Swine flu: official panic is making things worse

The gap between the reality of swine flu and officialdom’s hysteria is widening every day, with potentially dangerous consequences.

Rob Lyons
Columnist

30th April 2009

‘Are we there yet?’ ask the world’s press corps, like impatient children on the backseat of the swine flu bandwagon. ‘Not yet, but soon’, answered officials from the World Health Organisation (WHO) yesterday.

‘There’ is the official declaration of a pandemic of swine flu. At the moment, WHO says we are at Phase Five in its pandemic threat level, but it is likely to declare Phase Six – the highest threat – any day now. However, while much of the media and officialdom has treated these phases as hard evidence of imminent death and disaster, the WHO’s classifications are really administrative alerts to governments and health authorities. They tell us almost nothing about the ultimate severity of swine flu. It is global public health meets This is Spinal Tap, and this panic is swiftly being turned all the way up to 11 (1).

So, where do we stand? The latest WHO swine flu update, published on 29 April, stated that ‘nine countries have officially reported 148 cases of swine influenza A/H1N1 infection. The United States government has reported 91 laboratory-confirmed human cases, with one death. Mexico has reported 26 confirmed human cases of infection including seven deaths.’ There is also a sprinkling of cases in Canada (13), the UK (5), Spain (4), New Zealand (3), Germany (3), Israel (2) and Austria (1). There are also a larger number of unconfirmed cases in Mexico, some of whom have died. These figures are changing day by day and will undoubtedly increase for no other reason than doctors are now actively on the lookout for swine flu.

We also know that treatment with two modern anti-viral drugs, Tamiflu and Relenza, is effective and that many countries have large stocks of these drugs as a result of the last pandemic panic, over avian flu, which began in 2004. We also know that intensive care treatment is far more sophisticated than it was in 1968, during the last global pandemic of flu – ‘Hong Kong’ flu – which killed 30,000 in the UK and an estimated one million people worldwide. Even the 1968 pandemic was not all that much out of the ordinary when you consider that anything between 4,000 and 25,000 people die from influenza in the UK each year and there have been a number of substantial epidemics in the years since 1968 (2).

And while we fret about the possibilities of exotic new killer diseases, long-established illnesses receive much less attention. For example, WHO notes on its website – away from its frontpage splashes on swine flu – that there were ‘247million cases of malaria in 2006, causing nearly one million deaths, mostly among African children’ (3).

In short, any novel influenza virus should be a cause for concern, certainly in medical circles. If lots of people were infected, even a low mortality rate could lead to many deaths. But for most people, especially in the developed world, the likelihood of being made seriously ill or dying from swine flu would appear to remain very low; the vast majority of the cases so far have been mild. Our major concern right now should be that a widespread overreaction to swine flu might cause more harm than the virus itself.

There is a gaping disparity between the reality of the swine flu outbreak and the scare stories issued by WHO officials, some politicians, and media outlets. Influenza experts and health officials talk about remaining calm but they seem unable to resist making melodramatic statements. WHO’s director-general, Margaret Chan, gave a briefing yesterday in which she announced the raising of the alert level from Phase Four to Phase Five. She noted that ‘the world is better prepared for an influenza pandemic than at any time in history’ and that it was still very unclear how serious the situation would become; but then she said ‘this is an opportunity for global solidarity as we look for responses and solutions that benefit all countries, all of humanity. After all, it really is all of humanity that is under threat during a pandemic.’ (4) Meanwhile, a top EU health official argues that ‘it is not a question of whether people will die, but more a question of how many: will it be hundreds, thousands or tens of thousans?’ (5) Nothing like a new disease for a bit of global grandstanding, then.

Individual countries are also taking action that is likely to increase alarm. In Britain, the government is planning to send leaflets to every home with advice about what to do about swine flu. This is promoted as a sensible measure to ‘reassure the public’. The effect is likely to be the exact opposite. Good public health advice should be specific and well-informed. This leaflet can only possibly give the most general guidance about hygiene, and advise those who become ill to stay at home. But the symbolic significance of the government sending out such a leaflet – which is pretty rare – will not be lost on most people. It screams ‘HEALTH EMERGENCY’. Such a step will pointlessly increase anxiety. Far better to wait until the situation has become clearer, which may only take a week or two, before deciding what to do.

There have also been reports that the government is seriously considering asking vaccine manufacturers not to produce their usual winter flu vaccine but to devote their resources to producing a vaccine for swine flu. At the very least this needs to be carefully thought through. We know for certain that influenza will kill thousands of people this coming winter. We also know that, in most years, the seasonal flu vaccine provides considerable protection to vulnerable groups, such as the elderly and diabetics who might otherwise fall ill. Should we really replace that protection with a vaccine for a disease which, outside of Mexico, has thus far killed only one person (a young Mexican child in Texas)?

Further afield, alarm about swine flu is already having an impact. At a time when Mexico is struggling economically, the last thing it needs is for its tourism industry to be hit by advice to avoid ‘non-essential travel’, as suggested by the EU’s health commissioner and the US State Department, or the call for a ban on flights to Mexico from France’s health minister, Roselyne Bachelot. The vast majority of people coming back from Mexico are not infected. Nor are pigs and pork products a problem, yet that hasn’t stopped countries banning pork imports or even proposing the culling of pigs.

These panicky policies are more likely to increase public cynicism rather than do anything to tackle disease. WHO and national health authorities have been ‘crying wolf’ about avian flu, SARS, obesity timebombs, cholesterol numbers, binge drinking and numerous other issues for years. An old insurance slogan assured us that ‘We won’t turn a drama into a crisis’, but the people in charge of health policy seem to be doing precisely that.

Rob Lyons is deputy editor of spiked.