So swine flu has now officially been declared a pandemic. I’m guessing that most Americans will shrug at the news, having decided the threat was way overblown. Myself, I’m scheduled to start worrying about it again in the fall, when the flu season picks up again. Until then, the big questions are:
- Will the virus mutate to become more virulent? Or will it lose some of its punch?
- What will happen in the Southern Hemisphere over the summer? Will people in poor countries prove especially vulnerable, or will they be largely spared?
- And will the international public health community rush sufficient amounts of vaccine into production? This is still important even if the illness remains “mild.” Its novelty will create a strain on health systems, simply because many more people will fall ill than in a normal flu season. The “pandemic” label lets WHO accelerate the vaccine process, but I’m skeptical that supply will meet demand.
In the meantime, we are so lucky, because the State Department apparently knows where the threat is: elsewhere!!
I just got my new passport. It came with a little brochure that informed me about the RFID tracking chip in the passport (eek!), warned me against abducting my children overseas, and enlightened me on “Pandemic Flu”:
For information about pandemic influenza and how you can protect yourself if there is an outbreak while you are abroad, please visit the official U.S. Government pandemic influenza website at http://www.pandemicflu.gov.
Um, sorry to break the news to the State Department, but ground zero for the pandemic is right here in North America. The virus may well have originated in the U.S. before spreading to Mexico. Sure, plane travel spreads it, but there’s no reason to think I’ll be at more risk when I travel to Germany in a couple weeks than when I flew out to Seattle and Eugene last month.
I guess xenophobia is at pandemic levels, too.
Patron cat of Kittywampus (1985-2001)
To be fair to the State Department, perhaps the concern wasn’t so much that US citizens are more at risk of contracting the disease abroad than that they might be less able to access information about it while abroad.
I read yesterday that almost all of the victims of the current pandemic are under the age of 45. A possible explanation for this those alive during the 1957 and 1968 pandemics have retained acquired immunity. This suggests another question to add to your list: Is it really wise to attempt to suppress these diseases on first outbreak, as was achieved with SARS but not with H1N1? Perhaps pandemics are like forest fires. Suppressing them leads to a build-up of dead wood which fuels the next one.
(No offense intended by my analogy between the under-forties and dead wood.)
Sure, the State Department might have anticipated the problem, but if you’re in a country where you don’t know the language, getting online is likely to be an issue too. It’s also possible that this was meant to anticipate travelers’ worries and reassure them. Without context, though (e.g., “you’re not likely to be more at risk abroad”), it comes across as locating the problem outside of the U.S. borders.
As for the age groups affected – whether those of us 45 and over have any residual immunity depends on how different this virus is from earlier ones. I don’t know the answer to that, but it’s an interesting question. We haven’t heard much about the mechanism of death in these younger victims.
Revere at Effect Measure (a public health blog at Science Blogs) addressed the age distribution a few days ago (by the way, if you don’t know that blog, it’s an excellent one if you’re interested in these issues):
So he’s not saying that almost all the victims are under 45, but the toll is very disproportionate among young people. I don’t think that the forest fire analogy works, though, because a distinguishing feature of pandemics is that they’re caused by a major new mutation. That’s why so many more people get sick than with regular seasonal flu. We don’t have the capability to completely contain flu anyway, so we needn’t worry about the dangers of complete suppression. The goal of public health measures is to buy time, allowing a vaccine to be delivered before the pandemic gets too severe, and also spreading out the impact on health services. A hospital may be able to cope with 10 additional flu admissions per day over 30 days, but it may not be able to handle 30 extra admissions over 10 days. Either way, you’ve got 300 “surplus” cases, but the impact on services is quite different.