If you ever go down Trinidad
No Virus there make you feel too bad
Don’ Worry bout no Flu of Swine
Guarantee you one real good fine time
- With apologies to Morey Amsterdam
# 3393
I’ve seen some ham-handed (sorry, couldn’t resist) attempts at disinformation regarding the H1N1 swine flu virus, but I confess, this editorial which appeared in the Trinidad and Tobago Express is by far the most egregious example to date.
Thursday, June 25th 2009
Let us be quite clear: the H1N1 virus, or swine flu, is not dangerous. It is highly contagious but the flu symptoms are not generally life-threatening and, in fact, you are more at risk if you get the more common flu.
We feel it necessary to state this in light of what may be growing, and quite unnecessary, terror over the spreading of the swine flu.
<snip>
What also exacerbates such unfounded fears is the fact that deaths from the disease naturally garner more attention than mere infections. But the number of fatalities worldwide from the swine flu, as a percentage of infections, has been quite small. And most of the persons who have died from this disease have been very old, very young, or had compromised immune systems.
Put another way, if you are in good health and you get the H1N1 virus, you are going to have flu symptoms-the cough, the sniffles, the fever, and so on-and be fine again within ten days.
Of course, everyone should take all sensible precautions to avoid getting ill. But you need not add unwarranted stress to your mind as you do so.
Where to begin?
The Swine Flu virus is not dangerous?
You are more at risk if you get the more common flu?
Two lies for the price of one I guess. Early data indicates that this virus has a CFR (Case Fatality Ratio) roughly equal to, or perhaps slightly higher than, seasonal flu.
And seasonal flu kills hundreds of thousands worldwide every year. That, in my book, makes it at least a little dangerous.
There is little evidence to suggest that this virus is less dangerous than seasonal flu, particularly to those under the age of 50.
It may be that those over the age of 50 are less likely to contract it, or if they do, may see milder illness.
But it is probably too soon to draw that conclusion.
But to say this flu is less dangerous than seasonal flu is misleading. and also discounts the possibility that this virus could mutate over time.
Only the very old, very young, or those with compromised immune systems have died?
If you are in good health, all you will get is a cough, a fever and the sniffles?
Again, misleading to the extreme.
Very few elderly people have contracted this virus, and relatively few deaths have occurred in that age group. That may change with time, but for now, the elderly are not at particularly high risk from H1N1.
The `very young’ have also mostly been spared, with the bulk of hospitalizations occurring in the 5 to 24 year old age group. Scarcely the `very young’.
As far as those with compromised immune systems, it is true that they are at greater risk of serious illness, but they are hardly alone.
According to the WHO (World Health Organization) 1/3rd to 1/2 of serious illnesses have been reported in people with no known health problems.
Some very common health issues, things not normally lumped in with `immuno-compromised’, are particularly risky with this flu.
This includes Asthma, diabetes, and pregnancy.
Instead of trying to convince their readers that Swine flu was nothing to be concerned about, this paper should be urging people to take common sense precautions – including staying home if they have the `cough, the fever, and the sniffles’, washing their hands frequently, and covering their coughs.
Another teachable moment squandered. And in the process, lives may very well be endangered.
But hey, Mon. Don’ Worry, Be Happy!
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3 comments:
I've been researching this topic quite intensively for the last couple of months and the over-all severity (in terms of CFR) of new H1N1 does in fact (so far) compare well to that of the seasonal flu.
While it is certainly not significantly "less severe" it does not seem to be significantly more severe either:
Even with "normal" seasonal flu there are cases described in the literature of fatalities caused directly by the virus itself (i.e. by primarily viral pneumonia ) in otherwise healthy young adults.
Those are, however, rare: roughly one in 10.000 (0.01% CFR)- about ten times less frequent than the overall seasonal flu fatalities (i.e. including the elderly) with it's often-quoted 0.1% CFR.
Interestingly such a 0.01% younger-than-65-age-group CFR is what we are observing with the new H1N1 too:
Just take, for example, the recent CDC estimate of approx. one Million cases against the 120 confirmed fatal cases and we arrive roughly at the same CFR of 0.01% (at least for the younger-age-group)
However, I do suspect that
1. New H1N1 is still to reach the older age groups, nursing homes etc. (I am sceptical about the alleged immunity-of-the-older theory)
and, most importantly
2. Due to the higher attack rate, despite the comparable CFR, the overall impact of the coming large pandemic waves will be probably much higher than any singular "bad flu season" in the past.
So I agree with FLA_MEDIC that this new virus should not be underestimated and that personal preparedness is important.
To h1n1_watcher: Your calculation of CFR is fatally flawed because you fail to take into account that just as many infections are missed, many deaths will have been missed. In the US annually about 1800 deaths from influenza are recorded on the death certificate. However the best epidemiological estimates for deaths caused by influenza is 36,000 a year (in the US). In short by only counting cases where you realize and can prove conclusively (for that individual patient) that they died from the flu you count only 5% of cases. If we correct your estimate with this knowledge we get a CFR estimate of 0.2%.
The truth is that this is still a hopelessly poor way of estimating CFR. In my opinion what you need is to follow a representative cohort of people starting at their infection until 1 month later (for each individual). A lower bound on CFR can then be estimated from the deaths to that date and an upper bound from the number still hospitalised with serious complications at that date.
To my knowledge this hasn't been done (and the CFR will still vary over time and between countries). I look forward to reading the report from the first group that does this.
Looks like what's going on in Argentina right now might quickly end the campaign the convince the sheeple that "this is a mild flu -- nothing to worry about."
(See Niman's last two commentaries at Recombinomics.com)
But TPTB will come up with something else to keep the sheeple calm.
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