Monday, May 04, 2009

Predicting The Unpredictable



# 3125



Be glad it isn’t your job to predict, publicly, what the newly emerging A/H1N1 (the influenza formerly known as `Swine’) virus will do over the coming months.


Scientists with the CDC, the WHO, and other health agencies are being asked to do the impossible right now. 


Predict the unpredictable.


And to make matters worse, they are being second-guessed at every turn.  Mostly by pundits who, unlike public health officials, have nothing at stake by being wrong.


The truth is, no one knows what this virus will do over the coming months and years (yes, years). 


Some possibilities include:


  • It could simply become part of the seasonal flu mix, joining the other A/H1N1 currently circulating, the H3N2 virus, and the B influenza strains.   Even so, it shouldn’t be underestimated.  It could increase the mortality and morbidity of the upcoming flu season.


  • It could pick up virulence, either through a reassortment with another virus, or perhaps through a single amino acid change in some crucial area of the genome.   That could turn it from a `mild’ flu to a more deadly one.   That could happen next week, next month, or a year from now.   Stay tuned.


  • Or it could go the way of SARS, or the 1976 Swine Flu, and probably a lot of others we never knew about, and simply fade away.



An unsatisfactory range of scenarios, I know.  


But that doesn’t change the fact that viruses are unpredictable.  They mutate constantly and nature is a huge and unregulated laboratory that continually manages to surprise us.


So, what are public health officials to do? 


Exactly what they are doing.  


Treating this new virus as if it could become a very serious health threat.


Even though they know the media, and the public, will pillory them for doing their jobs if bodies don’t start piling up on street corners in short order.  


Of course, they will pillory them if bodies do start piling up, too. 


So, be glad it isn’t your job. 


The more successful they are in containing this outbreak, or in mitigating its effects, the more criticism they will receive in the press for over-blowing the threat.



A decade ago, I was part of a  huge coterie of computer programmers who worked frantically for several years to avert the Y2K problem.   


It was miserable, painstaking work, that went on for months, indeed, for years.  


I started in 1996, and finished – exhausted - in February of 2000.


When the world didn’t end at midnight, December 31st 1999, the media and the public decided the threat was hyped and they had been conned. 


But the truth is, millions of computer programmers working night and day had averted the disaster.  Our reward was ridicule and scorn. 


And to this day, people scoff at the Y2K threat.

So I am more than a little sympathetic to the plight of public health officials as they try to guide policy in the face of what may – or may not be – a serious public health threat.


No matter what they do here, the are almost guaranteed to be criticized for it.


Like I said, just be glad it isn’t your job.