius’s claim that people in the 18- to 24-year-old group who get this flu are six times more likely to be hospitalized than those in other age groups.)

Later in the article, there was some discussion of how the government is trying to use social media to get the word out about flu, vaccines, and ways not to infect your coworkers and classmates.

All of this seemed pretty reasonable, and pretty standard, to me.

But midway through the article, the author of the piece did this thing that I can only assume journalism programs are teaching staff writers on student newspapers to do. He asked students on campus for their views on the novel H1N1 flu and vaccines against it:

[Name redacted], a junior nutritional science major, said she doesn’t believe H1N1 is any different from seasonal flu.

“I think it’s just like any other flu going around,” she said. “You just have to be ready.”

[Name redacted] said she doesn’t plan on getting vaccinated.

“I am never going to get vaccinated,” [name redacted] said. “I’m against it.”

She said she is preventing herself from getting sick by eating nutritious foods to help boost her immunity, exercising, getting of rest and washing her hands before eating.

Sophomore chemistry major [name redacted] said he also doesn’t plan on getting vaccinated, as he isn’t worried about becoming infected with swine flu.

“I feel as though it’s not going to affect my life,” he said. “I feel I will not get it.”

[Name redacted] said he wasn’t doing much to prevent getting sick.

“I’m not doing anything in particular,” he said. “I try to stay healthy in general, but other than that, absolutely nothing.”

Senior nursing major [name redacted] said he was vaccinated to protect himself.

“I found out that the school was offering it for students, and so I thought it would be a great idea to get vaccinated,” he said.

(Note that the students interviewed for the linked story are identified by name in that story. I’ve decided to redact their names here in case they were misquoted, and because even if they weren’t, I’m not comfortable taking them to task here in a way that gives their names lingering negative Google-juice. I’m committed to the idea that people, and especially college students, are capable of learning.)

The junior majoring in nutritional science was the proximate cause of my first facepalm.

I’d be curious to know on what basis she’s claiming that the novel H1N1 is no different from seasonal flu. The fact that you could contract both (and that there are distinct vaccines for the two) would seem to argue for their non-identicality. Plus, the disproportionate rate of hospitalizations of the traditional “college aged” cohort with the novel H1N1 flu but not the seasonal flu seems like it might point to a relevant difference.

Also, I find it interesting (and perplexing) that her strategy for “being ready” for either flu does not involve vaccination (which she’s “against” for reasons not detailed in the article). Rather, she plans to “boost her immunity” with healthy foods, exercise, rest, and hand washing.

Don’t get me wrong here. I would be thrilled if all the students at our university ate lots of nutritious foods, got plenty of rest and exercise, and were scrupulous hand washers. But these steps do not render the body immune to viruses to which it is naïve. I do rather wonder whether this nutritional science major believes “immunity boosting” foods like lemon juice and garlic obviate the need for antiretroviral drugs in the treatment of HIV.

The sophomore chemistry major interviewed here made me sad (as a former member of Team Chemistry), but I reckon he’s probably just coming from a young person’s place of presumptive invulnerability. I’m sure he doesn’t believe he’ll get the flu, and thus sees no point in getting the vaccine. If he lives long enough, he’ll probably amass some data that suggests that our expectations and our actual outcomes are not always in agreement.

I’m not at all surprised that the senior nursing major interviewed for the article chose to get vaccinated. Entrance to our nursing program is extremely competitive, and the students in that program are extremely smart. No doubt the coursework for a nursing degree includes some discussion of the biology of the immune system, and viruses, and vaccines.

Now, as I mentioned above, I’m torn over where I should place my anger here.

On the one hand, I’m kind of angry at the way what seems to be a standard journalistic convention (at least in the universe of daily student newspapers on college campuses) juxtaposes presumably reliable information from experts with whatever a student wandering across the reporter’s path might happen to opine. The expert says X. The student says Y. And no analysis whatsoever of the gap between X and Y, or what it might mean that a student holds Y regardless of the expert opinion that X.

Journalists, what is the point of this juxtaposition? Especially in an article like this, which is not about, say, the difficulty of adding classes, or a proposed student fee increase?

Sure, I can do my own analysis — maybe anticipating that I may have more contagious students to interact with this term than I would have hoped (although I’ve had my vaccines for novel H1N1 and seasonal flu, so I’m not planning to free-ride on the rest of the herd).

But, I’m a wee bit concerned that the major field of the non-vaccinating student quoted at most length in the article may make her appear to the other students reading this story as if she is drawing on relevant expertise, too.

And honestly, if students are reading this article and thinking, “Well, someone majoring in nutritional science said, right there in the paper, that eating healthy foods, and exercising, and getting enough rest, will keep you from getting the flu, and that the vaccine is bad,” that’s pretty dangerous.

Admittedly, a student relying that heavily on an article in the school paper could do better at seeking reliable sources of information. But there’s not a hint in the reporting of the story that the view articulated by the nutritional science might not be credible. Arguably, identifying her major suggests that there is a certain range of topics on which she could be regarded as more credible than students majoring in other fields — the powers of a nutritious diet, presumably, falling within that range.

So is the problem here a stupid journalistic convention? A staff writer who didn’t go the extra mile to provide some analysis, or to put the presumptive expertise of an interviewee in perspective? An interviewee who was speaking with authority she didn’t have the knowledge base to back up?

Or could it be that they are actually teaching nutritional science majors here that foods have the power to render humans immune to influenza?

Comments

  1. #1 MGS
    January 29, 2010

    I think part of the blasé attitude may be in part because many of us know a couple of people who had flu at the peak of the H1N1 scare and found out from the hospital that it was an H1N1 strain, and it wasn’t that bad. So even though there is much less exposure to H1N1 in the population, making it more dangerous, many of us have a sense that it isn’t worse than common strains of flu on account of some sample cases.

  2. #2 pat
    January 29, 2010

    I have to admit to confusion about the vaccine myself. All last semester, the message was that the vaccine was for high-risk people – and folks of my age (50s) didn’t fall into any of those high-risk groups specified. So I reconciled myself to not getting vaccinated. Now there seems to be a message that everyone should get it. When did the recommendations change, and why?

  3. #3 Ed Yong
    January 29, 2010

    The bit about vox-pops in the middle of this awesome clips (http://blogs.journalism.co.uk/editors/2010/01/28/charlie-brooker-on-how-broadcast-journalism-works/) seems relevant to this discussion.

  4. #4 becca
    January 29, 2010

    Well, H1N1 and this year’s seasonal flu are different. But they’re basically the same bug phylogentically, just not immunologically (although viruses are classified in bizarro ways). It’s a little bit like Plasmodium swapping out var genes (“falciparum and the amazing technicolor dreamcoat” of many colors).

    But… yeah. Facepalm indeed. Letter to the editor?

  5. #5 Kate
    January 29, 2010

    Pat, I think the change might be because of availability. Until recently (if I understand correctly), there wasn’t a lot of the vaccine around. (I know the pharmacies around here only got it a month or so ago.) So they were trying to restrict vaccination to those most at risk. Now there is more vaccine, so they’re encouraging more people to get it–which would have been the original message had there been more to go around at the beginning.

  6. #6 Janet D. Stemwedel
    January 29, 2010

    MGS @1, I’d have been thrilled to see some exploration or analysis of not just students’ attitudes, but what sorts of things are behind them (e.g., experience of friends, difficulty dealing with probabilistic claims, etc.). That probably would have been enough to mitigate my facepalm.

    pat @2, last month when my health care provider was running a flu vaccine clinic, it was for ages 2 to 49. If folks with the vaccine in your area are now welcoming all ages, I’m guessing that’s because they feel like they have adequate supplies to vaccinate everyone seeking vaccine, rather than staring with the age range most likely to be naïve to the virus.

    Ed @3, that video is simultaneously awesome and scary as hell.

  7. #7 Kathy
    January 29, 2010

    We had one of the worst outbreaks worldwide last year in my home state of Victoria, Australia (3,000+ confirmed cases and 26 deaths) yet we still have a low rate of vaccination against H1N1. I think part of the reason is that the illness is being down-sold by both the media and the health authorities. The federal government’s health website says:
    “Despite some deaths in Victoria, the vast majority of cases of Human Swine Flu continue to be mild. Most people are still recovering without any medical treatment. However for people with chronic medical conditions, influenza can be severe. This is evidenced every year in Australia, where roughly 2,500 people die from seasonal flu annually.”
    http://humanswineflu.health.vic.gov.au/

    Anecdotal stories are statistically meaningless but emotionally powerful. Everyone seems to know or know of at least one person who had swine flu, recovered, and is fine. The cumulative effect of the government telling us not to panic, the media downplaying any actual deaths, and personal “experience” has led many people to conclude the vaccine is unnecessary for them.

  8. #8 Barry Leiba
    January 29, 2010

    Just addressing the journalism question: this isn’t new, of course, and it bothers me as well. It seems to be based on a perception (at least) that readers/viewers want to see what the entity-on-the-street has to say. About anything. Whether or not EotS’s opinion has any real value or relevance.

    I’m reminded of a time, years ago, when the ultra-local news on cable (yes, that’s what they call themselves: “ultra-local”) did some item about the search for Saddam Hussein that was going on at the time, and they stuck the microphone in front of motorists stopped at a main intersection in town. They asked them, “Do you think Saddam Hussein is still alive?”

    WTF?, said I. He’s alive, or he isn’t; what on Earth does it matter what these people in suburban New York think?

    Sigh.

  9. #9 Ed Yong
    January 29, 2010

    In the continuing vein of discussing this issue through the medium of British comedy: http://www.youtube.com/watch?v=OQnd5ilKx2Y

    “You may not know anything about the issue but I bet you RECKON something…”

  10. #10 chezjake
    January 29, 2010

    I’m struck by the fact that the student journalist apparently made no attempt to get comments or opinions from faculty in departments that might be presumed knowledgeable on the subject — e.g. nursing faculty.

    I’m also horrified at the implied new meaning of the word “mediating” by the nutrition science student in the very last sentence of the story.

  11. #11 Mister Doctor
    January 29, 2010

    What you can do about the Flu. First, don;t take those dangerous vaccines, next get treated if you do happen to get the flu. See a doctor. Out side of the doctor here are some things that will alos help:

    Vitamin A

    A powerful antioxidant and immune booster.

    Vitamin C

    Strengthens the immune system by increasing the number and quality of white blood cells.

    Colloidal Silver

    Good for viral infections, promotes healing.

    Garlic

    Has antiviral and antibacterial properties.

    L-Lysine

    Aids in combating viral infections and preventing outbreaks of cold sores in and around the mouth. Do not take L-Lysine longer than six months at a time!

    Zinc

    Zinc supports immune function and may have antiviral effects.

    NAC

    Thins mucus and aids in preventing respiratory disease.

    Maitake/Shiitake/ Reishi

    Helps boost immunity and fight viral infection.

    Elderberry

    Has antiviral properties and reduces flu symptoms.

    Olive Leaf Extract

    Enhances immune function and fights all types of infection including the flu virus.

    Recommendations

    Do not take Iron supplements while a fever exists. Sleep and rest as much as possible and drink plenty of fluids.

    Other Products

    LifeSource 4 Life All natural Antibiotic
    Botanic Choice Homeopathic Cold & Flu Formula
    Heel FluPlus
    Ecological Formulas Monolaurin
    NSI Cold & Flu Relief Formula

  12. #12 cass_m
    January 29, 2010

    Instead of buy supplements, I’ll have my immune system make anti-bodies by getting the vaccine so I can carry on with my life. It’s more cost effective.

  13. #13 Isabel
    January 29, 2010

    “# You Might Be a Redneck If… : On Becoming a Domestic and Laboratory Goddess (this site)”

    Someone is actually still PAYING to promote this racist garbage???? Who is paying – Isis? Or SB?

  14. #14 Badger3k
    January 29, 2010

    Ahh, I love the smell of woo in the morning. Colloidal silver? As a topical antiseptic, yeah, there is some benefit. Ingested – nope, it’s been tested. I think Science-Based Medicine had this, and so did the Skeptics Guide to the Universe. Anyone want to bet how many of those supplements have actually been tested (double-blind placebo controlled) and been found to have real effects? Considering that the “homeopathic” (ie sugar or water, no active ingredients) remedy is being put forth….I’d say, not very likely.

    It’s depressing seeing how much misinformation and general ignorance about medicine (along with biology and chemistry) there is.

  15. #15 becca
    January 29, 2010

    Dr. Freeride- my best guess- and it is only a guess, mind- is that the 2-49 is *not* the age range most susceptible. Rather it is the age range that can get the intranasal live attenuated vaccine safely. In my area, at least, the intranasal was available sooner. But of course, all the people I’m worried about aren’t in that age range (well, I was worried about bringing it home to them, so I got it, but yeah).

  16. #16 Pinko Punko
    January 29, 2010

    Dr. Free Ride bust free riders! BLAMMO!

    I love how people act like it is just the same as the seasonal flu. This is why we had a Summer flu season as big as each of the last two years’, a Fall flu season 3-4 times as big, and we’re waiting for the uptick on the Winter season (end of February is the usual peak). Wake up people!

    http://www.cdc.gov/flu/weekly/

  17. #17 Karen
    January 30, 2010

    My husband blew off annual suggestions that he get a flu shot… until the year he actually got the flu. Now, he’s quite happy to get a flu shot every year. :-)

    (An asthmatic, I get whatever immunization I can; trips to the ER for an inability to breathe are scary and expensive.)

  18. #18 speedwell
    January 30, 2010

    Out side of the doctor here are some things that will alos help:

    Inside of a doctor, you can probably rely on the MD’s immune system, since they are overwhelmingly likely to have taken the vaccine.

  19. #19 et
    January 30, 2010

    Why write:
    “Entrance to our nursing program is extremely competitive, and the students in that program are extremely smart.”?

    To me it sounds like you are setting “extremely smart” students in one program against less smart in other programs and then equaling smart with choosing vaccination.

  20. #20 Catharine
    January 30, 2010

    Unfortunately, I saw several people die of swine flu & complications (so far) this season. The saddest case was the 19 yr old freshman from University for Smart Kids. Heartbreaking. The problem *is* misinformation. Media presenting a buffet version of the truth doesn’t help, but neither does 12 years of teaching children to be uncritical, compliant, bubble-filling, relativistic, task-doers who lack the ability to make a sound, rational judgment entirely.

    #11 Something tells me you’re not a real doctor, but just play one on the internets.

  21. #21 David
    January 31, 2010

    Your school needs to fire the entire nutritional science faculty. They are turning out incompetent graduates (unless a whole lot of learning goes on in year 4).

  22. #22 Karen
    February 1, 2010

    I can see why a journalist might want to include the opinions of the “general public”. It might convey the concept of what people are saying despite the fact without actually saying hey this is what people are saying.

    And to address the ignorant perspective of some college students… it’s probably just the ignorant perspective of some college students. It can be hard to overcome long held ideas about things (vaccines, mental illness etc.) especially if you are being taught the facts. That is most likely why the nursing student was vaccinated. As a new nurse, I would never have gotten vaccinated against the flu before but not that it is basically unethical to not get vaccinated when you work with sick people. You could pass it on or bring it home. When you come into daily contact with folks with H1N1 on a daily basis and watch some of them die, you just take it more seriously.

    I feel you though. I don’t think I could work with college students at this point in my life…

  23. #23 Michelle
    February 5, 2010

    I’m just curious–are most of the staffers for your school newspaper actually journalism majors? Not that being an undergraduate student in something means you should already be good at it, but you could at least set the bar a bit higher. At my undergraduate institution, though, almost no one on the newspaper staff was actually a journalism student. Most of them were (weirdly) engineers.

    Either way, this is certainly disappointing on both ends: the writer of the article should have addressed the disparity between expert advice and student opinions, and college students should be much better informed about current events and science than they appear to be from this admittedly small sample.

  24. #24 Joe
    February 10, 2010

    “Don’t get me wrong here. I would be thrilled if all the students at our university ate lots of nutritious foods, got plenty of rest and exercise, and were scrupulous hand washers. But these steps do not render the body immune to viruses to which it is naïve.”
    Your above quote would lead me to assume that you naively believe that a vaccination would render the body immune to viruses. If so you are making a claim that even the vaccine manufacturers would not dare state.
    Taking alternative healthy precautions is wise, risk free, and of benefit to the entire community.
    To borrow a quote from another blog on this site.
    “You do need to be extremely careful about medical claims though; there are people out there who might have something valuable to sell but rather than sell it honestly they’ll make claims which simply are not true. Far more common are people with something of almost no value to sell and who make insinuations that their product is valuable. If you see any article which mentions “epidemiological studies” you can safely dismiss it as nonsense; first of all such studies only suggest a correlation – to which any decent scientists will shrug and say “so what?” Epidemiological studies are also used almost extensively for ‘data mining’ to support false assertions; the technique seems to be: (1) get a lot of worthless data, (2) ignore most of that worthless data to find a few bits that you can use to con the unwary into believing your claims.”
    I suggest you do further research into the real facts and statistics before you join the CDC/WHO choir.

  25. #25 Ed Darrell
    April 5, 2010

    Meanwhile, I keep getting those who claim there is “no proof” that vaccines work at all.

    They don’t even have to get a license to spout off like that.

    The Bush War on Education is taking its toll. Science illiteracy, and what would pass as plain insanity among informed people, becomes more common.

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