# 4310
I’ve no doubt that, given time, scientists and researchers will conduct a thorough post mortem on the pandemic of 2009.
Over the next few years they should be able to come up with a reasonable estimate (probably a range) of the number of pandemic related deaths, and should be able to analyze and quantify the effectiveness of various mitigation efforts undertaken around the world.
That work is going on right now, of course. But so is the pandemic. It will take some time before we get really good answers.
So I take articles, like the one below that appears eager to reach a conclusion based on early data, with a sizable grain of salt.
First the report, from the Daily Record, then some additional comments.
Revealed: Swine flu death rate in Scotland third worst in world..it's even worse than Mexico
Feb 1 2010 By Derek Alexander
SCOTLAND'S swine flu death rate is the third worst in the world - beating Mexico where the virus was first discovered.
Only Argentina and Latvia have worse death rates.
Last night, ministers were being urged to investigate as medical experts blamed Scotland's poor health record for the shocking findings.
Stefan Chmelik, of New Medicine Group, said: "There is something of a general health crisis in Scotland.
"It stands to reason that if you're fit and healthy then you're more able to fight off disease - and if you're unhealthy then you're potentially more susceptible."
In Scotland, the swine flu mortality rate is 13.2 per million people - more than double the 5.76 figure for the rest of the UK.
It's also 45 per cent higher than Mexico and three times higher than Poland, where health bosses have refused to administer a vaccine.
Argentina tops the poll with 15.37 deaths per million, followed by Latvia with 14.37.
Seemingly a damning indictment of the Scottish Health system, and one that apparently is becoming a bit of a political football.
But is it really?
I would submit that the evidence at this point is pretty thin.
Scotland has recorded 66 deaths that they have attributed to the H1N1 virus. And with a population of just over 5 million, that works out to 13.2 deaths per million.
This article compares Scotland’s national death rate to the rates being posted by the small number of countries that are actually counting and reporting swine flu fatalities.
Saying Scotland has the 3rd worst numbers in the world is a bit presumptuous when most of the world isn’t even reporting.
But even if you refine the declaration to `among countries reporting’, there are still problems with this analysis.
First and foremost, there is no standardized definition for what constitutes a `flu-related death’.
Someone who gets the flu, fights it off at home for a week, then is hospitalized with pneumonia isn’t likely to test positive for the virus by the time they hit the ICU. While almost certainly `flu-related’, in most reporting countries, this case wouldn’t be counted.
So what may be a flu-related death in one region might not be counted in another.
Secondly, surveillance and reporting is patchy at best, even in those countries reporting flu fatalities.
The deaths being counted are those with laboratory confirmed H1N1. The WHO, the CDC, and just about every public health agency in the world openly state that those represent just the tip of the iceberg.
The reported number of fatal cases is an under representation of the actual numbers as many deaths are never tested or recognized as influenza related. – World Health Organization.
Making comparisons with incomplete (and inconsistently gathered) information may make for an interesting news story, but it hardly qualifies as good science.
And when you look at the CDC’s estimate of the number of H1N1 deaths in this country you end up with a much higher number for the United States. Anywhere between 26 and 54 deaths per million.
Or 2 to 4 times higher than Scotland’s (or any other country’s) published rate.
Which number is right?
Right now, I don’t think you can point to any country’s count, or method of counting, and say they’ve got it right (although I suspect the CDC’s estimate is more realistic).
Ask me again in 3 to 5 years.
Does Scotland really have the 3rd highest H1N1 fatality rate in the world?
It’s possible, I suppose.
But based on what little we know, I wouldn’t put any money on it.
For more on how numbers can be used to prove just about anything, you might want to revisit:
Proving Anything With Numbers
Premature Extrapolations
