Swine Flu: What Matters (and What Doesn’t)
YOU GOTTA LOVE A POTENTIAL PANDEMIC WITH A NAME LIKE SWINE flu. Takes no prisoners. Very old world.
But so far, the reporting on swine flu has been very new world: reactionary, shallow and lacking context. That’s a shame since context is all that really matters in this story.
So let’s break it down:
The Numbers:
The numbers are not impressive unto themselves so far. About 20 cases in the U.S., with no deaths and only one hospitalization. That number will go up as everyone starts paying more attention--and identifying more cases. But for now, this is a pretty mild flu in the U.S. (By comparison, about 36,000 people die of regular flu-related causes in the U.S. each year.)
In Mexico, the numbers are more dramatic--although no one really knows what they are yet. The process of identifying the specific strain is maddeningly slow. But it’s safe to say that there has been a significant uptick in the number of serious pneumonia cases, and most of the patients identified so far appear to be under 50. So the strain in Mexico seems to be much more virulent, and no one really knows why yet.
Why This Matters:
The reason why all of this matters--and why the U.S. has declared a public health emergency--have to do with the behavior of the virus. So the numbers are not the main event, even though the media will obsess over the numbers (because what else is there to do?).
OK, so to put this in context: we are all waiting around for a pandemic flu to hit. Or we should be. In the past 100 years, Americans have endured three pandemics—in 1918, 1957 and 1968. As the American Public Health Association puts it, “We’re overdue for another pandemic. It’s not a question of if, but when.”
What is a pandemic flu? And does it look like this?
A pandemic flu is different from the regular flu. A pandemic flu happens when a new virus spreads around the world, causing serious illness and spreading easily from one human to another. It’s a big deal because it can kill many thousands of people (and shut down economies).
So that hasn’t happened yet here, and it probably won’t. But swine flu is worrisome for two reasons.
First, this is a new virus. It has genetic characteristics not seen in U.S. swine flu before. This matters because it means we don’t have a lot of immunity to this virus.
Second, this flu is spreading without contact with swine. That is alarming because it means it could be very efficient in moving through communities of humans. BUT it is not the first time swine flu has spread without any swine involvement.
What does any of this have to do with pigs?
Pigs are a nasty petri dish for flu because they can get both bird and human strains of flu. That means they can then act as a test tube for creating brand new viruses--to which we humans have no immunity.
Are we all going to die?
No. Well, yes, eventually. But for now, we just don’t know if this is the much-awaited Big One. A useful literature review from 2007 found a 14% fatality rate in past cases of swine flu. Whether that means anything about this strain, we don’t know. (By comparison, during the worst week of the 2007-2008 season, the regular flu had a mortality rate of about 9%.)
We do know that it appears to be receptive to drugs, which is great news. The sooner you get on these drugs after you get sick, the better. And a vaccine may be possible, but it will take at least a few months, according to the CDC.
What are the symptoms?
Same as a regular flu--fever, cough, chills, sore throat, aches, pain, general misery. Possibly vomiting or nausea.
What can we do?
Sounds simple but it can make all the difference: Wash your hands--and take your time. Cover your mouth when you sneeze. Stay home if you are sick. If you are the boss of other humans, encourage them to stay home if they are sick.
Two sites with the most useful information so far:
Clinicians’ Biosecurity Network (run by the Center for Biosecurity at the University of Pittsburgh Medical Center)
Joe Guerra said on April 26, 2009 at 8:51 pm
Amanda,
Life is full of so many uncertainties. Out here in the Northwest, for the moment anyway, I remain more pre-occupied with Cascadia Subduction zone activity resulting from major Pacific, Juan de Fuca, and North American plate shifts. This is not to make light of the impact presented by the current situation of a pandemic level emergency. Unchecked, a viral pandemic could exponentially cripple the American economy and prompt a crisis elevated national security posture.
A newsworthy earthquake just seems to bring the need for calls-to-arm closer to home than the danger presented by an invisible viral enemy. Again, for the moment, the swine flu is an abstract concept that thus far appears to be relegated to the SW US border region.
However, we know things can quickly change.
This swine flu emergency is one of the first in a string of likely emergency events the Obama administration will be faced with. Whatever the scale of this emergency event turns out to be, I will be watching for three key responses from the federal government:
1. Qurantine efforts within the US through vaccination to “cap” the spread of the virus.
2. The exchange of information and coordination efforts to mitigate the pandemic potential between countries with reported cases of infection and deaths as well as the remainder of the global community.
3. The ability of our Public Health capacity to effectively respond to any scale of this emergency.
My earthquake comment was a bit tongue in cheek in comparing the sense of urgency presented at the early stages of this swine flu emergency. What is not a laughing matter is the severe challenges our public health system, either locally or nationally, will be tested with in the wake of this or any other disaster of catastrophic proportion.
In the next four years, this country is likely to go through the cyclical disaster events that will prompt a Homeland Security/FEMA response. It’s a given that Americans will lose lives and property will be damaged due to the myriad of disaster events that are due to come. While we can’t stop bad things from happening, at the same time, we are not totally helpless sheep in this uncertain world of ours.
Rather than continue a mindset based on limitations and incapacity a different approach is needed now in response to this swine flu emergency. Instead we need to recognize we do have the ability to prepare for, allocate necessary resources, and adopt a think-from-the-end planning approach to mitigate the scale and scope of damage that will result from the next emergency event we are confronted with.
We’ve got to get better in formulating our capacity for effective contingency planning.
As we move ahead here, my hope is the drumbeat message of preparedness advocated by concerned citizens such as yourself, Stephen Flynn, and the emergency response community at large
takes root sooner than later. Whether we’re talking about swine flu, earthquakes, floods, terrorism, wildfires, tornadoes, hurricanes, etc, the imperative remains the same: we’ve got to get better in adopting a proactive rather than a reactive mindset in how we prioritize the maladies we will most certainly read about in tomorrow’s headlines.
It’s not a question if and when an emergency situation will occur but rather what we’re doing right now to mitigate the problem through effective preparation before disaster strikes.
Joe Guerra
Entropia Disaster Planning Consulting
Advice Medic said on April 28, 2009 at 10:38 pm
To remember, flu virus continues mutation. That is why flu vaccines change every year. Swine flu virus to the new vaccine has not been found. No one has natural immunity against this new virus. And take several months to develop this virus vaccination.
afakop said on April 30, 2009 at 8:36 am
This website http://www.swine-flu-tracker.com/ shows you in real time how quickly swine flu is spreading.
Adam Lark said on May 03, 2009 at 12:35 pm
Dr Bresse / CDC artical is simple, good overview.
No one should trivialise the risk from Swine Flu (H1N1). The Spanish Flu (also H1N1) killed more than 50 million people in 1918. The mortality rate from the Spanish Flu also started slow, just like the 2009 Swine Flu (H1N1) & it was the deadly second wave of the virus that hit in the Fall/Winter that killed most people
You need to read Flu Safe - Surviving the Pandemic by Dr Wayman http://www.flusafe.org
Some mathematical models are suggesting more than 100 million people will die from Swine Flu 2009. That is why people like Dr. Margaret Chan, the head of the World Health Organisation (WHO), is saying “all of humanity is under threat”
vilan said on May 04, 2009 at 2:39 pm
health and safety review at uc irvine with gladys bazan irvine orange county vector incident reporting public safety research .
HSA said on February 05, 2010 at 9:22 pm
This swine flu wouldn’t have even been news if it had happened earlier because they would have put the swine flu vaccine into the regular flu vaccine and we wouldn’t have been none the wiser. The media loves bad news and they love to spread it. Luckily, the swine flu hasn’t been as bad as the media has reported it would be.