Neuron Culture

This swine flu business is moving fast now, with confirmed or reported cases popping up everywhere and the first reported death outside Mexico — a 23-month-old child in Texas — reported this morning. As Effect Measure notes

Some of the fear [generated in the U.S. by this deat] will be lessened by the new knowledge that the baby contracted the disease in another country. The empathy remains, as it should. Mexican babies are still babies, loved by their parents and grandparents even while being hostages to fortune like everyone.

As this outbreak moves forward we will be barraged by numbers and statistics. This is a form of spectator sport to which we have become accustomed. We follow baseball, the Dow Jones and public opinion polls.

But these numbers are different. As the late epidemiologist Irving Selikoff once remarked about the horrific toll of asbestos victims, “death statistics are people with the tears wiped away.”

While I will post on the swine flu here and may do some more pieces for Slate, I won’t attempt to be serve as a news tracking site or clearinghouse here. For that, I’d suggest H5N1, who seems to keep up better than anyone. And for perspective — which we all need at least as much as we do news, if not more so — I’d suggest Effect Measure, where the bloggers are experts who have been doing this for a while and are as concerned with measuring the effects of communications as they are the flu.

As EM regularly stresses, it’s very early in this, and things will change, and compared to what we NEED to know, right now we know jack.

In my Slate piece about the uncertainty of the numbers coming out of Mexico I tried to convey that while it seems certain that this flu should draw concern and a lot of attention, the data available still has tremendous uncertainty, and anything anyone does with numbers right now must be taken with many caveats and the recognition that the numbers could be wrong.

Along those lines, I offer these two gleanings — one from H5N1, one from EM – to ponder and keep in mind during what promises to be a wild and sometimes scary ride the next few days or weeks. One highlights the depth and range of the uncertainty right now. The other suggests how to set your sails accordingly


From H5N1:

Via the Sydney Morning Herald in Australia: Only 7 swine flu deaths, not 152, says WHO.. Excerpt:

A member of the World Health Organisation (WHO) has dismissed claims that more than 150 people have died from swine flu, saying it has officially recorded only seven deaths around the world.

Reports have put the likely death toll from the virus at 152, with Mexican officials confirming 20 deaths.

The number of cases under observation in Mexico alone has reportedly reached 1614.

But Vivienne Allan, from WHO’s patient safety program, said the body had confirmed that worldwide there had been just seven deaths – all in Mexico – and 79 confirmed cases of the disease.

“Unfortunately that (150-plus deaths) is incorrect information and it does happen, but that’s not information that’s come from the World Health Organisation,” Ms Allan told ABC Radio today.

“That figure is not a figure that’s come from the World Health Organisation and, I repeat, the death toll is seven and they are all from Mexico.”

Ms Allan said WHO had confirmed 40 cases of swine flu in the Americas, 26 in Mexico, six in Canada, two in Spain, two in the UK and three in New Zealand.

Ms Allan said it was difficult to measure how fast the virus was spreading. She said a real concern would be if the flu virus manifested in a country where a person had had no contact with Mexico, and authorities were watching all countries for signs of that.

And indeed, when I look back at WHO’s update 4, posted in haste earlier today, I see that it does indeed say 26 confirmed human cases and seven deaths in Mexico.

Here we have a problem that Flublogia has wrestled with for years. Rumours abound. Suspected cases of bird flu pop up, often fatal, but vanish without confirmation. Believe every report, and you wouldn’t expect any of us to still be alive.

But H5N1 isn’t suggesting we shrug it off; just that we really don’t know how virulent this is. His main point:

H1N1 has hit so fast, in a country dealing with recession, drug wars, and other sorrows, that the process of testing, confirming, and informing just can’t cope.

Not terribly reassuring. How are we to gauge our own responses?

Here Effect Measure (as so often) lends perspective:

As we keep looking, we will find cases, so the total will rise, probably on a daily basis. Like poll numbers, it is probably wise not to pay attention to daily fluctuations but look at the big picture. Right now the big picture isn’t visible, but with the passage of days or a week, it should become clearer. The current spate of cases could burn itself out as warmer weather ensues. Flu is a highly seasonal disease, for reasons we don’t understand. That wouldn’t mean we were home free, however. Wherever flu hides in the “off season” (flu does find work in the southern hemisphere’s winter), it can come back the following year. Those familiar with 1918 know there seems to have been a milder “herald wave” the previous spring which came back like a freight train in August. CDC is well aware of this possibility and should this outbreak wane will clearly urge and engage in continued preparation in the event this evolves in the same way.

If it evolves the same way. Influenza is a virus full of mystery and surprises. The more we study it the more complicated it becomes. Remember the adage: “If you’ve seen one flu pandemic, you’ve seen one flu pandemic.”

As the news mounts and things move closer to home, one feels internally the debate that Buzz and Woody had at one point in Toy Story, where Buzz, trying to calm Woody, says, “This is no time to panic!” and Woody responds, “This is a perfect time to panic!” The news will give fodder — and talking heads will give arguments — for either response, everything from complacency to panic. Managing our expectations and fears may be difficult at times. My own feeling is that this would be a sensible time to stock the larders well (Can you really have too much pasta?) and weigh travel plans conservatively. (My sister’s getting married in Texas in 2 weeks, but though I have tickets to go, that trip looks iffier with every passing day. (Sorry, Sarah!) Meanwhile, we can all hope that as the infection spreads — for flu generally spreads fast — we’ll get a better, and with luck more encouraging, read on how virulent it is.

Comments

  1. #1 Militarytracy
    April 29, 2009

    Thank you mucho for your input. Our son is due to leave soon from Alabama for a titanium rib expansion surgery in San Antonio on May 12th. As with any health issue concerning your children it gets a bit stressful, and I’m doing what I can to also emotionally prepare for the surgery to be delayed since it isn’t for a currently life threatening condition.

  2. #2 Russell
    April 29, 2009

    Never panic. That’s rule one.

  3. #3 Thad Logan
    April 29, 2009

    Doesn’t it seem possible–even likely–that two factors you didn’t mention are at work? i.e. 1)Americans have better access to health care, and are more likely to see a doctor early in the course of a disease, than many/most people in Mexico and 2) people who live in Mexico City have immune systems already severely compromised by air pollution.

  4. #4 jimbo
    April 30, 2009

    After reading the book 1491 which posits that most of the indigenous population of the Americas were wiped out because they had no ability to contend with European diseases, I wonder if the Mexicans who may have died (150 or 7) may be endowed with similar lack of immunity to swine flu, and this may explain why we are seeing greater mortality in Mexico?(if we are in fact seeing greater mortality in Mexico)