May 2, 2009
Swine Flu in PerspectiveBy Frank S. Rosenbloom, M.D.
Outbreak! was the title of the movie released in 1995 about an Ebola epidemic, inspired by news reports of outbreaks of the deadly virus in Africa. Some experts opined that "it could happen here" and that it was just a matter of time before Ebola would show up in the US. Never one to play along, I posted a sign in my office in 1996 that if Ebola broke out here I would move to Africa and live with the monkeys. I am still here.
In 2003 a horrible new disease was spreading out of Asia. SARS (Severe Acute Respiratory Distress) had the potential to cause a worldwide pandemic. My waiting room looked like the inside of a Bombay bus during rush hour as crowds of patients impatiently waited for me to reassure them that the dripping nose they had was not SARS. After all, the WHO, the CDC and CNN all told them that doomsday was likely only weeks away.
"We are counting down to a pandemic," said Guan Yi, a professor at the University of Hong Kong who helped trace the outbreak of SARS in 2003.
I was seeing patients from 8Am until 6PM daily, then returning phone calls until late night, consoling poor souls who were sure they had seen their last days. I ended up with pneumonia, but unfortunately for me, it was not SARS and I had to keep working. Had I contracted SARS, at least I could have gotten some rest.
So, whatever became of this "Andromeda Strain"?
About 56 million people die yearly in the world. SARS caused .00001% of those deaths in 2005, fewer than those caused by choking on a bean! Yet the press had a field day and billions of dollars were spent on a threat that never materialized.
When 2004 passed without a real health crisis, the media were purposeless. Thankfully, Avian (bird) Flu came along and was all the rage by 2005. This one, we were told, was the big one. Continuous news coverage included video of people in Asia wearing masks and destroying chickens. Experts from the WHO, CDC and, I think, even KFC (Kentucky Fried Chicken), were on every newscast proclaiming the coming of avian Armageddon.
Again, I saw many terrified patients and I tried to put things into perspective for them. How could they ignore the evidence? Why, it was as good as the evidence for global warming.
In fact, the likelihood of a Chinese person dying from bird flu was .00005% . The probability of dying by a lightning strike in the US was about 100 times greater than the risk of a Chinese person dying of Bird Flu. If you were afraid of bird flu, I advised my patients, certainly don't go out in the rain.
The WHO data on Avian Flu, that terrible mutating monster that was then to be another 1918 pandemic, can be found at this link. In mid 2005 it was thought to have caused 54 deaths in China, the absolute least important cause of death recorded. In fact, later data showed it had been responsible for only five deaths in China in 2005. Later data showed that over seven years, this terrible virus was responsible for a whopping 25 deaths in China. From a peak of 115 deaths worldwide in 2006, the dreaded Avian flu was the cause of death of only 33 people in 2008. Terrifying!
In 1918, nearly half of the 675,000 Americans killed by the influenza pandemic had been in the trenches of Europe fighting a war. They had been dirty, cold, wet, underfed, and exhausted. Stateside there was no real scientific understanding of the disease. There were no effective medications and no antibiotics for secondary pneumonia. Most Americans had access to only primitive health care. While it is true that 40 million people died of this disease worldwide, we must understand the circumstances then and also that today, we live in an advanced country with excellent health care essentially available to all in an emergency.
In 1957-1958, about 70,000 Americans died from the "Asian" flu. In 1968 the "Hong Kong" flu killed around 34,000 Americans. Interestingly, the total death rate in 1968 did not increase, indicating that most of the victims were already quite unhealthy.
In 1976 "Swine Flu" turned up in a soldier at Fort Dix, resulting in his death and the quarantine of his close contacts. Alarmed experts convinced President Ford to take action. Some 40 million Americans were inoculated before the program was scrapped.
During this "pandemic" more people died in the US from the vaccination than from the disease. Another outbreak in 1988 killed one woman, who contracted the disease while pregnant. She sadly succumbed soon after her healthy baby was delivered. Her husband, who also contracted the disease, recovered completely.
Swine Flu, known since the 1930's, has now returned. Again, the WHO sounded the alarm, raising the "threat level" to 5. To be fair, the disease will be more of a threat in underdeveloped countries and we see the higher death rate in Mexico as evidence of that. It is, predictably, being compared to the flu pandemic of 1918. Medical experts fill our television screens, talking about "N" this and "H" that urging that the federal government spend more money to combat this new microscopic doomsday monster.
Look at the facts in the light of the other potential disasters described above. Remember that a good crisis means that somebody is spending money and somebody is making money. Rahm Emanuel advised never to waste a good crisis. In the case of a public health crisis, it is the government, hence the taxpayer, that is spending money. When you hear an influenza research scientist raising the specter of a possible pandemic, you should also visualize large sums of money going from your pocket to his.
Finally, 36,000 people die from Influenza every year in this country. That's 100 people a day on average! Sadly, a baby from Mexico died in Texas from the Swine Flu. There will likely be more deaths here, but not in the numbers some would have you believe. However, about 100 people in the US die from the typical flu every day. Swine flu is a flu! Of course, every life is precious. But more Americans die from car accidents than the flu. Do we need to be vigilant? Of course. Should we foment panic? Absolutely not.
If you develop symptoms such as a severe cough, shortness of breath, fever, chills, nausea or vomiting, see your doctor. Always take precautions to prevent the spread of any illness to others. Most importantly, wash your hands often. But, live your life fully, not fearfully. You are in much more danger from panic than from the Swine Flu itself. Oh, and eating pork is of no danger at all, unless you intend to try to eat it while it is still moving.