Selling 'pandemic flu' through a language of fear
- From: "TC" <tunderbar@xxxxxxxxxxx>
- Date: 20 Mar 2006 15:47:45 -0800
http://www.csmonitor.com/2006/0321/p09s01-coop.html
Selling 'pandemic flu' through a language of fear
Traditional skepticism is missing in discussions of pandemic flu.
By Peter Doshi
CAMBRIDGE, MASS. - Americans consider the United States to be a
country where debate flourishes. Yet with regard to avian flu, hyped
sound bites predominate. When President Bush asked Congress for $7.1
billion toward "pandemic flu preparedness," even his critics replied
"not enough." Meanwhile, public health officials seem obsessed with
preparing for an impending crisis - even before they have established
that doom is truly heading our way.
What is lacking in the overall discussion about pandemic flu is
disagreement, criticism, and skepticism - once the bedrock of science -
from researchers willing to question and test the data. Further, little
has been done to educate the public on what exactly defines a pandemic.
In the Monitor
Tuesday, 03/21/06
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Editorial: Selling 'pandemic flu' through a language of fear
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First, some facts: According to the World Health Organization, the
first "outbreak" of the H5N1 virus, also known as avian flu, killed six
people in 1997 in Hong Kong. Since then, H5N1 has allegedly killed 97
more worldwide, the majority of whom lived in poor, rural areas and had
direct contact with dead or sick birds often kept in unsanitary
conditions.
These numbers do not suggest the human population faces an
insurmountable threat from this virus. Peter Palese, flu scientist at
Mount Sinai School of Medicine in New York, told The New York Times in
a Nov. 8, 2005, article that H5N1 is a false alarm. The virus has been
"around for more than a dozen years, but it hasn't jumped into the
human population." The reason? It probably can't. Dr. Palese points to
studies of serum collected from rural Chinese populations in 1992. The
results indicated that millions of people had natural antibodies to
H5N1. This suggests they had been infected and recovered without
becoming noticeably or extremely sick - not the outcome one would
expect from a virus as feared as this one.
The Centers for Disease Control and Prevention (CDC) estimates that
36,000 deaths in the US occur during an "average" flu season. During
the last "flu pandemic" of 1968, however, they state 34,000 Americans
died.
In response to an article I recently published in the British Medical
Journal, questioning the reliability of US flu death statistics, the
CDC countered that "it cannot be assumed a priori that pandemics will
cause more mortality than interpandemic seasons." Unfortunately, this
information is rarely explained to the general public.
The CDC's statement is echoed by scientists at the National Institutes
of Health in Bethesda, Md. "The mild 1968 pandemic was actually
exceeded by a few more recent severe A(H3N2) seasons," they say. In
other words - technical jargon removed - the annual (nonpandemic) flu
season can (and has often been) more deadly than a pandemic. Despite
this, the World Health Organization informs readers that among the top
10 things you should know about pandemic flu: "Large numbers of deaths
will occur."
If regular flu seasons can be worse than "pandemics," just what does
the word mean? Many people seem unsure. The online Merriam-Webster
dictionary reports that "pandemic" was the seventh most frequently
looked up word in 2005. But what the dictionary doesn't tell its
readers is the definition that flu scientists employ.
To influenza researchers, "a pandemic" occurs when the flu virus in
wide circulation has changed more dramatically than the normal seasonal
variation. While important to flu virologists, it's not clear what
relevance this viral caveat holds for the average American. As
historian John Barry recently put it, "The last time a new influenza
virus reached pandemic levels was in 1968, but the episode was not
significantly deadlier than a typical bad flu season. Few people who
lived through it even knew it occurred."
Our healthcare system - and Americans' general state of health - is not
in such great shape that little is left to do but spend billions of
dollars on fighting so-called killers that may never come or may not
have a significant impact if they do.
Certainly public health officials are sincerely interested in our
well-being. Dr. Julie Gerberding, director of the CDC, stated in a
telephone press conference last fall, "We've been putting an awful lot
of attention on pandemic influenza, so influenza is on people's minds,
and I think the factor of pandemic influenza is very frightening to
people." One begins to wonder whether some officials might not cherish
their worst case scenario, and even see vindication in it.
There are better ways to promote America's health than selling sickness
through the language of fear. Before the government employs "all
instruments of national power," including "quarantine authority," as
the National Strategy for Pandemic Influenza declares, we need to be
told what "pandemic flu" really means. So far, we have not been given
the full story in plain language.
· Peter Doshi is a graduate student at Harvard University focusing on
issues where medicine, politics, and journalism intersect.
*********
TC
.
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