THERE’S too much worry afoot about the swine flu, with sniffles cases filling our ERs. To gain control of the emerging outbreak, Americans must cooperate calmly with a measured public-health response. So far, this isn’t happening.
Nothing captures the negative imagination like a new scourge. Fear works as a warning mechanism against imminent danger, but too often we worry about risks that are remote.
Perhaps we’d all worry less if we felt we could trust our health officials. St. Francis Preparatory School in Queens remained open and an alumni party was held even after more than 100 students became ill. I spoke with a student there who suffered from severe fatigue and vomiting, but she said no one from the Centers for Disease Control or New York State Health Department had talked to her.
As the new swine flu strain spreads in America after infecting more than 1,000 in Mexico, we imagine the worst. We hear about an unseen killer and worry that we’ll be next. The best antidote for this fear is facts: This flu strain is being transmitted from human to human, but is not killing people here and has not yet spread beyond its initial clusters. This may be a good sign, as when a powerful hurricane makes landfall and begins to lose power. It’s also possible that we may have some immunity to parts of this virus we’ve seen before.
Even more important than slowing the spread of the flu is slowing the fear that accompanies it. The best way is to deflate the fear-laden terms used to describe it. Take pandemic: It sounds scary, but actually the term refers to any new flu virus spreading among people in several areas of the world at the same time. Pandemics can be mild, moderate or severe.
Everyone knows about the 1918 Blue Death that killed more than 50 million people worldwide, but how many people realize that the last pandemic, in 1968, killed only 32,000 in America and 700,000 worldwide because it was ameliorated by vaccines, antibiotics, and public health measures? Yes, these numbers sound large, but in fact more people often die in a given year from a typical outbreak of the flu and other diseases.
Isolating sick people and using anti-virals such as Tamiflu and Relenza to decrease the flu’s severity are wise precautions. Wise, too, is Mexico’s decision to close schools, museums, movie theaters and libraries in and around Mexico City to prevent its spread. Historically, isolating sick people has been a much more effective measure for containing emerging viruses than regional quarantines.
We also need to remember the lessons of history. In 1976 an emerging swine-flu virus appeared to be responsible for the death of a military recruit at Fort Dix, NJ, sparking a public hysteria fueled by CDC press conferences. It was an election year, and President Gerald Ford ordered 40 million hasty vaccinations, probably leading to almost 1,000 cases of ascending paralysis (Guillain-Barré Syndrome) and driving most of the vaccine makers out of business. We certainly don’t need a repeat of this performance.
We are also afraid because the new disease emerged in a foreign land and comes from a smelly creature. But we should be comforted by the time of the year: It’s the end of the flu season. It is likely that this outbreak will die out as the summer comes, even as we monitor it closely.
I am glad that we are dealing with a swine rather than a bird flu, because the greater historical lesson to guide us now comes from the 1976 pig-flu hysteria, not the 1918 bird-flu plague.
Marc K. Siegel, an associate professor of medicine at NYU Langone Medical Center, is the author of “Bird Flu: Everything You Need to Know About the Next Pandemic.”