The Obligatory Swine Flu Post

by John Hawkins | April 29, 2009 12:42 pm

Despite the fact that Swine Flu has been a hot topic, I’ve stayed away from writing about it for a simple reason: it’s hard to tell if this is another heavily hyped SARS that will end up killing one person for every 300-400 stories that are written about it — or a real killer that could sweep across the world leaving millions dead in its wake.

Just in case, you’re unaware, there have been some momentous pandemics which have killed staggering numbers of people — and that was before the world became so interconnected.

For example, consider the Spanish Flu[1],

In March 1918, in the last months of World War I, an unusually virulent and deadly flu virus was identified in a US military camp in Kansas. Just 6 months later, the flu had become a worldwide pandemic in all continents.

When the Spanish Flu pandemic was over, about 1 billion people or half the world’s population had contracted it. It is perhaps the most lethal pandemic in the history of humankind: between 20 and 100 million people were killed, more the number killed in the war itself.

So, is this another Spanish Flu, another SARS, or something in-between? Of course, major outbreaks like the Spanish Flu or the Black Plague are extremely rare. That means odds are it isn’t that bad. Still, given the seemingly rapid rate of transmission and the death rates in Mexico, I’m starting to think it may make a bigger impact than SARS. From Megan McArdle[2],

How worried should we be about the Swine Flu?

The mortality in Mexico is shockingly high: 81 cases out of 1300, or about 6%. The great Spanish Flu pandemic, on the other hand, had a mortality of about 2.5%. Normal rates for flu are less than a tenth of 1%, with most of those deaths occurring in people who are already weak: children, the elderly, the immunocompromised. The Spanish Flu hit hardest the 15-34 age group, who seem to have been done in by their own strong immune response. It’s not clear which pattern this flu follows.

But mortality is not the only consideration; transmissability also matters a great deal. Something like 25% of Americans ultimately got Spanish Flu. But animal viruses usually aren’t that efficient at moving from human to human. And the quicker and deadlier a virus is, the less likely it is to spread–the victims die before they can pass it on.

At first glance, though, this one seems to have gotten pretty good at passing from human to human. A few days after we first hear of it, it’s in New Zealand, Hong Kong, Spain, the US.

…The bright side is that mortality here seems to be a lot lower–nonexistant so far. People living in poorer countries tend to have weaker immune systems for the obvious reasons. And the strain that’s arrived here may just not be as deadly as the one still in Mexico.

Now, could this ultimately turn out not to be, comparatively at least, that big of a deal compared to other more mundane health concerns? Sure, but it’s worrisome enough that we should be taking stronger precautions.

At a minimum we should be ramping up our border security to prevent sick Mexicans from coming over the border and attempting to curtail unnecessary travel between the US and Mexico. Unsurprisingly, President “I vote present” has sat on his hands rather than take any sort of significant steps to curtail the risk.

Should we completely close the border? That’s admittedly a tough decision, because if you do it and the Swine Flu peters out without major casualties, you’ve inconvenienced millions of people and cost businesses on both sides of the border a considerable sum of money. On the other hand, if you don’t take strong steps and tens of thousands of people die, the first question will be, “Why didn’t the government do something?”

It’s tempting to give an opinion on what Obama should do, but in all honesty, this is something the President needs to be discussing with his high level advisers and experts on the spread of communicable disease, not a bunch of bloggers and media commentators — but, it’s worth noting, that IS something Obama should be doing.

  1. consider the Spanish Flu:
  2. Megan McArdle:

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