This politicisation of swine flu is bad for our health

There have been approximately 9,000 confirmed cases of swine flu in the UK over the past couple of months. The total number of people to have since suffered swine-flu related deaths is 17.

Of these, only one has been described as not suffering from ‘other health related conditions’. (Tests are currently being carried out to see whether two other people who have died from swine flu, a doctor and a young girl, were also ‘otherwise healthy’.) In other words, only one so far has been confirmed as an otherwise healthy person who died as a direct result of contracting swine flu. These are the bald facts about swine flu’s impact in the UK.

What swine flu has come to signify, however, is a different story. From newspaper headlines earlier this year like ‘Killer pig flu threat to the UK’ to more recent ones such as ‘Health chief warns of new killer virus’, the narrative of swine flu in the UK has sounded a consistently ominous tone, with each swine flu-related fatality seemingly providing yet further proof of the catastrophe to come.

Often, the media have uncritically taken their cue from officialdom. Whether it is the UK government or the World Health Organisation (WHO), over the past two months there has been a steady drip-drip of anxiety-inducing statements, accompanied by ‘but-don’t-panic’ caveats – which, given their frequency, seem intent on doing the very opposite. Never has a sense of fear been cultivated so pragmatically. Indeed, since swine flu provides the seemingly all-too imaginable threat against which people must be protected, thus providing some semblance of a point to policymaking, one suspects that if the disease did not exist the authorities would have to invent it. Which, in a sense, they have.

On 3 May this year, with a health alert raised to level 5 – one short of a full-scale siren-headed pandemic – WHO chief Margaret Chan used the key motif of the swine flu narrative: uncertainty. ‘We hope the virus fizzles out’, she said, ‘because if it doesn’t we are heading for a big outbreak’ (1). On 11 June, following several weeks of excitable, spluttering anticipation, WHO finally announced that swine flu was now worthy of its highest alert status. Level 6. Global pandemic. And still the announcements and statements come. Just a few days ago, Chan declared a pandemic of this type ‘unstoppable’ (2).

While WHO preoccupied itself with second-guessing the apocalypse, the UK Department of Health proved itself equally adept at coughing up anxiety in public. In May, then health secretary Alan Johnson, eager to allay any calm, observed that ‘you get a first wave [with flu pandemics] which is often very mild and then you get a much more serious wave that comes along in the autumn and the winter’. Chief medical officer Liam Donaldson was also keen to point out that it was ‘premature’ to think the virus mild (3). And, just to maximise any public concerns, special flu advice leaflets were sent out in May. For the frighteningly unsocialised, or just the extravagantly rude, advice such as ‘cover your mouth when coughing phlegm everywhere’ might have been useful – but for everyone else it just seemed to highlight the strange, exceptional nature of swine flu.

The public announcements continue. On 3 July current health secretary Andy Burnham declared that we might see 100,000 cases a day by August (4). And in a pangloomian attempt to imagine the worst in the worst of all possible worlds, chief of unhealthy speculation Liam Donaldson decided to drip some more anxiety into the public sphere. ‘The worst scenario’, he fantasised, ‘is it mixes together with another virus to produce a new variant’ (5). Asked if that meant bird flu, he replied: ‘That is a possibility. It is the worst-case scenario.’ In the context of such excitable prognoses, worst-case scenarios and glib catastrophism, the announcement yesterday that the Department of Health expects to have enough vaccines for only half the population merely seemed to confirm just how seriously the government would like the public to take swine flu.

Not that swine flu is to be taken lightly, as the death of an apparently healthy man indicates. By all accounts swine flu is potentially more severe than normal seasonal flu. Professor of biological sciences Ian Jones, summarising recent American research published in Nature, concluded that ‘the new virus is about five times more pathogenic than seasonal H1N1 but that, nonetheless, the major outcome to infection is recovery. For the few cases of severe infection the data will help in clinical management of hospitalised patients.’ (6) Also having looked at the Nature research, Mark Henderson of The Times (London) noted: ‘It’s not a mild illness, but neither does it seem especially severe. Perhaps “moderate” is the best term.’ (7)

Yet ‘moderate’ hardly seems apposite for a strain of flu that has dominated the news headlines at various points over the past two months. And it is precisely that predominance that is the problem. Each policy announcement, each subsequent media report, ripping swine flu from any clinical context, adds to the impression that it is not just flu; it is something more significant. In other words, it is not just a moderate strain of influenza, it is an exceptional strain of influenza. So while politicians and officialdom are simultaneously forced to admit that, for most people, swine flu will not even require treatment, their incessant swine-flu chatter, their constant need to make announcements, to speculate and faithlessly reassure, ends up creating swine flu as something extraordinary. Swine flu has become more than a clinical problem; it has become politicised, a symbol of the fear that both legitimises and underpins security-conscious policymaking today.

This unrelenting, myopic focus on swine flu, regardless of the content, cannot help but decontextualise what is in effect a strain of flu. It doesn’t matter if the statement contains the ‘don’t worry’ caveat; what is problematic is the announcement at all. As Rob Lyons has previously pointed out on spiked, the obsession with swine flu, or A/H1N1 as the increasingly popular flu geekery would know it, effaces far more serious diseases, such as malaria. In the words of WHO, there were ‘247million cases of malaria in 2006, causing nearly one million deaths, mostly among African children’ (8).

The elite’s obsessive flusteria does not just detract from other more serious ailments. It also makes it difficult to put swine flu into any perspective, to contextualise it in terms of similar conditions. Take the following statistic from the National Institute for Clinical Excellence: the average mortality rate of influenza in the UK is 600 deaths per year in a non-epidemic year and between 12,000 and 13,800 deaths per year in an epidemic year (9). So while swine flu is, in rare cases, fatal, so are the other strains of flu which we cope with year in, year out.

As the authorities continue their unhealthy, increasingly desperate cultivation of swine flusteria, a telling paradox has emerged in the public’s attitude to swine flu. Since it has well and truly established itself as part of the illness landscape in the UK, it no longer seems, well, threatening. In fact, when swine flu was ‘over there’, in Mexico to be precise, and not over here, when it seemed an unknown threat on the horizon rather than a known threat in the UK, it was the potential subject of far greater trepidation. Or rather, it was far easier to exploit. To make a cause of combating an illness, of protecting people from flu, was far easier for WHO and the UK government to trumpet when the threat was vaguer, less defined. It could loom spectre-like over the near future, a threat of unknown proportions. Or at least it could until the all-too-flu-like mundanity of it hit home. But now it is here, swine flu is more likely to be the object of jokes than panic amongst the general public.

So while the occasionally tragic reality of swine flu is clearly not a creation of the authorities’ feverish imaginations, the political and waning media obsession with it is. A top-down politicisation of an illness has served only to obscure and problematise a clinical problem. That most people seem largely unflustered by the hype simply reveals its unhealthy elite origins.

Tim Black is senior writer at spiked.

When public health becomes a public nuisance, by Dr Michael Fitzpatrick

What swine flu reveals about the culture of fear, by Frank Furedi

Putting Mexico in an isolation unit, by Tessa Mayes

Avian history repeated as porcine farce, by Tim Black

Swine flu and the dramatisation of disease, by Frank Furedi

The day I was tested for swine flu, by Tessa Mayes

Swine flu: official panic is making things worse, by Rob Lyons

Read more at spiked issue Pandemic fears.

 

(1) WHO warns of swine flu second wave, ABC News, 4 May 2009

(2) WHO warns swine flu ‘unstoppable’, BBC News, 3 July 2009

(3) Cited in Avian history repeated as porcine farce, by Tim Black

(4) Cited in When public health becomes a public nuisance, by Dr Michael Fitzpatrick

(5) Health chief warns of new killer virus, Daily Star, 12 July 2009

(6) Swine flu is worse than seasonal flu, research suggests, The Times, 13 July 2009

(7) Swine flu: just how virulent is it?, The Times – Online, 13 July 2009

(8) See Swine flu: official panic is making things worse, by Rob Lyons

(9) Amantadine, oseltamivir and zanamivir for the treatment of influenza. Technology Appraisal 168. National Institute for Health and Clinical Excellence, 2009