I have a few non-authoritative comments regarding recent and current medical developments. This concerns the flu (esp. the H1N1 Swine Pandemic Flu), and the two recent changes in screening recommendations, for breast and cervical cancer and related issues.
Regarding the flu, we are seeing more evidence that a peak has passed in the H1N1 outbreak. What you need to know if you are in the US is that as of today, the CDC has NOT declared that a peak has passed here. The number of states with “outbreak” level occurrences has dropped and the number of children who die per week has gone down a little, but it is too early to say if a peak has actually passed.
What you need to know is this: Starting over the next few days, Americans start to travel in large numbers. This is very likely to increase exposure and enhance the spread of H1N1 and any other respiratory viruses that happen to be hanging around. Perhaps we will start to see the appearance of seasonal flu, perhaps we will see an increase in H1N1 infection. If there is an increase in H1N1 infections over the last several days in November, we will be looking back at this month and we will be tempted to engage in a trivial debate as to whether or not there was a peak and then another peak, a non-peak with some variation, or a hump on a peak, or yada yada.
The point is that the immediate conditions under which the flu spreads are winter time conditions that are arriving as we speak, and the larger scale conditions under which it may spread … increased travel … will be a major factor over the next several days and again in late December and early January.
It would be very reasonable to assume that the highest rate of infection … the tallest peak in the data across time … will happen over the next month or two.
Now, on to mamograms and pap smears. I have not read the papers, I have not read much of my fellow science/medicine/public health fellow bloggers’ commentary. I will, but to date I’ve been busy with other things. So, this comment is short and sweet and based entirely on what I’ve heard on the news, and is subject to revision:
It seems to me that we were making mistakes before based on the information that was gathered as part of frequent screening. We were finding indications of possible problems, then treating problems that really were not there.
It seems to me that the solution being recommended is this: Let’s have less information at hand so that we don’t fuck up our use of that information. If we don’t have information that we can misuse, then we can’t misuse it.
It seems to me that it would be better to use the information better than to reduce the amount of information.
It seems to me that these recommendations are the end result of a neocon-esque analytical approach that assumes that people learning and knowing and acting apropriately on scientific information is nil and can’t be improved.
It seems to me that such an attitude totally sucks. Am I wrong?