Hype?

My newest podcast is up on iTunes (go here for the web-based version).  It\’s the first of a two (maybe more) part series on influenza – covering flu in general.  We have been seeing a significant number of cases of the flu over the past week, which is extremely unusual for this time of year.  Epidemic flu goes around between November and Late April, with sporadic cases appearing at other times.  What we have seen so far is not sporadic, so it probably represents pandemic flu (H1N1).

I did a poll on Facebook, asking what people thought of the H1N1 situation.  The overwhelming majority responded that they felt the press and the government were hyping it way too much.  This really surprised me – not that people would think that, but that a majority of people felt this was the case.  It may have related to how the question was phrased or what the other choices were, but still this number betrays a lack of worry about the H1N1 virus.

This worries me.

I don\’t think the fear of the H1N1 is misplaced.  The normal flu kills over 30,000 people per year, and the H1N1 is expected to infect 3 times more people than the usual flu (for reasons I will go into in the next podcast).  The implication of this is that even if this flu is \”nothing special\” it will kill over 90,000.  Put in perspective, prostate cancer killed 27,000 men and breast cancer killed 41,000 women in 2008.  A \”normal\” potency H1N1 virus could then kill more than both of these combined.

Thankfully, the cases we\’ve seen so far have not been severe, but still there have been 522 deaths already from the H1N1 in the US.  But in 1918, the virus mutated around this time of year and became significantly more deadly.  I think those who get it now are actually probably fortunate.

The warnings about pandemic influenza are not hype.  But the cynicism about the government and the press are widespread.  Some of the more \”unconventional\” thought (read into that word generously) espouse conspiracies by the government.  Here\’s one example of this:

It\’s man-made. It can be used as a biological weapon. It was developed as an AIDS vaccine-related organism. It was extracted from AIDS patients. It is responsible for virtually all of the symptoms which AIDS patients suffer from. The AIDS virus is at best a co-factor, and not even such a strong co-factor as to bring on all of the symptoms of AIDS. This particular organism, the micoplasma, is associated with this upper respiratory flu-like illness. And it\’s also associated in its pathogenic process with a whole variety of other symptoms that mimic AIDS.

This guy is totally nuts extreme, but the theories on the Internet of this flavor abound.

Unfortunately, the religious right Obama-haters have seized on this as anything from a means to push universal health to a weapon to sterilize the US populace.  I can assure you that this has nothing to do with Biblical thought and everything to do with the vulnerability of some people to fear-mongering.  I even had one patient ask me what I thought about the sterilization theory.  I reassured her that I had just gotten mine – although sterilization is no longer an issue for me as it has already been done with my consent.  She laughed and went ahead with the vaccine.

But less extreme people still feel this is far too much hype for the severity of the disease.  This scrutiny puts the CDC in a bad situation.  The only thing that would vindicate their dire warnings is the exact thing they are trying to prevent: a deadly pandemic.  Conversely, the more they succeed in preventing this problem, the more people will cast aspersions on them.

Take it seriously, folks.  It\’s like a massive storm forming in the tropics – it could be deadly and it could be a dud.  Either way, we need to do whatever it takes to minimize the damage.

24 thoughts on “Hype?”

  1. What exactly does “take is seriously” entail? Lets say I agree with you and I’m ready and willing to take H1N1 seriously. What should I be doing that I wouldn’t normally already be doing if H1N1 didn’t exist?

  2. What exactly does “take is seriously” entail? Lets say I agree with you and I’m ready and willing to take H1N1 seriously. What should I be doing that I wouldn’t normally already be doing if H1N1 didn’t exist?

  3. Do you think I am going to give a spoiler?Seriously, the first thing is to simply follow it on news, twitter, or other places. I get a regular tweet from the CDC as well as subscribing to the RSS for the CDC ( http://www.cdc.gov/flu/rss/ ) flu website.
    Second is to get the vaccine when it comes out.
    Third is to get educated on the signs/symptoms and what to do if you or a family member gets sick.
    I know of a podcaster who covers this subject.

  4. Do you think I am going to give a spoiler?Seriously, the first thing is to simply follow it on news, twitter, or other places. I get a regular tweet from the CDC as well as subscribing to the RSS for the CDC ( http://www.cdc.gov/flu/rss/ ) flu website.
    Second is to get the vaccine when it comes out.
    Third is to get educated on the signs/symptoms and what to do if you or a family member gets sick.
    I know of a podcaster who covers this subject.

  5. You’re right, the organizations (CDC) that are supposed to be watching for pandemics and other horrible happenings are doing their job well. But the media in America love to blow things out of proportion (and scare the hell out of everyone….fear mongering). Nobody knows what to believe! Which brings me to the healthcare debate, where things get really scary and confusing! I’m watching this national debate from a rural vantage point in middle America. I tend to agree that these town hall meetings the media is covering so closely (Fox anyway) are a good indicator of what the average American is thinking. You only get a large turn out at these events when people are scared or mad, or sometimes very happy about something. Turn out at the town hall meetings around here has been off the charts…people are engaged in this debate. These are not religeous right Obama haters, they are just normal people concerned about the future….and generally wishing the best for their country. Yes, political tactics used by both sides to win a debate are deplorable. But I am going to give the American people some credit and say they know a rat when they smell one (or whatever the saying is?). This strategy of totally excluding one party in the legislative process is just not going to work…we’ve got to have at least a bit of bi-partisanship on this issue that is so important to all of us. Surely, Obama and Pelosi and Reid can figure that out??

  6. You’re right, the organizations (CDC) that are supposed to be watching for pandemics and other horrible happenings are doing their job well. But the media in America love to blow things out of proportion (and scare the hell out of everyone….fear mongering). Nobody knows what to believe! Which brings me to the healthcare debate, where things get really scary and confusing! I’m watching this national debate from a rural vantage point in middle America. I tend to agree that these town hall meetings the media is covering so closely (Fox anyway) are a good indicator of what the average American is thinking. You only get a large turn out at these events when people are scared or mad, or sometimes very happy about something. Turn out at the town hall meetings around here has been off the charts…people are engaged in this debate. These are not religeous right Obama haters, they are just normal people concerned about the future….and generally wishing the best for their country. Yes, political tactics used by both sides to win a debate are deplorable. But I am going to give the American people some credit and say they know a rat when they smell one (or whatever the saying is?). This strategy of totally excluding one party in the legislative process is just not going to work…we’ve got to have at least a bit of bi-partisanship on this issue that is so important to all of us. Surely, Obama and Pelosi and Reid can figure that out??

  7. I appreciate your concerns – awareness is integral to survival – and I enjoyed your investigations into the silliness of conspiracy theories.
    I detect a rather noticeable fallacy in your argument over the severity of the H1N1 “outbreak.” You said that “The normal flu kills over 30,000 people per year, and the H1N1 is expected to infect 3 times more people than the usual flu ” and then argued that the result would be a tripled fatality rate. Actually, it does not necessarily follow that if the first part of that premise, the 3x higher infection rate, is true, that the fatalities would also be greater by 3x. It’s just a dangerous, overeager assumption, especially if you’re trying to convince people of the severity of the threat.

    I did the math: if, by Aug 26, only 522 deaths in the US (calculating from about mid-April), that is an average of 3.6… (some very long number) per day, over 134 days. Over 365, that equals about 1422 deaths. Terrible, awful loss of life, but not pandemic. Even doubled, or trebled, we’re still talking waaaaay less than the usual flu.

    I’m not sure what you mean by “take it seriously” (another commenter asked this, too) since I’m definitely not interested in tweets from a government agency. The flu vaccine makes sense, to a degree, but I’m getting a bit frustrated with the emails at my place of work about using antibacterial gel (against a virus?!?!) or possible campus closure in the event of an epidemic here. I do think the hype is a bit much, and I’m not entirely certain of the level of the threat, except to the usual suspects: children, the elderly, and the immunocompromised.

    Just thinking. Hope I didn’t offend or seem on the attack!

  8. I appreciate your concerns – awareness is integral to survival – and I enjoyed your investigations into the silliness of conspiracy theories.
    I detect a rather noticeable fallacy in your argument over the severity of the H1N1 “outbreak.” You said that “The normal flu kills over 30,000 people per year, and the H1N1 is expected to infect 3 times more people than the usual flu ” and then argued that the result would be a tripled fatality rate. Actually, it does not necessarily follow that if the first part of that premise, the 3x higher infection rate, is true, that the fatalities would also be greater by 3x. It’s just a dangerous, overeager assumption, especially if you’re trying to convince people of the severity of the threat.

    I did the math: if, by Aug 26, only 522 deaths in the US (calculating from about mid-April), that is an average of 3.6… (some very long number) per day, over 134 days. Over 365, that equals about 1422 deaths. Terrible, awful loss of life, but not pandemic. Even doubled, or trebled, we’re still talking waaaaay less than the usual flu.

    I’m not sure what you mean by “take it seriously” (another commenter asked this, too) since I’m definitely not interested in tweets from a government agency. The flu vaccine makes sense, to a degree, but I’m getting a bit frustrated with the emails at my place of work about using antibacterial gel (against a virus?!?!) or possible campus closure in the event of an epidemic here. I do think the hype is a bit much, and I’m not entirely certain of the level of the threat, except to the usual suspects: children, the elderly, and the immunocompromised.

    Just thinking. Hope I didn’t offend or seem on the attack!

  9. Thank you, this is a very timely post and podcast.
    I recently became aware of a number of parents (on a listserve to which I belong) who also think it is a lot of hype, and have no intention of getting the vaccine for themselves or for their children.

    I was stunned.

    I was flabbergasted by more than one parent indicating his/her belief that this is an effort to forward the agenda for healthcare reform.

    I just don’t get it, on SO many levels.

    Thank you for your honest, straightforward, logical, and science-minded approach.

  10. Thank you, this is a very timely post and podcast.
    I recently became aware of a number of parents (on a listserve to which I belong) who also think it is a lot of hype, and have no intention of getting the vaccine for themselves or for their children.

    I was stunned.

    I was flabbergasted by more than one parent indicating his/her belief that this is an effort to forward the agenda for healthcare reform.

    I just don’t get it, on SO many levels.

    Thank you for your honest, straightforward, logical, and science-minded approach.

  11. Not an attack at all. Challenge away! I agree that there are lots of assumptions that can be questioned, but there are also a lot of questions about your statistics. You have to also look at the case to fatality rate. Yes, 552 isn’t much, but a very small percent of the population has been infected. 552 cases with 25,000 confirmed cases does not seem like much, but if you consider that the US population is 300 Million, if 10% of the population gets the flu and we round down to 25 million cases of the flu, the death rate would be 552,000. 90,000 deaths with this case/fatality ratio would require approximately 400,000 cases of the flu, which is only 0.13% of the US population.
    Bottom line? Statistics are difficult to determine and the 90,000 number is not one I came up with, but one that is reported in many places. I just think it is wise to err on the side of caution. If there is a hurricane in the gulf coast, do you prepare for the worst, or do you take your chances? I say you prepare for the worst and hope you are wrong.

  12. Not an attack at all. Challenge away! I agree that there are lots of assumptions that can be questioned, but there are also a lot of questions about your statistics. You have to also look at the case to fatality rate. Yes, 552 isn’t much, but a very small percent of the population has been infected. 552 cases with 25,000 confirmed cases does not seem like much, but if you consider that the US population is 300 Million, if 10% of the population gets the flu and we round down to 25 million cases of the flu, the death rate would be 552,000. 90,000 deaths with this case/fatality ratio would require approximately 400,000 cases of the flu, which is only 0.13% of the US population.
    Bottom line? Statistics are difficult to determine and the 90,000 number is not one I came up with, but one that is reported in many places. I just think it is wise to err on the side of caution. If there is a hurricane in the gulf coast, do you prepare for the worst, or do you take your chances? I say you prepare for the worst and hope you are wrong.

  13. Do you really think the Republicans have any political motivation to cooperate? If the plan fails, it is wholly the Democrat’s fault. I think the Dems would do well to get more republican cooperation, but how motivated are they to give Obama the ability to say he fixed healthcare?

  14. Do you really think the Republicans have any political motivation to cooperate? If the plan fails, it is wholly the Democrat’s fault. I think the Dems would do well to get more republican cooperation, but how motivated are they to give Obama the ability to say he fixed healthcare?

  15. You don’t have to be a nut-case to be a “flu skeptic.” Epidemiologist Philip Alcabes has a pretty convincing argument that H1N1 is over-hyped and that the CDC and the President’s Council are over-reacting. He doesn’t propose conspiracy theories or nefarious motives. He just looks clearly at what has and hasn’t happened already. http://www.philipalcabes.com/blog/

  16. You don’t have to be a nut-case to be a “flu skeptic.” Epidemiologist Philip Alcabes has a pretty convincing argument that H1N1 is over-hyped and that the CDC and the President’s Council are over-reacting. He doesn’t propose conspiracy theories or nefarious motives. He just looks clearly at what has and hasn’t happened already. http://www.philipalcabes.com/blog/

  17. I don’t say that all who question are nut-cases. Thanks for sharing an opposing opinion. I would say, however, that I would approach it with the same care I would a sick infant. If there is a 1% chance the infant has a life-treatening illness, I act with urgency. If there is a 1% chance that millions would die, should we act with caution or discount things? I think there is far more than a 1% chance in this circumstance.
    It is always good, however, to have people questioning. Without questioning, bigger mistakes would be made.

  18. I don’t say that all who question are nut-cases. Thanks for sharing an opposing opinion. I would say, however, that I would approach it with the same care I would a sick infant. If there is a 1% chance the infant has a life-treatening illness, I act with urgency. If there is a 1% chance that millions would die, should we act with caution or discount things? I think there is far more than a 1% chance in this circumstance.
    It is always good, however, to have people questioning. Without questioning, bigger mistakes would be made.

  19. Here are the/some facts. We have healthcare legislation that nobody likes and the republicans have no reason to contribute (and nothing to lose…. or gain really). I say now is a good time for the dems to steal some long standing republican healthcare ideas and make this thing better. Go ahead and put some language in the final bill about insurance portability…..create more competition across state lines between insurance companies. The dems are not beholden to these companies and the republicans can’t currently do much about it anyway. And while they are at it might as well change some of the tax laws that affect individual “vs” employer provided heatlh insurance. The ideas would certainly help defray the cost a bit.

  20. Here are the/some facts. We have healthcare legislation that nobody likes and the republicans have no reason to contribute (and nothing to lose…. or gain really). I say now is a good time for the dems to steal some long standing republican healthcare ideas and make this thing better. Go ahead and put some language in the final bill about insurance portability…..create more competition across state lines between insurance companies. The dems are not beholden to these companies and the republicans can’t currently do much about it anyway. And while they are at it might as well change some of the tax laws that affect individual “vs” employer provided heatlh insurance. The ideas would certainly help defray the cost a bit.

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