My usual response when some sickness hits the news is to roll my eyes and change the channel, telling myself it has little to do with me and will probably amount to nothing and it's not worth worrying about. Earlier this week - because the alternative is thinking about dinosaurs, which just goes to show that priorities really get skewed when you're struggling with a PhD - I decided to crawl out of my "epidemic scare stories are boring exercises in mass hysteria" hole in the ground and educate myself.
My conclusion after a few hours was that epidemic scare stories are boring exercises in mass hysteria and my time would be better spent learning about a group of animals that have been extinct for 65 million years.
But then the brain processes kicked in, and I started paying attention to what people were saying - and by 'people', I don't mean the mainstream media, who as always are screaming loudly for no other reason than that announcing the new apocalypse is more fun than talking about money or whether or not we should prosecute confirmed warcrimes.
The BBC are currently hosting a page called: Swine flu: How serious a threat?
basically seems to say "we just don't know yet: probably not too bad but 'flu is unpredictable." WHO have upgraded
the influenza pandemic alert to level 5, on a scale of 6. This doesn't mean that we're 83% of the way towards the need to be ware of the walking dude; the alert scale
is more structured than that:
Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.
It's not about the numbers - how may or few people have suffered from or died from the 'flu yet, but recognition that transmission is occurring. The reason to worry is not in the numbers of people affected, but in the potential
. This is the lack of understanding that accounts for my usual blase attitude towards disease outbreaks; I saw what I thought of small numbers and lots of people talking about what 'could' happen, and my cynical hat comes out. After all, I'm used to not talking about what could happen in favour of focusing on what has happened - everything I study has long since stopped evolving.
stop evolving. They're famous for it, in fact. They have a very rapid lifecycle that promotes response to selection pressures, and a very great part of those selection pressures is the immune systems of the host organisms; in this case humans and pigs. The basic tenants of evolution is very simple: the environment (host organism) changes, and the organism changes to continue living in it; at the same time, organisms change for other reasons, and this could open up new environments for the organism to live in. When H1N1 crossed from pigs to humans, it showed that evolution in action, and opened up a whole new environment to live in, with whole new challenges in our response (both immune and social) to overcome, and because it's a new virus, we can't predict how it will react. But we can be sure of something: we won't have hard evidence that this is a definite threat until it's too late to do anything. We know this is a 'flu virus, but that's like knowing that an animal is a bird; until it's been observed and studied we won't know whether we're dealing with a pigeon or an albatross, and if we wait until we know... I'm trying to fit this into a Coleridge analogy, but it's just not working. You can do your own.
There have been, so far, relatively few worryingly serious cases, but even plain old run of the mill regular 'flu is nasty if you're unlucky. This is a new virus, and as such the human population has no natural immunity to it (yet); so whether a case of it is serious or not, it has the opportunity to spread fast. And when viruses spread fast, they evolve fast. So even if it is no worse than seasonal flu right now, by the time it's had the chance to spread more it will be able to evolve further and it could get worse. Still, we've no real idea how potentially bad it is in its current form, because we just don't know.
"Hope for the best, plan for the worst" is, as always, a helpful rule of thumb. What we need to be doing now; what by all accounts it seems we are
doing, is encouraging sensible behaviours to reduce spread, to stock up on anti-viral drugs, and to prepare ourselves to provide healthcare at home and aid abroad when needed. It's possible this might all blow over, and the me of earlier this week will be justified in bitching to myself about how it's a big storm in a tea-cup; I certainly hope so; if only because I think the way the tabloids are screaming about Parmageddon is not justified in any way.
In an ideal world, every global healthcare system should be able to handle an outbreak of something nasty, as outbreaks happen, but they're not, and as long as healthcare stays shocking underfunded, they're not going to be. The best we can do is recognise when new threats appear and prepare as well as we can as fast as we can.
So don't panic; panicking solves nothing and we don't know
that we're all going to die. But deliberately being contrary does no good, either. Just because some people are overreacting, it doesn't mean there's nothing to
react to, and joining the collective chorus in order to put down valid concerns could wind up being just as harmful if - I'll emphasis the big if
- we do end up with an humanitarian disaster we could
prevent with the right action now.
Oh, and those facemasks? Only prevent you transmitting the virus; they don't prevent you catching it. And they make you look like a prat.Some helpful PagesEffect Measure's Swine Flu category The Flu Wiki H1N1 Flu outbreak mapBen Goldacre on the same subject