Tag H1N1

More Wonders Of Science

Just in case you were too busy stacking the corpses littering the streets to notice: the H1N1 pandemic is officially over. Final death toll in the U.S. is estimated to be between 8000-18000, and it will only ever be an estimate because the CDC stopped officially counting when it became evident that people weren’t dropping like flies. They cite the mid-range figure of just over 12,000 as the probable actual tally. To put this into perspective, about 42,000 people in the U.S. die every year in automobile accidents.

It seems like we can’t get through a single daily news cycle without some amazing breakthrough in the research on Alzheimer’s Disease being reported. Just last week there was this story about how a recent discovery of biological markers in spinal fluid that might help diagnose the disease early on came about due to an unprecedented effort by researchers to more effectively share their data . Yet, this Singularity Hub post explains why it seems like very few therapies actually make their way into clinical use.

At it’s core, science is about developing reliable, repeatable, quantifiable mechanisms for explaining and defining the universe, yet there are some basic things that have either eluded scientific attempts at analysis or have simply been overlooked in favor of better targets. Here’s a Discover article from May of this year that talks about work being done by a researcher in Israel to develop a quantifiable approach to analyzing smells. And here’s a video by a psychologist who has come up with a scale of “evil”:

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Can Of Worms, Opened

can-of-worms

Boy, this is a loaded one…this article in The Atlantic by Shannon Brownlee and Jeanne Lenzer calls the whole program of influenza vaccination into question, not because of any supposed danger involved, but because, they say, there is no substantive body of clinical evidence to suggest that flu vaccines work at all. They argue that the public health community simply borrowed wholesale the idea that vaccines are an effective method of disease prevention (as demonstrated from decades of successful immunization programs for many childhood diseases and other epidemic outbreaks) and decided that therefore flu vaccines must work, and that the intense political pressure not to break with the conventional wisdom stifles all criticism. At the heart of their argument is a study done in 2004 by a public health physician in Seattle named Lisa Jackson; her study looked at eight years of medical data about flu mortality and concluded that getting a flu shot was not a predictor of surviving a case of influenza due to the over-representation of healthy people among the population of people who received the shots. In other words, the data that say that flu shots are effective is skewed by people who weren’t going to get sick and die from the flu in the first place, and so we don’t really know if flu shots do anything beneficial for the people who ARE at risk from dying from influenza. Needless to say, Jackson’s study isn’t very well liked in the medical establishment, which has a pretty seriously vested interest in the status quo.

Well, this certainly muddles everything. The media’s insistence on see-sawing the already-overpanicked public with equally sensationalized reportage about the H1N1 epidemic and the H1N1 vaccine makes it damned near impossible to find a clear path through all of this. But let’s work out a couple of things here:

First and foremost, vaccines work. The eradication of many childhood diseases over several generations and across the globe demonstrate the effectiveness of immunization programs using vaccination.

However, what this article and the study it is predicated upon say is worth considering: just because vaccines work, doesn’t mean that there should be a default assumption that every vaccine will always be the most effective treatment. The lack of adequate investigation into the effectiveness of flu vaccines is surprising and disappointing, and probably indicates that somebody should do some proper studies, and not just about flu vaccines.

This article and its arguments really ought to be taken into consideration in the near-hysteria being generated this particular flu season, but should not be used simply to bolster the arguments of people who are spreading FUD about the H1N1 vaccine. What this article does is to wave a red flag that makes public health officials uncomfortable, and it does so at a moment where they are particularly vulnerable to the political pressure of some decidedly badly-informed individuals.

This whole H1N1 panic has made it very difficult to clearly identify good judgment from bad judgment in terms of the actions of the agencies the public has no choice but to rely upon. It’s important, therefore, to hear voices like Dr. Jackson’s to try to begin to separate reality from conventional wisdom, and to separate hysteria from effective public health. In many ways, it’s a bit of a lucky thing that the craziness is occurring around a mild-if-widespread illness, because perhaps as the next several months unfold there will be the opportunity to weigh out some of the assorted claims and counter-claims without the added pressure of mounting mortality statistics.

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Swine Flu Scorecard

Oh, sorry. It’s politically incorrect to call it “Swine Flu” now. The right-wing wackjobs and the Israeli government have decided to call it the “Mexican Flu”, while the powerful National Pork Producers Council has forced the U.S. government to go with “H1N1″.

But I digress. I just wanted to offer a quick look at some handy statistics from the Centers For Disease Control to give us all a little more perspective.

As of the week ending April 18, there had been 55 deaths total nationwide in the previous three weeks from the standard seasonal influenza (All Type As and Type B combined). Somewhere around 25,000 cases of flu had been reported to medical authorities in that period.

Swine Flu: 109 confirmed cases, 1 death (that victim was actually a Mexican toddler brought to the U.S. for treatment, so to date NO mortality among cases in the U.S.)

Also, I note that the large number of deaths in Mexico that had originally been attributed to H1N1 has been substantially reduced to a confirmed number of 7 by the WHO.

If this sucker is going to kill everyone in the world, it’s going to have to make up for a lot of lost ground. The latest rumor being mongered is that the flu will fizzle for now, but come back with a vengeance next flu season. Which is, of course, exactly what the loonies have been saying about bird flu for the last five or six years. It’s always right around the corner, so you have to start panicking well in advance.

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Are We Dead Yet?

flying_pig

The news media are like a can of Redi-Whip, churned into a self-consuming froth of sweet, tasty panic at the press of a button. After several years of waiting patiently, the H5N1 bird flu has pretty much been written off once and for all as a threat to anybody except, you know, birds. But, they still had all that pre-produced material ready to roll on a moment’s notice for it, so the instant the people from WHO started saying the H1N1 swine flu in Mexico was going to be widespread, the news people didn’t wait even a fraction of a second to squeeze the nozzle and start spewing.

I guess that whole “World Economy Headed Into The Shitter” story wasn’t enough to keep their dicks hard any more.

Part of the problem, I think, is the overblown impact of the word “pandemic”. There is a sensibility that says “OHMIGAWD, pandemic!!!!!! We’re all gonna die!!!”, but quite technically “pandemic” merely means that cases of the disease have been found in a very wide geographical dispersal. By comparison, the word “epidemic” in its technical sense means a number of cases in a single location. The media and the public both tend to misinterpret the word to mean that everyone will get the disease, but the terms are reflective of geographic spread, not number of cases. We have learned to associate the word “pandemic” with massive outbreaks like the 1918 Spanish Influenza, without recognizing that the number of cases (and resulting deaths) in that outbreak were freakishly huge and came in an era of much less effective medical treatment.

WHO raised the level of their alert based on criteria that account for the geographic spread — 11 countries on 3 continents to date — and the increased ease of human-to-human transmission. Phase 4 of the WHO alert protocol marks an uptick in the ease of transmission, which is a likely factor for an increased number of cases, but NOT an inidcation of any imminent mass die-offs of vast swaths of humanity.

(Oh, and for what it’s worth, the highly-touted bird flu that was going to kill us all, has still had fewer human cases after five years than the current swine flu has had to date just in Mexico. You can all stop holding your breath for that one.)

What has health officials worried is the severity of the cases in Mexico and the resultant death toll, but outside of Mexico the severity of the illness seems to be completely equivalent to the usual seasonal flus. The lessening of the severity coupled with the increase in ease of transmission generally implies that even at “pandemic” levels the disease will not pose a significant lethal threat because it has been mutated into a form that human immune systems can adequately resist. I’ve been reading people freaking out about the “cytokine storm” reaction, which is thought to have been a significant factor in the lethality of the 1918 pandemic, but given the already-moderated severity of the flu, the deaths triggered by cytokine reactions are likely to stay centered around the epicenter of the outbreak rather than becoming commonplace.

Those of us old enough to remember Jerry Ford’s swine flu debacle in the mid-1970s will recall that similar dire warnings were given out, and the entire public health infrastructure of the country was mobilized to distribute vaccine, only to have exceedingly few cases turn up and only one fatality, while the vaccine itself caused a number of illnesses and several deaths. More recent considerations of that event cast a favorable view on the ability of the public health sector to mobilize for endemic illness, despite the problems that arose with the tainted vaccine, and while Ford took a public relations hit then, historians now tend to put a more positive spin on his decision-making. As of today, the Obama Administration has had little to say publicly except to assure people that President Obama himself is in good health after visiting Mexico a few days ago and coming into contact with someone who apparently died of the flu. The Obama people are much more circumspect about diving into the middle of “panic/scandal of the day” media blitzes, and maybe that will help quell the frenzy.

As for me, I am going to grill some pork chops for dinner and maybe go out for Mexican at lunch. I am a good doo-bee about washing my hands, and don’t spend a lot of time hanging around with pigs, so you won’t catch me at the mall wearing a face mask and spraying Lysol everywhere I go.

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