Swine Flu: A Panic to Be Thankful For
Apparently, President Obama told some good jokes at a dinner. The British Parliament is mired in an expenses scandal (one politician charged the government more than $3,000 to repair a leaking pipe under his tennis court). In China, they're marking the anniversary of the earthquake that left some 80,000 people dead or missing a year ago, and in France, a young tennis star has tested positive for cocaine. But swine flu? The world's media have moved on.
Two weeks ago, there was almost nothing else to read about and nothing else to look at either, what with all the photographs of uniformed Mexican police officers, guns and face masks, not to mention the snarling pigs. But as of Sunday, there were 2,532 confirmed cases of swine flu in the United States, mostly mild, and only three deaths -- all people with other illnesses. A handful of cases has shown up elsewhere around the world, but outside of Mexico just two, as of this writing, have been lethal. Given that some 200,000 Americans are hospitalized each year for the ordinary flu, and some 36,000 die from complications -- up to 20 percent of Americans contract flu annually -- these numbers do seem rather low in the context of phrases such as "lethal pandemic" and "deadly virus."
No wonder the anti-panic backlash started rather quickly, fast on the heels of the panic itself. Already last week, a rather senior former European health official was (privately) declaring the whole thing a crock of nonsense, cooked up by the World Health Organization as a fundraising gimmick. Someone else told me, as if with absolute certainty, that the publicity was in fact a plot by the pharmaceutical companies: Look no further than the massive surge in demand for Tamiflu and Relenza. Face masks never did catch on in most places, so the rumors of a conspiracy by the companies that make them never caught on either. Instead, we'll surely conclude that the whole thing was a plot by the media, designed to increase Web viewership on sites that featured herds of stampeding pigs.
To which the correct response should be: So what? Before "that panic was ridiculous" becomes the conventional wisdom, let's be frank about it: Where infectious diseases are concerned, panic is good. Panic is what we want. Without panic, nothing happens. As many as 500 million people will get malaria this year, and more than a million of them will die, mostly in very poor countries. Yet there is no fear of malaria in the rich world, there is no hysterical media coverage, and thus there is still no satisfactory prevention or cure.
By contrast, the design of preventive measures and cures for swine flu are already, after merely two weeks of hyper-attention, well on track. The U.S. Centers for Disease Control and Prevention have not only developed a test kit to detect the presence of the H1N1 virus that causes the flu but have already shipped this test kit to all 50 states, plus Puerto Rico and numerous other countries. The genetic sequence of the virus has been analyzed and determined, more than once. A vaccine will probably be ready in time for flu season next fall. Boxes of Tamiflu have been transported to guarded warehouses around the globe, where they await distribution.
Should the panic-mongers turn out not to have been crying wolf, and should the virus worsen in the coming weeks, there will still be plenty of potential obstacles to effective prevention. The methods used to make flu vaccine are ridiculously old-fashioned (they involve chicken eggs), and in a truly lethal epidemic, we would certainly run out. No one has really worked out the morality of that Tamiflu distribution either: If the United States and Europe distribute their stockpiles to their citizens, then no one in the developing world will get any. Our hospitals aren't prepared for massive numbers of flu victims, and our health-care system would probably crack under the strain. Would doctors accept uninsured patients who have a lethal flu virus? Possibly not.
Yes, if the H1N1 virus mutates into something really dangerous, we'll all be in trouble. But not in as much trouble as we would be if that possibly ludicrous but nevertheless useful moment of mass hysteria that brought us such terrific headlines over the past couple of weeks had never happened.