When pig flu flew
Once again, critics are claiming public health experts last year hyped the potential threat of a uniquely piggish version of the influenza virus, the H1N1 virus – or so-called swine flu.
This time, however, some of the critics add that the hype was done to benefit the drug industry.
The World Health Organization and other leading health authorities strongly reject the criticism saying they acted prudently given the risk of a deadly pandemic such as the world experienced in 1918.
The truth is likely somewhere in between.
If the goal is simply to do whatever it takes to reduce risk, why aren’t we also setting up nuclear-tipped rockets to blast killer asteroids given that scientists say it is a near-certainty that the planet will again be struck by one of these things?
Because, on balance, the cost and trouble of doing so seems unjustified given the level of uncertainty about when and where.
An especially dangerous flu pandemic like 1918 is more likely than a killer asteroid, but when and where it will strike is similarly uncertain.
When the H1N1 virus was first discovered in a flu outbreak in Mexico, authorities sounded the alarm because young people had died and the virus contained a unique combination of pig, bird and human flu genes. The experts said a repeat of 1918 was a distinct possibility.
Pandemic. That was the word that got everyone excited. In the excitement, the pharmaceutical industry was exhorted by WHO and other leading health authorities to step up production of anti-viral drugs and vaccines to respond to the looming threat.
But, technically, flu is always pandemic since it spreads worldwide and kills a large number of people – every year.
As this “swine flu” spread worldwide, it became pretty clear early on that the mortality rate in Mexico was unique and due to some factor (perhaps poor health care) other than the virus. The death rates were not out of the norm for regular flu. But, because of the genetic nature of this virus, WHO and others continued to warn that this flu could still turn exceptionally nasty.
When the threat did not materialize, WHO changed its working definition of “pandemic” to remove its own requirement that to label an outbreak as pandemic must involve excessive mortality.
People were still warned that this was something special. Individuals were urged to get vaccinated and agencies stockpiled drugs.
The recent criticism implies that the WHO was unduly influenced to keep fanning the flames by experts with ties to the drug industry. WHO director Dr. Margaret Chan says they were not.
Who knows? But one big lesson here is that you can’t un-ring a bell.
Tom Paulson covered science, medicine and global health as reporter for the Seattle Post Intelligencerfrom 1987 to 2009, before the print version of the paper closed and PI became the online news site. Now he continues to report as a freelance and blogs about the local global health scene at his website: A Page from Tom Paulson.
Category: Global Health, Global Health Seattle, Influenza, Tom Paulson
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I agree. The failure of WHO and others doesn’t lie in their initial response. In its early stages, H1N1 did seem scary. Their failure came when it became obvious, even to a layman like me, that the scare was overblown. At that point, they continued to act as if it wasn’t. They had too much invested in their initial rhetoric. We may never know how much their motivation was ego (“I save the world”), grant-seeking (grants fund careers), or efforts to please the drug industry, given the revolving door between industry and NGOs.
But what we do know is that the next time there’s a potentially scary virus, the public is likely to be more skeptical because of this.
Thanks Mike. I share your concern that given this episode the public may not respond appropriately to a serious (and full-fledged) pandemic. Maybe we will need a new word, like megapandemic, to get the point across and distinguish it from WHO’s watered-down definition.
Tom