Saturday, August 14, 2010

Denialism and NDM-1

 

 

 

# 4807

 

 

Within hours of making my first post (see NDM-1: A New Acronym To Memorize) on the emerging `superbug’ producing enzyme known as NDM-1, this blog began to receive numerous comments calling it a hoax, a Big Pharma conspiracy, or simply overblown and overhyped by the media.

 

Since most of the comments were comprised of nothing more than a brief declarative statement – offered without evidence of any sort – I’ve declined to print all of them.

 

While I don’t intend to allow the comment section of this blog to become a platform for conspiracy theorists or unsupported opinions, I have printed the comments of (and responded to) one of the posters who was a bit more verbose in his/her skepticism.  

 

You can read the exchange here.

 

 

The logic of this poster (and others) seems to be that since many earlier threats (SARS, terrorism, H1N1, bird flu) – at least in their estimation - haven’t lived up to the early media hype, that NDM-1 won’t either.

 

And while it may sound like heresy on my part, I’m perfectly willing to admit, they could be right.

 

In fact, I hope they are.  But that doesn’t make their arguments any less specious. 

 

Here’s why: 


As a Floridian I’ve ridden through more than a dozen hurricanes and tropical storms, and in some of those cases  the NHC warned coastal residents to prepare for what could be a disaster.

 

Yet, in all these years,  I’ve never been in the core of a major (CAT 3+) hurricane. 

 

It would be easy – based on a half-century’s personal experience with these lesser storms – to conclude that hurricanes are all over-hyped and that the next one will similarly fail to live up to its advance press.

 

But of course, every once in awhile a Hurricane Andrew, or Camille, or Katrina shows just how bad a disaster can really be.

 

When these storms first formed, no one could know how much damage they would end up doing.  One proto-cyclone looks pretty much like the next.

 

The same can be said for nearly every new threat – whether it be a storm, an emerging virus, or a rising antibiotic resistance.  

 

  • The next pandemic may duplicate the horrors of 1918, or we may get lucky, and have it end up like the relatively mild pandemic of 2009.

  • A newly emerging virus can behave like SARS and and only claim a few hundred lives, or it can end up killing tens of millions like HIV.

 

Trouble is, In the early stages of their development, you can’t know how any new threat will turn out.

 

And just because the last storm didn’t blow my house away, or the last pandemic didn’t kill one of my loved-ones, doesn’t mean it didn’t disrupt or even destroy the lives of many others.

 

Basing a threat’s impact simply on how it affected me is not only myopic, it is incredibly self-centered as well.

 

Yet that seems to be the litmus test for many.

 


Part of the problem is that the media (new and traditional) tends to sensationalize a lot of stories.  It sells newspapers, boosts ratings, and drives traffic to websites.

 

Some of that is intentional.  But sometimes I suspect that it comes from an inability (or unwillingness) on the part of some bloggers, journalists, and pundits to read for comprehension.

 

Qualifiers like `may’, or `could’, or `potentially’  embedded in journal articles and in public health statements all have real meaning, and yet many people seem to filter them out of the message.

 

I suppose, because they tend to get in the way of a good story. 

 

 

At this juncture, I have no way of knowing how big a threat NDM-1 will pose to society a year, five years, or ten years from now. 

 

Since I’m not a scientist, all I can do is to read and try to understand the evidence, listen to the opinions of those whose background and experience I respect, and base my opinion on the preponderance of evidence.

 

And right now, NDM-1 appears to have the earmarks of a genuine public health threat.

 

I believe it deserves our attention, and until proven otherwise, our respect.

 

I understand that many people find it easier to ignore threats until they show up on their doorstep.  But public health agencies, emergency management officials, and research scientists haven’t that luxury.

 

It is their job to look for, and try to mitigate, threats before they become disasters.

 

While some can look back at SARS and see nothing but an over-hyped virus that burned itself out and failed to cause a devastating epidemic, I look back and see something quite different.

 

I see the efforts and personal sacrifices of doctors, nurses, and HCWs in hospitals in China, Hong Kong, Vietnam, and even Toronto, Canada that helped treat and contain the outbreak.

 

Some of those individuals lost their lives in the process.

 

And I see the incredible scientific detective work by researchers like Guan Yi and Malik Peiris, that helped us understand the virus, and to eventually defeat it.

 

Whether the conspiracy advocates and the anti-vaccine crowd want to admit it or not, it is very likely that a couple of the reasons that 2009 H1N1 sputtered as a pandemic was due to the hundreds of millions of doses of vaccine dispensed around the world and the rapid deployment and use of antivirals.

 

Areas, like India, where mass vaccination wasn’t carried out are still seeing high levels of influenza-related illness and some H1N1 deaths.

 

Would H1N1 have risen to the levels of 1918 without intervention?  

 

Almost certainly not. But these interventions undoubtedly saved a number of lives, nonetheless.

 

Which is more than you can say for the naysayers and denialists who would rather ignore or disparage a threat, than actually deal with it. 

 

If they are wrong, no one will remember or really care.  After all, it wasn’t their job to serve and protect the public.

 

 

Whether you personally buy into the concerns over NDM-1, or bird flu, or the next big storm to waltz out of the Atlantic or Gulf of Mexico . . . just be glad that there are people who make it their business to take these threats seriously and try to prepare for them.

 

After all. Someone has to.