# 1132
While I'm generally heartened when I see an article in the mainstream press about the threat of a pandemic, all too often I end up dismayed by the careless slinging of `facts' in these articles.
Case in point, this article from the Tulsa World. The statements in this article that caught my eye I've highlighted in red.
U.S. expected to see bird-flu pandemic soon
By KIM ARCHER World Staff Writer
9/26/2007
A bird-flu pandemic likely will reach U.S. shores in the next decade, Dr. Kristy Bradley, deputy state epidemiologist for the Oklahoma State Department of Health, said Tuesday.
"Prior to the last decade or so, the thought was the influenza from birds would be mild or just cause conjunctivitis in humans," she said at the second annual Prevention Conference, being held through Wednesday at the Tulsa Marriott Southern Hills hotel, 1902 E. 71st St.
But "bells went off" in 1997 when 18 people in Hong Kong contracted bird flu and six died from it, Bradley said.
"Bird flu" refers to an influenza from a virus found chiefly in birds, but infections can occur in humans.
"We've been tracking H5N1 (a strain of bird flu) since 1997," Bradley said. "It has continued to spread to parts of Africa and the Middle East and continues to cause a lot of problems in Asia."
The questions are whether the U.S. should worry about a bird-flu pandemic and whether the nation is prepared to respond to a massive outbreak of the virus, she said.
"We do get a little more concerned about the H5N1 virus because it's not behaving like any other bird flu we've seen," Bradley said.
It has shown resistance to antiviral medications, and human-to-human transmission has been confirmed, she said.
"We always have that possibility we could have an imported case in our country," she said.
Depending on its severity, a U.S. bird-flu pandemic could mean that 43 million to 100 million people would be infected and an estimated 89,000 to 207,000 people would die, according to the U.S. Centers for Disease Control and Prevention.
Between 314,000 and 733,000 Americans would be hospitalized, again depending on the severity of the outbreak, Bradley said.
"Hospitals would be stretched to the max," she said.
The economic impact of a U.S. bird-flu pandemic is estimated at between $71 billion and $166 billion, Bradley said.
"That can seem pretty daunting," she said.
Both the federal government and Oklahoma health authorities have plans in place to respond to such a crisis, Bradley said.
Vaccines typically are the first line of defense for a flu outbreak, although authorities are limited to speculation about which strain of virus will prompt an epidemic.
The U.S. has begun stockpiling 40 million doses -- at two doses per person -- of prepandemic H5N1 bird flu vaccine. Oklahoma is set to receive 20,000 doses of the vaccine, Bradley said.
After five years, the medication loses its effectiveness, so the doses must be thrown out and new ones brought in, she said.
"This is the hedging and the risks you take, because you cannot predict how effective it will be," Bradley said.
State plans include prioritizing who will get the vaccine based on risk factors for complications, she said.
Any flu pandemic that hits the U.S. most likely would originate from a bird influenza, Bradley said.
"As you can see, it's very much up in the air," she said. "Nature generally has the upper hand."
The numbers quoted in this article, particularly for the expected attack rate, fatality rate, and economic impact are quite a bit lower than the federal government and many states have been using for planning purposes.
What gives?
Well, these numbers come from a paper published in 1999 entitled The Economic Impact of Pandemic Influenza In the United States: Priorities for Intervention by Martin I. Meltzer, Nancy J. Cox, and Keiji Fukuda
Centers for Disease Control and Prevention, Atlanta, Georgia, USA
This is an excerpt from the abstract:
We estimated the possible effects of the next influenza pandemic in the United States and analyzed the economic impact of vaccine-based interventions. Using death rates, hospitalization data, and outpatient visits, we estimated 89,000 to 207,000 deaths; 314,000 to 734,000 hospitalizations; 18 to 42 million outpatient visits; and 20 to 47 million additional illnesses. Patients at high risk (15% of the population) would account for approximately 84% of all deaths. The estimated economic impact would be US$71.3 to $166.5 billion, excluding disruptions to commerce and society.
The numbers, as you can see, are identical to those used in the article.
Unfortunately, this study is nearly a decade old, and doesn't take into account the data we've acquired since that time. The Federal government currently is looking at a 2% CFR (Case fatality ratio), and upwards to a 10% hospitalization rate.
In other words, 2 million fatalities . . . not 207,000. And 10 million hospitalizations . . . not 734,000.
The State of Florida's pandemic assumptions include 640,000 hospitalizations in that state alone, along with 128,000 fatalities. The numbers used in this article are roughly 1/10th of current assumptions.
As far as the vaccine information provided, I'm genuinely confused. I suspect the reporter has mixed up pre-pandemic vaccines with Tamiflu, but I'm not sure. The reference to throwing it out after 5 years would suggest Tamiflu (although vaccine has a shelf life, too).
Admittedly no one knows what the next pandemic will bring. The estimates from 1999 could end up being closer to reality than today's assumptions. We'll know for sure when the next pandemic is over.
Granted, not every reporter can follow and understand pandemic issues like Helen Branswell or Maryn Mckenna. I understand that. It takes a science background, a genuine interest in the subject, and a firm commitment to stay current. That's why we bloggers tend to hold the really good reporters in such high regard. They are a rarity.
Despite its failings, however, this article may do some good.
It may raise some awareness. And for that the reporter should get some credit. The average person won't remember the numbers, I suppose, and will likely come away with the idea that a pandemic would be bad.
And right now, even that message isn't getting out.
