Swine Flu: Should We Panic?

First, a bit of mental housekeeping. Thanks to everyone who suggested various metaphors for depression on my post “Co-opting Churchill’s Black Dog“. I’ve decided to go with Kobolds. Kobolds, in Dungeons and Dragons, are little critters that, in small numbers, are easily defeated, but in large numbers can overwhelm a full party of adventurers and be nearly impossible to kill. I think it’s a perfectly apt metaphor, so it’s what I’ll be using. It also lets me issue “kobold alerts” which can describe my mood. Today’s a “one kobold” alert, which means I’m mostly feeling pretty good. A “kobold army” alert would mean “stay the hell away from Richard, for today he’s a black hole of depression that will suck your emotions down into a singularity of despair.”

So, that’s done.

Next up: swine flu, and whether we should panic or not. Now I’m all for a general state of panic accompanied by vigorous looting, so long as I’m far away from it and it can be brought under control by the authorities quickly. But it has to be warranted. And, frankly, at this point, there’s no need to panic over swine flu. There’s not even any need to worry. There is, however, some cause for concern, so let’s take a look at that.

Note that the following observations are based on my admittedly limited understanding of how pandemics work. I’m not an epidemiologist or a statistician or a doctor of any sort. If you have corrections to offer, please let me know and I’ll try to incorporate them.

First, the World Health Organization’s issuance of a “stage 4 pandemic alert”. The pandemic alert is not a measure of a pandemic’s severity or panic worthiness, like a hurricane alert scale. Rather, it’s a measure of the infectiousness of a newly emergent disease. The stage 4 alert indicates “sustained human to human contact”, meaning that the disease can be spread from person to person. This compares with, for example, H5N2, the “bird flu”, from last year, which got as high as stage 3, meaning that infection required sustained contact with animals. Most cases of avian flu and avian flu deaths occurred in people who spent long periods of time in close quarters with chickens. This does mean that the disease is more infectious than the avian flu, but still doesn’t call for a state of panic.

Second, the fact that this flu seems to have a disproportionate effect on younger, healthier people. This doesn’t indicate that the swine flu is more malevolent in any way than regular influenze; rather, it’s actually a function of a healthier person’s healthier immune system. As a person’s immune system sends white cells to the location of an infection, more white cells at that location are formed, causing a more severe response, until, say, a person’s lungs fill up with fluid, and they drown; this positive feedback loop is called a “cytokine storm”.

Third, there’s the question of spread. While early cases of the avian flu and SARS were confined mostly to Asia, outbreaks of the swine flu have been reported all over the world, from the United States to New Zealand. It’s important to remember that in each case, the number of infections was very small. As of this writing, there are about 40 cases in the United States, and two in New Zealand; more people have leprosy than have swine flu, and that’s likely to stay true. The fact that we can’t necessarily trace the outbreak and figure out how far it’s spread raises concern but is still not a concern for panic.

Fourth, there is no vaccine against the swine flu. This isn’t all that surprising. Flu vaccines — which are pretty effective and which you should definitely receive, especially if you have respiratory conditions like asthma or are more susceptible to the flu — are based on best guesses anyway. Informed best guesses, of course, based on epidemiologists’ observations of what seems to be spreading among chickens in southeast Asia (that’s an oversimplification, of course), but still best guesses. It’s not unusual that a few strains come out of the blue that weren’t predicted, and sometimes the strains that are predicted don’t materialized.

Texas and California have already declared states of emergency, in order to receive federal funds to deal with a possible epidemic. According to Governor Schwarzenegger, this is primarily to ensure that the various state agencies that would be involved in dealing with an outbreak would all be working on the same page; I’m not sure what Governor Ric Perry of Texas has said, so I won’t speculate. Also, I won’t get into politics here. I’ll probably do that elsewhere, like on Twitter or Facebook (see my Contacts page if you want to follow me on either of those venues; chances are, though, if you’re reading this, then you already are).

So yeah, there are causes for concern with regards to the swine flu outbreak. However, there are no causes for worry, panic, or even elevated anxiety. As I mentioned, more people in the United States have contracted leprosy than have contracted swine flu. More people contract and die of regular influenza each year as well. More people die of drunk driving accidents, or of lightning strikes. Another way of saying this is that 0.002% of Americans have contracted the disease, and that number is very likely an exaggeration, since I don’t do percentages very well.

The mortality rate of swine flu is not that high. It’s disproportionately high in Mexico, but during outbreaks, such diseases do tend to have higher mortalities in less developed nations. The exact reason for this is unknown, but it probably has to do with economic status and access to health care. True, there has so far been one death in the United States from swine flu, but that was an 23-month-old child who was visiting with his family from Mexico. This isn’t to make light of the tragedy of anyone who’s died or their families’ pain and grieving; it’s just an observation.

It’s also easily prevented, just like regular influenza. All it takes is common sense. Wash your hands whenever you pass by a sink, especially if you’re out in public, or use an alcohol-based sanitizer. If you have flu symptoms, stay at home. Stay away from other people who have symptoms. And so on. In other words, take the very same steps to avoid the swine flu as you would take to avoid the regular flu.

If you do catch swine flu, you should, of course, visit a doctor, but your chances of dying are about the same as for the regular flu.

Remember also that the media has a propensity to spread panic anyway; most news media count more as entertainment shows rather than actual information, and are driven primarily by what gets the ad revenue. Bad news and scare stories generate more viewers and more ad revenue than actual news, so there’s that to keep in mind.

So, should we panic? Not really. If you want to panic and loot, well, that’s your prerogative, but you’ll have to be responsible for the consequences of doing so. Taking that 42-inch plasma screen TV might seem like a good idea, but trust me, it isn’t.

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