Joined: 28 Apr 2005 Posts: 7885 Location: Halfway between here and there
Posted: Feb 03, 2010 3:45 pm Post subject: Was the swine flu pandemic a big fat porky?
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It's been a good week for drug companies and an even better one for conspiracy theorists. Last Tuesday, angered by the bumper rise in profits being reported by vaccine manufacturers as the incidence of swine flu plummets, the former head of health at the Council for Europe accused the World Health Organization of "faking" the pandemic.
"It looks like the WHO is under the influence of industry," Dr Wolfgang Wodarg told a hearing in Strasbourg. "It was stated in panic-stricken terms that this was a flu that could threaten humanity. This is why billions of medications were bought."
Exhibit number one, says Dr Wodarg, is the WHO's decision to soften its definition of a pandemic last April, shortly before the emergence of the H1N1 virus. By eliminating the requirement that influenza pandemics should cause "enormous morbidity and death", the WHO provoked an unnecessary "scare" that conveniently triggered the activation of "sleeping" contracts with vaccine manufacturers. Yet since the WHO's declaration of a pandemic in June, swine flu has caused just 14,000 deaths worldwide – a fraction of the number who die from seasonal flu every year. This month, the Department of Health reported that cases had fallen to such a low rate that it was cancelling its weekly press briefings.
Like all conspiracy theorists, Wodarg started with the question "Cui bono?" and served up a plausible bad guy. For its part, the WHO vigorously denies the allegations and says Wodarg is "trivialising" what for millions of people has been a very serious problem.
So who is right? Was swine flu ever a genuine pandemic threat, or was it all a lot of (very expensive) fuss about nothing? And what are the lessons for the future? When, in late March, residents of La Gloria, in Mexico, began complaining of peculiar fevers, aches and sore throats, no one took much notice at first. The Mexican government, like the WHO, was focused on a different threat: bird flu. Following the re-emergence of the H5N1 avian virus in 2005, the WHO had drawn up a comprehensive pandemic plan, complete with a phased alert system, to be activated in the event that the virus, which had a mortality rate as high as 60 per cent, began spreading widely in human populations.
"The concern was that if bird flu suddenly went pandemic, it could trigger mortality on a massive scale," explains John Oxford, professor of virology at Barts and The London Hospital. "The last thing anyone was expecting at that point was a pig virus from Mexico."
It seems odd to recall now, but the massive stockpiles of Tamiflu which have come in for so much criticism were originally purchased for bird flu. Indeed, it wasn't until two Californian children developed flu-like illnesses in mid-April that officials at the Centers for Disease Control and Prevention (CDC) in Atlanta realised that a new swine flu virus was on the loose.
Scientists quickly began joining the dots, and when the CDC confirmed that the H1N1 subtype from the Californian cases was identical to a virus isolated from a five-year-old boy in the La Gloria outbreak, it automatically triggered a "phase five" alert.
At around the same time, the WHO published those new guidance notes, deleting the requirement that pandemic strains should cause "enormous morbidity and death". This was part of an ongoing review of how it should define a pandemic. Henceforth, all that would be required was "sustained" transmission in at least two different parts of the world at the same time. The result was that on June 11, when it became clear that swine flu had spread to more than 70 countries, the WHO had no option but to declare a pandemic.
But Wendy Barclay, professor of virology at Imperial College London, who was present at many of the meetings where the change of definition was discussed, says it is a "nonsense" to make out, as Wodarg does, that it was a conspiracy. "The timing was coincidental," she says. "The WHO was considering the change long before swine flu." And in view of the initial reports from Mexico, which suggested unusual mortality patterns among young adults, she believes the WHO was right to call for the fast-track manufacture of vaccines. "The drug companies should be applauded for delivering the vaccines in record time," she says.
Peter Openshaw, the director of the Centre for Respiratory Infection at Imperial College London, agrees with that verdict, pointing out that the fear at the time was that swine flu could prove as deadly as the 1918 "Spanish" influenza, another strain of H1N1 that killed an estimated 50 million people worldwide. Although he has reservations about the definition change, saying that pandemics should also be required to meet a "severity threshold", he argues that "on balance it would have been irresponsible not to have taken the measures we did".
Having said that, Prof Openshaw admits there are some things that should be done better next time. The Department of Health's prediction in July that as many as 65,000 Britons could die over the winter was wrong, because scientists did not have accurate data. Initial reports suggested the virus was less widespread than it was, artificially elevating the death rate. However, a study just published in The Lancet, based on more extensive tests conducted over the summer, shows that, at that time, as many as one in three people in Britain were carrying the virus, 10 times more than could be estimated from the data available from hospitals and surgeries. As a result, the fatality rate has now been downgraded to a paltry 0.03 per cent, meaning that swine flu is 100 times less lethal than Spanish flu. "What we didn't know at the time was that there were a large number of asymptomatic carriers," explains Prof Openshaw.
Having said that, swine flu has tended to target people between the ages of 15 and 45, a group not normally at risk from seasonal flu, which has, the experts say, fully justified the NHS's decision to provide early treatment with Tamiflu. In the United States, points out Prof Openshaw, those infected did not get antivirals until much later, and admissions of young adults to intensive care units have been far higher.
In fact, if anything, he believes we need to deliver antivirals and vaccines even faster next time – which is why he would like to see the NHS "iron out the bottlenecks" in its distribution system. That is a message seconded by Prof Oxford, who points to the "salutary" experience of Ukraine, where a huge surge in swine flu infections late last year brought the country's medical system to its knees and had politicians scrabbling for supplies of Tamiflu and vaccines.
Prof Oxford also warns that the winter flu season is by no means over, and that vaccination could prove vital if, as he expects, H1N1 returns next year. "Swine flu is behaving in classic Darwinian fashion," he says. "It has already displaced 99 per cent of the other flu viruses out there. My worry is that when it gets into the elderly next year, we could see many more deaths." So far there have been 390 deaths in the UK.
No doubt Wodarg and his supporters will see this as a further example of scaremongering. The issue, they say, is not whether swine flu poses a risk but whether the risk is big enough to justify the diversion of precious funds to influenza vaccines, when diseases such as heart disease and hypertension kill many more people each year. And the row is not likely to be resolved any time soon. Although the government is now holding talks with GlaxoSmithKline to find a way of disposing of 60 million unwanted doses of vaccine, analysts predict that it and other vaccine manufacturers stand to make windfall profits of around £4 billion.
Yet rather than looking for scapegoats, Prof Barclay says we should be grateful that the pandemic turned out to be so mild. "In many ways, swine flu has been a dress rehearsal," she says. "Next time, we may not be so fortunate."
Just in case the title confused you it's cockney ryhming slang. Porky pie=lie.
But it raises an interesting point. I know of at least 2 supposed cases of swine flu in my company alone. Although I do question how many were actual cases of H1N1 and how many were just lazy doctors telling people "Oh, you have swine flu, take these tablets and have a week off work" just because it's what people wanted to hear and it was easier than saying "It's just a cold. man the fuck up and stop whining about it".
Plus it is an all to easy excuse to say you can't come into work because you have swine flu. I know at least 1 of those supposed cases in my company didn't even produce a doctors note.
People know that if you call up your office saying you have the virus that they are going to tell you not to come anywhere near the office.. no matter how busy it may be. So I personally just think it was just a big Tamiflu marketing campaign.
I do wonder though, if bird flu and swine flu ever came into contact and mutated would that make pigs fly? _________________ Hard work pays off in the future. Laziness pays off now
Joined: 09 Mar 2003 Posts: 6019 Location: Just beyond your reach
Posted: Feb 03, 2010 6:44 pm Post subject:
I'm so sick of conspiracy hypothesizers (their arguments don't rise to the level of theory). The world got very lucky that H1N1 wasn't very deadly. But it caught everyone off guard, spread like crazy and exposed a lot of major flaws in the public health safety net. If this virus were more virulent, there would be bodies piling up around the world.
Just recently The Lancet retracted their 12 year old article linking vaccines with autism. But it comes quite late as many people are now convinced that life saving, culture changing vaccines are dangerous. These fools are sowing the seeds for the return of deadly diseases that are easily preventable. _________________ Advocate for the Devil
Joined: 28 Apr 2005 Posts: 7885 Location: Halfway between here and there
Posted: Feb 05, 2010 10:25 am Post subject:
I hear ya Sneeral, but it seems like every other year there is some new deadly virus that is going to wipe out humanity.
Heck, I remember when Aids was that "deadly new virus". In my lifetime alone and off the top of my head I can name a few of said virus's that were supposed to wipe us out.
Aids, Sars, Bird flu, Swine flu. Then you have all the other things that were meant to be a major health risk to us humans and was meant to cause mass fatalities. Mad cow disease, foot and mouth disease.
If there were such major flaws in the public health safety net as you say then why didn't the get closed up with any number of said viruses before it?
All I am saying is that the media overhype these things so much that how are we the public to know what is a legitimate concern and what is just the media milking a story to either boost their ratings or to help boost sales of the new "wonder cure"? _________________ Hard work pays off in the future. Laziness pays off now
Joined: 09 Mar 2003 Posts: 6019 Location: Just beyond your reach
Posted: Feb 05, 2010 1:53 pm Post subject:
You're conflating separate issues: the problem with containing potentially dangerous communicable disease, and the problem with 24 hour news reporting making proper perspective impossible to maintain.
I am somewhat taken aback by your use of scare quotes around the phrase "deadly new virus" in relation to AIDS. Do you find it not to be a deadly serious public health threat? I'd attribute that to you're being too young to remember when it was, indeed, a death sentence, before the current (and very expensive) treatments were available to manage (not cure) the disease. Except I recall that you are from South Africa, where over 250,000 people died of AIDS in 2008. There are an estimated 1.4 million AIDS orpahans there. More alarming than the gross number is the increase in mortality as a whole attributed to AIDS in S. Africa.
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In October 2008, Statistics South Africa published the report "Mortality and causes of death in South Africa, 2006". This large document contains tables of how many people died from each cause according to death notification forms.
The report reveals that the annual number of registered deaths rose by a massive 91% between 1997 and 2006. Among those aged 25-49 years, the rise was 170% in the same nine-year period. Part of the overall increase is due to population growth. However, this does not explain the disproportionate rise in deaths among people aged 25 to 49 years. In 1997, this age group accounted for 29% of all deaths, but in 2006 it accounted for 42%.
The influence of population growth can be removed by looking at death rates per 100,000 people, which are provided by Statistics South Africa in another report called "Adult mortality (age 15-64) based on death notification data in South Africa: 1997-2004". These data show that between 1997 and 2004, the death rate among men aged 30-39 more than doubled, while that among women aged 25-34 more than quadrupled. The changes are even more pronounced when deaths from natural causes only are examined. Over the same period there was relatively little change in the death rates among people aged over 55 and those aged 15-20. In their report, Statistics South Africa call such developments "astounding", "alarming" and "disturbing".
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Did you know that in America, throughout the 1990's, over 36,000 people on average died each year of the regular seasonal flu? That's a whole lot of people. But the seasonal flu is not news. It comes around every year and we're used to it. I guarantee you that if a new illness caused as much death it would be major headlines and "over-hyped."
Blame the state of news reporting today and human nature on the perception problems that bother you about how things become over-hyped and sensationalized. 24 hours is a lot of time to fill with same-old, same-old. Scary is good for CNN & FOX, and bloggers. I recall that fairly early on in the H1N1 story, doctors were on TV telling people that if the used common sense and observed good hygiene (washing hands often) that they would go a long way towards reducing their risk of getting sick.
But people like to be tittilated so they focus on the scariest potential extreme and chatter among themselves about how dangerous the world is and try to feel alive by vicariously living through someone else's tragedy and risk. And then when the worst doesn't happen, they look for someone to blame for their expectations not being met and decide that they were the victims of a conspiracy.
So how are you to know what to think about such stories? Stay calm, do research, and be skeptical. However, keep in mind, that if a flu virus combined the ease of contagion of H1N1 with the deadly virulence of H5N1, people would be asking why the alarm wasn't sounded much earlier and louder. And the conspiracy theorists would be telling us that the deadly pandemaic was engineered by (take your pick): The USA, Muslim terrorists, the Jews, aliens, etc. _________________ Advocate for the Devil
Joined: 28 Apr 2005 Posts: 7885 Location: Halfway between here and there
Posted: Feb 05, 2010 2:39 pm Post subject:
Yes infact I do know that seasonal flu has such high numbers of deaths associated with them. Like with most viruses the old, young and those with already poor health are always the first to be hit.
What gets me is how much miscommunication is come along with this current scare. How many people have you seen with the face masks on when they have been proven to not help stop the spreading of the virus?
Hell, in Thailand last year the airport was full of people with them. On the roadside you saw government posters telling people to wash their hands and wear their face masks.
I don't have a problem with the call being raised for a potential health threat. But like I said, people use it as an excuse. And I am sure many doctors have misdiagnosed H1N1 for your run of the mill cold.
I think I have mentioned it before but I work in the education sector. When the hype to swine flu started you should have seen how many schools closed down because one or more pupils supposedly had the virus. Sometimes for a week or more in some cases.
Yes, the prospect of the virus mutating with a deadlier virus is a scary one, but personally I think there are more realistic possibilities out there that are scarier. Such as being hit by a piece of falling space debris.. or being hit by a bus.. or getting cancer.
If I was half as scared by these potential causes of death as some people are of catching swine flu then I would probably never leave the house (though even that wouldn't save me against falling space debris or a meteorite).
Ok, I'll give you the Aids one. I was to young to really remember the early days of it. But I know lots of people do die from it yearly in Africa and a lot of that is down again to misinformation. Many rural areas in Africa still believe in Muti-men (medicine men) who tell them silly rituals or potions is the only way to get rid of the virus. The worst case of this I have heard of was a few years ago where a Muti man told an african man the only way to get rid of the Aids was to have sex with a pure, virus-free baby. Which he did.
The mere thought of this would sicken most civilized people, but in rural africa such misinformation is rife, though not to this severity in most cases thankfully.
Personally I think all these virus's are just mother natures way of trying to cull an already exploding human population. If everyone who was going to die from Aids, flu, H1N1 etc.. was to survive and reproduce we would quickly (quickly being a relative term, in this case I mean like 20-50 years) find ourselves with a food supply problem. _________________ Hard work pays off in the future. Laziness pays off now
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