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Flu Alerts: Just Doing Our Job

Written by: Paul Motter

The job of the CDC is to warn us of the worst possible outcome. Is it our job to be the voice of reason? if not us, who?

The CDC has a duty to protect us from diseases, especially deadly ones, and they do their job very well. Were they to mistakenly underestimate the H1N1 flu virus they alone would bear the responsibility, so they have nothing to lose by erring on the side of caution. Furthermore, as a government agency don’t expect anyone in government, especially the President, to contradict them.

Unfortunately, that leads to a very one-sided point of view. Doesn’t someone need to be the voice of moderation, or even contradiction to the CDC? In the past that would have been the media, but not this time around. Okay, so being in the travel industry maybe I need to say a few things. You can take my words with a grain of salt if you prefer.

We just got the latest H1N1 updates from the CDC, the new head of Health and Human Services, Kathleen Sibilius, and Janet Napolitano of the Department of Homeland Security.

Interviewer Chris Wallace asked CDC spokesman Dr. Richard Besser if he would characterize the media’s response to flu reports as overreaction. Besser replied “if the virus had shown other factors that made it more serious, then the reaction would be warranted.” Perfect syntax, Richard, “If, then, would be…”

Then the CDC warned us once again that the virus could come roaring back next fall, as the 1918 Swine Flu pandemic did. This is the CDC’s trump card to keep us all on our feet. They have no way to give us the odds that will happen, however, but they have one case where a swine flu did that, and so we have to assume it is a possibility. Even though the CDC said the current H1N1 does not have the same genetic markers for “sustainability” as the 1918 flu did.

So, what are the chances a flu that currently does not have a certain genetic marker could develop one? Isn’t it a tenet of evolution that mutations are random, and survival is more or less a fortunate accident of nature? In other words, lets not put it in people’s minds that the virus has a will of its own to become more “sustainable.” It might happen, but its a roll of the dice, like growing spots.

Even if it does mutate for sustainability. What is different between 1918 and 2009? Today we have antibiotics, flu vaccines and robust quantities of anti-viral medicines such as Tamiflu which have proven to be very effective to H1N1. Put them all together and what do you have? Well, so far we know this virus has responded pretty well to many medicines they didn’t have back then, enough to make a difference…

Still, all we currently have to study is the existing flu. Besser says H1N1 in its current U.S. form has all the characteristics of a regular seasonal flu. That was a huge statement, in hugely understated terms.

Still pursuing the “are we overreacting theme” Besser was asked whether Fort Worth was right to close 147 Texas schools, leaving 80,000 kids with no place to go for two weeks, due to just one confirmed case of our flu. Besser replied, “If that one case had proven to be more virulent and the flu had spread to more students then it certainly was not an overreaction.”

“If that case had proven (which it didn’t) and it spread (which it didn’t) …

They sent 80,000 kids home instead of one student that never showed symptoms worse than an average flu. And where did he go? Not to the hospital as far as I know. The media has not been given one hospitalization to follow, to show the progression and severity of the disease. How many cases in the U.S. have been hospitalized out of some 230 confirmed cases? Only about 30.

Besser said on Sunday that schools should close if they have a “confirmed” case of H1N1 — But it was just last Tuesday that President Obama said a “suspected” case is enough to close a school.

In this country, after a week of full attention, we now have just 227 confirmed cases of H1N1. We have only 19 deaths in two months from this virus worldwide, all of them contracting the disease in Mexico, and we still have no answer as to why these people died. The CDC has suggested the Mexican form of the virus was much more virulent and there were likely mitigating circumstances such as no access to health care, other weaknesses, etc.

In Mexico, the virus affected mostly older children and young adults. The CDC suspects that older U.S. citizens are already immune to the virus. There have been strains of human, avian and swine flu in this country before, such as in 1976. Why don’t we have a better break down of the ages of people it has affected in the U.S.? Out of 227 confirmed cases, why have only 30 of them been hospitalized? What are the exact criteria for hospitalizing an H1N1 flu victim in this country, or for closing a school? That has not been defined for us by the CDC. In fact, almost nothing about this disease, as it exists in its current form, has been defined for us by the CDC – except the very scary possibility that it will lurk in the shadows until next autumn and return with a murderous vengence. Tuck in your kids and let your imagination run wild, mom!

To me it seems the CDC doesn’t want us to know much of anything. How many specifics do we really have about this disease? Has the CDC really been working on this, are did they go straight to the road show? Every tidbit of scientific evidence I have heard comes out in in convoluted and disjointed dribs and drabs between stern warnings about what might happen next year. Is this science, or the prelude to a horror movie?

We also heard this from the CDC; the health departments in individual states have now received test kits to verifying the flu independently. This explains the big increase in reported cases the last few days, but it will level off quickly at the end of the week because in fact the disease is not spreading much at all any more. There are more confirmed cases, but they are coming from the backlog. Oh, the CDC didn’t actually spell that out? Read between the lines, America.

The CDC further said that from now on they are less concerned about certifying the exact virus in every case(!) They are now only concerned about verifying the virus in serious cases where it is vital to the treatment. In other words, even the CDC is no longer officially verifying and counting cases of H1N1 anymore. Interesting.

The CDC has now confirmed yet another step to actually give us less information about the virus. I am not implying there is any harm in this, just the opposite. It tells me the concern by the CDC about the H1N1 virus has slipped yet another notch towards being just another flu virus. Even the CDC is getting bored.

Is the CDC warning the general public not to travel? No. Both Sebelius and Napolitano said today, “we are not asking people not to travel. People should go on with their normal daily lives.” Then they couched it as “If you are ill or if you are exposed to someone who is ill we ask you not to go into confined public places.”

I’m surprised they didn’t work longer on getting a better double negative for that last piece of advice.

And finally, after being pressed a third time, Dr. Besser said, “we are seeing encouraging signs that H1N1 is no more severe than any regular seasonal flu.” And that may be as close as we get to the CDC saying this is not be the crisis we were being led to believe.

So, what have we learned? We have learned the CDC is very unlikely to characterize ANY reaction to this flu as an overreaction, except one. And we finally heard the CDC say it acts pretty much like any other virus.

The absence of another reaction, that makes complete sense but is of no concern to the CDC, is an even larger unspoken confirmation that the CDC is not all that worried. What about closing the borders with Mexico? The argument that it is like closing the barn door after the horse has escaped is ridiculous. This is a herd of horses.

If they had any real concern about the obviously more virulent form of the virus continuing to escape from Mexico they would at least be monitoring and quarantining a few people at the border. But, have you heard of one person being denied entry to the United States due to exhibiting flu symptoms at any border crossing? I know I haven’t. The Administration won’t even step up illegal border crossing surveillance. Even though a sick person would probably not try to enter the United States through a monitored border crossing.

But, we did hear about an airliner landing in Boston because a woman onboard was sniffling. The CDC did not characterize that as an overreaction either.

All indications are that we should be hearing the CDC say that they are no longer obsessed with H1N1. We should hear them say it’s time to return to normal life. But they haven’t said it and they probably never will.

Yes, the CDC and other public health officials are doing their jobs very, very well.

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Comments

Comment from khadijah
Time May 4, 2009 at 5:39 am

can we stop the flu so no one can got sick

Comment from Paul Motter
Time May 4, 2009 at 7:27 am

Your question is one of “containment.” The CDC, WHO and Administration seem to have decided early on that containment of the disease in Mexico was not even worth trying. To me their argument (shutting the barn door after the horse has already escaped) is VERY weak.

If you want to contain a virus you isolate and quarantine. Not only have they not closed borders, they have hospitalized relatively very few people, even in Mexico.

That indicates to me (though I am not an expert) that they feel the disease is not that virulent. If it was (easy to pass on) they would be far more vigilent in isloating cases. Furthermore, the people who seem to catch the disease secondarily (from an infected person who travels to a new location) almost always seems to catch a very mild form of the virus, not much different from a regular flu.

Every indication I have is that the CDC just is not that concerned about the virus in its current form. It is the future mutated form, which could be horrible or might not even happen, that they keep warning us about.

Comment from Dave Beers
Time May 4, 2009 at 3:28 pm

The problem I see is this overreaction (and I think it is) being a “the sky is falling” thing, which could minimize any warnings should this strain indeed come roaring back in more deadly form come October. They have set this up to be ignored by the public in the fall, and then it could be too late.

Comment from Paul Motter
Time May 4, 2009 at 3:56 pm

It took me a second to wrap my head around what you are saying but I see it now, and you are right. By their overreaction to a mild form of the virus we have been conditioned already to believe anything that comes later is probably not as bad as they say.

That is until we see 1000s of people dying, then we will take it seriously. And that is exactly the point. At some point they really should say “This flu is not that dangerous, (because people are NOT dying here) but we will let you know when it is”. To date, they have not characterized anything people do as an over-reaction.

Did you see the lady at WHO who got upset that people were saying it was being sensationalized? OK, the truth is WHO itself has not been over-reacting, they have been pretty conservative in their analysis of the progression of the disease.

It is the media sensationalizing it. The CDC is not sensationalizing, they just aren’t being clear about the reaction to what they say. At some point they really should say “yes, there has been an overreaction to THIS virus, we’ll let you know when to really panic.”

Comment from Lynn Beach
Time May 5, 2009 at 12:23 pm

I think it is human nature to judge what others do, even when we have no direct knowledge of their field of expertise. My husband is an epidemiologist for the CDC, currently working on the H1N1 outbreak. What I hear you observing as a lack of clarity from the CDC is an assumption that CDC has immediate and clear information. In the face of any outbreak it takes time for epidemiologists to gather information, test samples, analyze and sythesize data, and make recommendations in the best interest of the general public. As the data and information continues to come in from various public health departments, epidemiologists and policy makers reassess their recommendations based on the most recent data and information. This is particularly difficult under the scrutiny of the 24/7 news cycle, when journalists are clamouring for information even before epidemiologists have had time to analyze and assess the most recent data. Some of the same issues that you point out here are the same ones these scientists are having at the CDC, because they know that each piece of information they post has far-reaching implications. Perhaps you may have felt that they were overreacting; they worry about that as well. But, until they have more data about the nature of the virus, they also worry about the possibility that the outbreak could be more virulent and that also could have far-reaching implications. I suggest you put a face on the scientists that work at the CDC; they could be your neighbor, your relative, or like me, your husband. They are extremely hard working ( I have barely seen my husband since he started working on this outbreak last Thursday) and very conscientious. They have the general public’s best interest in mind. They constantly weigh out the risks of recommendations (ie closing schools and leaving parents in a difficult situation) to the risks of spreading the disease.

Additionally, you mention the differences in medicine that we have today. Yes, we have antibiotics, but the flu is viral and antibiotics are ineffective on viruses. Yes, we have vaccines, but it takes quite some time to develop an effective vaccine, and then more time to produce and distribute it. The scientists did not know in the beginning that the virus might be less virulent, since it had strains of swine, human, and avian flu. As you might remember, avian flu was quite deadly and only was contained by quarantining the chickens.

So, while I think it is important that we all ask these questions, I also think we need to stop the finger pointing and accusations, and instead recognize that the information that you are getting may be unclear to you because it is constantly changing and adjusting as new data comes to light.

Comment from Paul Motter
Time May 5, 2009 at 4:37 pm

Lynn…

I appreciate your input and I agree that what you are saying makes complete sense. I have no doubt about the integrity of the scientists like your husband. I heard people say they are smart, talented and intelligent people.

I just have to say that I would have appreciated hearing the head of the CDC, the policitians and the media who really seem to be benefitting from this event, saying what you just said.

I would have loved to have heard Janet Napolitano or Dr. Besser say “we don’t know what we don’t know.” But I never did.

What I experienced was a media gone “hog-wild” with sensationalism first and foremost, and the politicians (like Obama) who could have ameliorated the panic, just standing by a letting them do it. I won’t say why they did that (I have already said it), I just know they did.

Perhaps IF Napolitano, Besser or Obama had ever said what you just said I would have been far less cynical and put off by what I saw.

Thank you for bringing us the truth. I only wish the majority of people with influence in this country had the same humility you have.

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