CDC was irresponsible in claiming 1 million Americans have swine flu
What
were they thinking?
At a June 26 CDC press briefing, Anne Schuchat, director of the CDC's
National Center for Immunization and Respiratory Diseases, took the agency's number of
verified cases (over 27,000) of H1N1 ('swine flu') and extrapolated them into a
much higher number.
Having dealt with the press previously and on numerous occasions, Schuchat must have anticipated the resulting headlines, and
the ensuing panic.
Here's what she said:
"We're saying there have been at least a million
cases of this new H1N1 virus in the United States so far this
year. That's really not a perfectly accurate estimate. It's just a
number, a ballpark figure, that we think for sure there's been more than a
million of these new infections."
As if that "not perfectly accurate," "we think for sure" statement wasn't enough to guarantee headlines, when asked for
clarification Schuchat said she believed the number probably
exceeded 1 million.
I think that was irresponsible, especially since Schuchat said most hospitals and clinics don't have the means to test and classify virus samples.
"Fortunately, we have a new test that
can be done in state and public health laboratories that can differentiate this
new virus from other viruses but there's
really not the sufficient number of those tests or the capacity in terms of the
people to do those tests to test every single person who has an influenza-like
illness," she said.
Doctors may
have an extra busy day Monday morning dealing with the added people who come in clamoring for a flu shot that doesn't yet exist.
Oh well. At
least a dozen or more companies (already paid billions by our government) in a half dozen countries are
in a race to develop the first commercial swine flu vaccine. Some say they have created doses that are ready for testing on animals. May the best man win.
And may we not have a repeat of the 1976 debacle when public health officials vaccinated 40 million Americans to ward off a new flu strain, also called "swine flu" with a largely untested vaccine. The anticipated swine flu pandemic never occurred but at least 500 people who got the vaccine developed Guillain-Barre Syndrome, an often deadly neurological disorder for which there is no cure.
I read the entire briefing, Kstone, and I thought it was an appropriate session. The one million is probably an underestimate, but its importance lies in the fact that at that level, a substantial number of individuals with underlying health problems will be at risk for serious or fatal illness, and hence hospitals and state public health departments must be on the alert for this. Testing individuals with mild illness (the majority) is impractical, but individuals at higher risk can be tested, and if necessary, administered antivirals such as Tamiflu.
The briefing did not convey to me a sense of panic, but rather an objective assessment of the current state of the epidemic. Unlike the 1976 swine flu scare, this one is real. It is already killing people, but the death rate is low. The problem lies in the potential of the virus to mutate into a more virulent form, particularly in the Southern Hemisphere, where it is now winter and therefore "flu season". When we arrive at flu season in the Northern Hemisphere cold weather next fall and winter, we need to be prepared for something more serious than is now apparent.
June 28, 2009 10:02 PM | Reply | Permalink
The 1976 swine flu scare was very real. The vaccine killed more people than the disease. While one soldier at Ft. Dix was believed to have died from a new strain of flu, also called H1N1, 300 people developed Guillain-Barré syndrome after receiving the rushed vaccinations, and 25 of them died. After inoculating 33% of the US population over a three-month period, the vaccination program was halted. That's pretty scary.
July 2, 2009 2:47 PM | Reply | Permalink
FM, you seem to be a logical and level-headed chap, and not prone to panic. The CDC spokesperson is equally logical and level-headed and chooses her words carefully.
But others hearing that same message about the 'flu tests and shots *may* panic and tell a friend of a friend and set off a chain reaction. These "worried well" are probably calling their friends as we speak.
June 28, 2009 10:51 PM | Reply | Permalink
I'm not sure which could be considered more irresponsible, announcing the estimates CDC has come up with, or not announcing them. Information is power, and I advocate open information with regard to infectious disease. I was a little confused by your description of various, publicly funded companies racing to 'develop' the first commercial flu vaccine. Flu vaccine is produced the same way every year, though their are or may be proprietary differences between the different cos. licensed, (by the FDA), protocols. The 'seed' virus is distributed to the various manufacturers simultaneously, and yes, there is a rush to bring the product to market first, but that is not what is generally considered vaccine 'development'. I am a bit confused by the 'billions of dollars' the US govt. funds these companies with. That number does not pertain to influenza vaccine production, I can assure you. Public health policy has to be geared to statistical probabilities, so criticizing the '76 miscalculation is easy in retrospect, though it might have just as easily turned out to be a success of public health policy had the virus been as infectious as their estimates had predicted. I should also note that the 'seed' for the vaccine is isolated and refined by CDC based on the prevalent strains active in Asia during their flu season. Production of the vaccine, generally takes 5 or more months before the vaccine can be brought to market, a time during which the active strains at large in the world can easily have mutated so as to render the vaccine less effective. My point is that, CDC's job in flu or any other infectious disease prevention is a very fluid process, and errors if they're made, carry less risk to the general population if they err on the side of caution. I'll shut up now.
June 29, 2009 2:54 AM | Reply | Permalink
No, don't shut up! :-)
I've enjoyed reading the comments. Sounds just like something I would have written a couple years ago. You see (and this might sound radical) I think money from corporate interests is driving public health policies and priorities. Yep.
Corporate interests and the mainstream media help fan fears about minor health threats while ignoring larger ones. Three hundred probable deaths due to H1N1 around the whole world (see latest status report from WHO: http://www.who.int/csr/don/2009_07_01a/en/index.html ) doesn't come even close to AIDS/HIV -- a true health emergency (even in the US where DC's AIDs infections equal that of Uganda).
Another reason I question public health authorities’ handling of and public pronouncements on H1N1 is that the majority of people who reportedly died from H1N1 had serious unrelated health conditions. One has to also at least consider all the money that flows to Congress from pharmas and their lobbyists, the connections between health, defense (See Rumsfeld-Tamilu) and regulatory agencies and industries, the poor track record and negative reports about Tamiflu and other antivirals, how this country and some of the poorest countries in the world stockpiled Tamiflu during the avian flu scare (now outdated stockpiles). And if you STILL resist the idea that there is such a thing as unbridled corporate greed, look at the swirling financial crisis.
Yes, I agree it is the mandate of the CDC, HHS and other agencies to prepare for and ward off potential health emergencies. But they should leave the fear-mongering out of it. People are being primed to line up for their flu shots -- two or three of them this fall -- that will not have been rigorously tested.
Folks, we still don't have necessary firewalls between policymakers and private interests. If I'm wrong and the reports about "swine flu" are not fear-mongering, I am sorry. But somebody should at least be asking, even if it's uncomfortable to think about.
July 2, 2009 2:20 PM | Reply | Permalink