| The Swine Flu Boogeyman
“The boogeyman will get you!” parents sometimes tell
misbehaving children. With about 40% of parents saying “no!”
to vaccinating their kids for swine flu, apparently health officials
think turnabout is fair play. And the media seem happy to help.
You see it in such
headlines as “CDC Shocker: Swine Flu Killing Young People
at Record Rate!” And in lines of panicked parents queued
outside vaccine clinics like fans trying to score tickets to a
Paul McCartney concert. And in schools closing willy-nilly, which
could cost the nation tens of billions, according to a recent
Brookings
Institute study.
Which is so sad, because this boogeyman is not much more substantial
than the legendary one. And adding the proverbial insult to injury,
parents are told they must get their children vaccines that–because
of the shortage and despite Obama administration promises–they
can’t get.
As told, the tale does sound scary. Almost a quarter of deaths
from swine flu since Sept. 1 have occurred “in young people
under the age of 25,” Centers for Disease Control and Prevention
(CDC) official Anne Schuchat declared at
a press conference. Among cases of seasonal flu, those over
65 account for about 90% of deaths.
What Schuchat didn’t say is that, as tragic as any child’s
death always is, in this case they merely represent a disproportionately
larger slice of a very small pie. Very few people are dying of
swine flu in any age category. Put another way, it’s not
that younger people are being slammed but that older ones are
catching a break.
Hence among 65,000 college students afflicted with CDC-defined
“flu-like illness” seriously enough to seek medical
help, according to an American College Health Association running
survey, there have been only 123 hospitalizations and zero
deaths. That in turn reflects swine flu as a whole, which in the
seven months since the outbreak began has
apparently killed fewer Americans than normally die every
two weeks from “ordinary” flu during the season.
But the CDC claims to have scary numbers as well as percentages,
with 85
attributed swine flu fatalities under age 18 in the last two
months, as of Oct. 30. By comparison, in the 2006-07 and 2007-08
seasons there
were 78 and 88 such deaths reported, respectively. Although
it appears the epidemic
has peaked, attributed child swine flu fatalities this season
will eclipse them. But it probably won’t mean much according
to James Chin, a professor at the University of California, Berkeley,
and former World Health Organization epidemiologist.
That’s because, he says, the deaths attributed to swine
flu both now and in the future will reflect the rule that “the
more you look, the more you find.”
Understand first that neither the seasonal nor the swine flu death
figures are supposed to represent total numbers, but rather what
the CDC
surveillance system nets. Causes of death are determined not
by computers but by human beings who are sensitive to what Chin
calls “media hype.”
True, to be labeled a swine flu fatality you have to have the
virus. But after that it gets tricky. According to the CDC, “Many
millions” of Americans have been symptomatic with swine
flu and, therefore, says Chin, many people “will be dying
of any number of things but just happen to be infected.”
The CDC says about 30% of the cases classified as swine flu fatalities
had chronic medical conditions such as asthma, cerebral palsy,
and muscular dystrophy. These could be contributing causes, but
they can also kill on their own. The more swine flu is in the
news, the more likely it will be listed as the primary cause of
death.
Such a phenomenon, Chin says, occurred during the early 1980s
media blitz over the tampon-related “toxic
shock syndromeepidemic.” According to Chin, “Every
time there was a headline, toxic shock cases shot up. It turns
out it was occurring in small numbers. It was blown out of proportion.”
A later CDC analysis showed that through 1986 fewer than 200
women died, including those who never used tampons.
Chin says a bonafide apples-to-apples comparison might still
show swine flu claiming more children’s lives than does seasonal
flu typically, but based on his observations “It still can’t
be that much more severe.”
It’s also necessary to view childhood flu deaths in perspective
to all childhood deaths.
Annually, about 50,000
Americans perish before their 18th year. Unintentional injuries
alone kill about 5,000 children below age 15, according to the
National Safety Council. Of these, 1,100 are drownings and an
additional 600 are from suffocation. These occur each year and
yet could be prevented without quarantining Johnny or Jane at
the South Pole.
Specifically regarding infectious diseases, there are probably
few Americans who fear methicillin-resistant staphylococcus aureus,
or MRSA–indeed many probably haven’t heard of it. Yet
each year it kills about 19,000 Americans, including an estimated
150 below the age of 18.
It’s sad that public health officials seem to believe that
getting people to do “the right thing” requires presenting
a modern version of the Slaughter of the Innocents. It’s
also ironic in that surely some vaccination antipathy reflects
the constant cries of “Wolf!” since the swine flu outbreak
began.
There was the first declaration of a public health emergency
in late April, with almost no U.S. deaths at the time. Then came
the President’s Council of Advisors on Science and Technology“plausible
scenario” of 30,000 to 90,000 deaths with a “mid-October”
peak. It came up rather short–though the latest CDC weekly
FluView report may indeed indicate the peak of hospitalizations
and deaths came in mid-October.
For that matter, consider five years of scary promulgations and
headlines about avian flu such as “Flu Pandemic Could Kill
150 Million, U.N. Warns.” Remember avian flu?
It’s folly to think you can solve a problem caused partly
by crying wolf simply by crying wolf even louder. That just squanders
the credibility among public health officials–credibility
which should be their most precious asset.
Reference Source: pandemicfluonline
November 12, 2009
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